ECRs and Definitions

ECRs and Definitions

HCI3 Evidence-informed Case Rate® (ECR®) Definitions

When using ECR definitions, it is important to understand the difference in file types and which one best suits your needs. While ECR definitions need logic applied to make them applicable for implementation, these free files provide a pivotal foundation for new payment models or performance analysis.

Before downloading the files, we recommend you familiarize yourself with An Introduction to ECRs to better understand the principles and guidelines, as well as boundaries and sub-types rationale, that were followed in order to create these definitions.

In addition, we offer monthly webinars aimed to help you understand how ECRs are built and how the definitions are being used.

Summary Descriptions
The ECR Summary Descriptions, listed in the table below, are available for all users interested in understanding the scope and boundaries of a specific episode. These summary descriptions are not the full machine-readable files and therefore, additional information and logic needs to be considered and applied through an analytical system in order to fit the user’s needs for which the metadata files are more useful.

Summary Description Limitations
When using these definition summaries, it is important to understand the distinction between the clinical logic of an episode system and the service assignment and other rules associated to the construction of episodes. These rules have been defined by HCI3 as part of the ECR Analytics® system, which is available from certified third parties.

Metadata Files
The ECR Metadata Files are machine-readable versions of all the HCI3 ECRs in detail. These XML files are available to anyone, with the acceptance of a user agreement, and are useful for those considering payment reform programs or cost and quality analysis implementations.

Metadata File Limitations
While these files are more comprehensive than the summary descriptions, methodological decisions on service assignments, triggers and episode construction still need to be addressed as the files describe the clinical boundaries of episodes but not the rules for analyzing claims based on those limits. However, these rules have been defined by HCI3 and embedded in the complete ECR Analytics® system, which is available for license from certified third parties.

To download the XML metadata files, accept the user agreement.

