ECR Definitions and PROMETHEUS Analytics© FAQs

ECR Definitions and PROMETHEUS Analytics© FAQs

Below are frequently asked questions that we have received regarding our ECR definitions and the PROMETHEUS Analytics©. If your question is not answered below, please email us at

I’ve downloaded the XML machine-readable file of the ECR definitions, but need guidance on how to use or read the file. Is there additional documentation? 
As mentioned on our site, the XML file contains only the clinical boundaries of episodes but not the rules for analyzing claims based on those definitions. The rules will need to be decided by the user to fit individual organizational needs.

At this point in time, no additional documentation and guidance is available with regards to trigger rules and logic, service assignments, or episode construction. However, these rules have been defined by HCI3 and are part of the complete ECR Analytics® system which is in development, and will be available from certified third party vendors and listed here when available. Please check back often for listings of partners.

What is the difference between type 1 and type 2 PACs (potentially avoidable complications)?
PAC Type 1: PACs related to the index condition. These are potentially avoidable complications that are directly related to the condition being studied and could happen during the index stay or look forward period in procedural and acute medical conditions or any time during the episode time window for acute as well as chronic medical conditions. Examples of this are emergency room visits due to diabetic coma in a diabetic patient, respiratory failure in a patient admitted with pneumonia, or readmissions for the same and related reasons as the initial admission and relevant to the patient’s condition. These PACs are typically taken care of by the servicing physician. Physicians are often comfortable in being held accountable for type 1 PACs.

PAC Type 2: PACs related to patient safety failures. These include inpatient-based PACs which include HACs (CMS defined Hospital Acquired Conditions) and PSIs (AHRQ defined Patient Safety Indicators). The Prometheus definitions for type 2 PACs go beyond these standard definitions and also encompass other situations related to patient safety such as adverse drug events, drug interactions, many kinds of avoidable infections etc., that could best be avoided by process improvement.

I see there are two versions of the ECR summary descriptions: 5.2.005 vs 5.2.006. Which one should I use?
The 5.2.006 definitions are updated versions of 5.2.005. We made the older versions available as references to help track the differences. The most current and up to date ECR definitions are labeled as the higher number and should be used in lieu of older versions.

I was/am currently using the 3.6 version of PROMETHEUS Analytics©. Is there an updated version?
The 3.6 version software and related freeware is no longer available because it has outdated ICD-9 and CPT codes. We now offer Version 5.3 of the PROMETHEUS Analytics©, which is available from third-party certified partners. Click here for a list of certified partners.

My organization is interested in becoming an HCI3-certifed partner. How do I go about doing so?
You can email or go to our “Become an PROMETHEUS Analytics© Certified Partner” page for more information. You can also learn more about the benefits and advantages of using the PROMETHEUS Analytics© here.