Name Abbr ID Type 5.2.006
Episode
Definitions
5.2.005
Episode
Definitions
Accidental Falls (SRF) FALL ES0806 System Related Failure Definition Definition
Acute CHF / pulm edema (SRF) AcCHF ES0525 System Related Failure Definition Definition
Acute Myocardial Infarction AMI EA0506 Acute Definition Definition
Acute Renal Failure (SRF) ARF ES1104 System Related Failure Definition Definition
Adverse effects of drugs (SRF) ADRUG ES2102 System Related Failure Definition Definition
Allergic Rhinitis/Chronic Sinusitis RHNTS EC0301 Chronic Definition Definition
Arrhythmia / Heart Block / Condn Dis ARRBLK EC0518 Chronic Definition Definition
Arterial thromboembolism (SRF) EMBOL ES0529 System Related Failure Definition Definition
Aspiration Pneumonia (SRF) ASPPNE ES0408 System Related Failure Definition Definition
Asthma ASTHMA EC0401 Chronic Definition Definition
Bariatric Surgery BARI EP0610 Procedural Definition Definition
Bipolar Disorder BIPLR EC1903 Chronic Definition Definition
Breast Biopsy BSTBIO EP0902 Procedural Definition Definition
Breast Cancer BRSTCA EX0902 Other Definition Definition
C-Difficile Infection (SRF) CDIFF ES0605 System Related Failure Definition Definition
C-Section CSECT EP1404 Procedural Definition Definition
CABG, Valve Rep, Complex Heart Surg CXCABG EP0509 Procedural Definition Definition
Cataract Surgery CTRTSU EP0202 Procedural Definition Definition
Catheter Associated UTIs (SRF) CTHUTI ES1102 System Related Failure Definition Definition
Cellulitis, Skin Infection (SRF) CELUTS ES0904 System Related Failure Definition Definition
Central Venous Catheter Infn (SRF) LINE ES0522 System Related Failure Definition Definition
Chronic Obstructive Pulmonary Disease COPD EC0402 Chronic Definition Definition
Colon Cancer CLNCAN EX0602 Other Definition Definition
Colon Resection COLON EP0602 Procedural Definition Definition
Colonoscopy COLOS EP0603 Procedural Definition Definition
Coma, persistent veg. state (SRF) COMA ES0106 System Related Failure Definition Definition
Complication of Implanted device SRF DEVICE ES2301 System Related Failure Definition Definition
Complication surgical procedures SRF COMPLC ES2302 System Related Failure Definition Definition
Congestive Heart Failure CHF EC0510 Chronic Definition Definition
Coronary Angioplasty PCI EP0520 Procedural Definition Definition
Coronary Artery Disease CAD EC0508 Chronic Definition Definition
Decubitus Ulcer (SRF) DECUB ES0902 System Related Failure Definition Definition
Deep Vein Throm/Pulm Embolism (SRF) DVTPE ES0520 System Related Failure Definition Definition
Delirium, Encephalopathy (SRF) DLRMEN ES0108 System Related Failure Definition Definition
Depression DEPRSN EC1902 Chronic Definition Definition
Dermatitis, Urticaria (SRF) DRMTIS ES0903 System Related Failure Definition Definition
Diabetes DIAB EC1001 Chronic Definition Definition
Diabetes, poor control (SRF) DMUNC ES1003 System Related Failure Definition Definition
Diverticulitis DIVERT EA0608 Acute Definition Definition
Fluid Electrolyte Imbalance (SRF) IMBALN ES0521 System Related Failure Definition Definition
Gall Bladder Surgery GBSURG EP0604 Procedural Definition Definition
Gastro-Esophageal Reflux Disease GERD EC0601 Chronic Definition Definition
GI Bleed (SRF) GIBLD ES0604 System Related Failure Definition Definition
Glaucoma GLCOMA EC0202 Chronic Definition Definition
Hepatitis (SRF) HPTTIS ES0702 System Related Failure Definition Definition
Hip Replacement & Hip Revision HIPRPL EP0812 Procedural Definition Definition
Hip/Pelvic Fracture HIPLFR EA0807 Acute Definition Definition
Hypertension HTN EC0511 Chronic Definition Definition
Hypotension / Syncope (SRF) HYPOTN ES0507 System Related Failure Definition Definition
Hysterectomy HYST EP1301 Procedural Definition Definition
Infections (SRF) INFECT ES1803 System Related Failure Definition Definition
Intestinal Obstruction (SRF) INTOBS ES0607 System Related Failure Definition Definition
Knee Arthroscopy KNARTH EP0811 Procedural Definition Definition
Knee Replacement & Knee Revision KNRPL EP0813 Procedural Definition Definition
Low and High Risk Pregnancy PREGN EX1401 Other Definition Definition
Low Back Pain LBP EC0801 Chronic Definition Definition
Lumbar Laminectomy LBRLAM EP0816 Procedural Definition Definition
Lung Cancer LNGCAN EX0402 Other Definition Definition
Malignant Hypertension (SRF) MGHTN ES0526 System Related Failure Definition Definition
Mastectomy MSTCMY EP0904 Procedural Definition Definition
Meningitis / Encephalitis (SRF) MNGENC ES0107 System Related Failure Definition Definition
MRSA, Drug Resistant Infections (SRF) MRSA ES1802 System Related Failure Definition Definition
Nutritional Deficiency (SRF) NUTDEF ES1004 System Related Failure Definition Definition
Osteoarthritis OSTEOA EC0802 Chronic Definition Definition
Pacemaker / Defibrillator PCMDFR EP0510 Procedural Definition Definition
Pancreatitis (SRF) PNCRTS ES0703 System Related Failure Definition Definition
Pneumonia PNE EA0403 Acute Definition Definition
Poisoning (SRF) POISON ES2103 System Related Failure Definition Definition
Preventive Care PREVNT EX9901 Other Definition Definition
Prostate Cancer PRSTCA EX1201 Other Definition Definition
Prostatectomy PRSCMY EP1202 Procedural Definition Definition
Rectal Cancer RCLCAN EX0601 Other Definition Definition
Respiratory Failure (SRF) RESPFL ES0407 System Related Failure Definition Definition
Sepsis (SRF) SEPSIS ES1801 System Related Failure Definition Definition
Shock / Cardiac Arrest (SRF) SHOCK ES0508 System Related Failure Definition Definition
Shoulder Replacement SHLDRP EP0817 Procedural Definition Definition
Stroke STR EA0101 Acute Definition Definition
Tonsillectomy TONSIL EP0301 Procedural Definition Definition
Transfusion related complications SRF TRNSFU ES1601 System Related Failure Definition Definition
Transurethral resection prostate TURP EP1203 Procedural Definition Definition
Upper GI Endoscopy EGD EP0601 Procedural Definition Definition
Upper Respiratory Infection URI EA0303 Acute Definition Definition
Urinary Tract Infection (SRF) UTI ES1106 System Related Failure Definition Definition
Vaginal Delivery VAGDEL EP1403 Procedural Definition Definition