Adding or editing an episode definition

If you are new to using episodes, we recommend that you first review Defining encounters.

Episodes are organized around anchors.

Anchor - A key event in the patient's history that defines the activities related to the treatment. For example, childbirth, surgery, or doctor visit to address a specific issue.
Pre-anchor - An activity that precedes the anchor event, usually related in preparation for the anchor event, such as preparing for surgery or childbirth.
Post-Anchor - An activity that happens after the anchor event. For example, observation after surgery or a necessary check-up after childbirth.

NOTE: Not all the episodes include pre-anchor or post-anchor activities. For example, if a patient visits a doctor, recovers, and does not need an additional check-up, then this episode will not include either a pre-anchor or post-anchor.

To add or edit an episode definition:

From the Enterprise Decision Support home page, in the Encounter analysis section, click Define encounter rules.
To add or edit a definition in a folder, click the folder name.
Do one of the following:
- To add a definition, click + Add, and from the drop-down, select Episode.
- To edit a definition, in the Actions column, click the ellipsis (...), and from the drop-down, select Edit.

Anchor encounter tab

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At the top of the page, type a name for the definition.

NOTE: Although the forward slash is accepted, you should avoid it.
In the 1. Select date range section, select Admit or Discharge.
In the 2. Select start and end dates section, select the start and end dates of the encounters to evaluate.
In the 3. Select criteria section, do any of the following:
- To add a criterion, click Criteria. To identify the records in the database in which to identify the encounter, click Criteria. The Filter Wizard dialog displays, allowing you to select a specific attribute to define the record(s). For example, based on procedure code, diagnosis code, or any other attribute tied to the encounter. For instructions, see Using the Filter Wizard.
- To edit a criterion, click the existing filter name.
- To delete a criterion, click X next to the criterion name.

At the bottom of the page, select the following options, as needed:

Option	Description
Allow an encounter to be in multiple episodes	Select this option to allow an encounter to be in more than one episode. For example, an encounter may meet the criteria of the anchor and post-anchor encounters. This option would allow that encounter to be an anchor in one episode and a post-anchor in another episode within this definition.
Ignore time	Select this option if you do not want to consider the time when determining which encounters are eligible to be pre-anchor or post-anchor encounters. You may want to select this option if your encounter data does not have accurate timestamps on admit or discharge dates. NOTE: If selected, 'Hours’ will not be available when you define the timeframe for pre- and post-anchor encounters.
Use secondary encounter identifier	By default, Axiom returns results that meet the filter criteria and groups them into episodes/returns based on patient ID only. However, you can optionally use a secondary identifier to fine pre- and post-anchor encounters that have the same or different values (from the anchor) for the following codes: Principal diagnosis code (ICD-10-CM) Principal procedure code (ICD-10-PCS) APR-DRG code MS-DRG code CPT code For example, if you create an episode for heart attacks and choose a secondary identifier of ‘Same MS-DRG code’ for a given patient, only the post-anchor encounters that also have the same MS-DRG code as the anchor encounter will be included in the episode. Any post-anchor encounters for that patient with a different MS-DRG code will be excluded from that episode.

Option

Description

Allow an encounter to be in multiple episodes

Select this option to allow an encounter to be in more than one episode. For example, an encounter may meet the criteria of the anchor and post-anchor encounters. This option would allow that encounter to be an anchor in one episode and a post-anchor in another episode within this definition.

Ignore time

Select this option if you do not want to consider the time when determining which encounters are eligible to be pre-anchor or post-anchor encounters. You may want to select this option if your encounter data does not have accurate timestamps on admit or discharge dates.

NOTE: If selected, 'Hours’ will not be available when you define the timeframe for pre- and post-anchor encounters.

Use secondary encounter identifier

By default, Axiom returns results that meet the filter criteria and groups them into episodes/returns based on patient ID only. However, you can optionally use a secondary identifier to fine pre- and post-anchor encounters that have the same or different values (from the anchor) for the following codes:

Principal diagnosis code (ICD-10-CM)
Principal procedure code (ICD-10-PCS)
APR-DRG code
MS-DRG code
CPT code

For example, if you create an episode for heart attacks and choose a secondary identifier of ‘Same MS-DRG code’ for a given patient, only the post-anchor encounters that also have the same MS-DRG code as the anchor encounter will be included in the episode. Any post-anchor encounters for that patient with a different MS-DRG code will be excluded from that episode.

Click Next at the bottom of the page, or click Step 2 Pre-anchor at the top of the page. Complete the steps for these tabs using the instructions in the next section below.

Pre-anchor and Post-anchor tabs

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The Pre-Anchor and Post-Anchor tabs work similarly in that they allow you to define any pre- or post-anchor events for the definition.

To define the Pre-anchor and Post-anchor tabs:

In the 1. Select frequency section, select one of the following:
- To include only the first pre- or post-anchor encounter related to the anchor encounter, select First time.
- To include every pre- or post-anchor encounter related to the anchor, select Every time.
- If you do not want to include any pre- or post-anchor encounters, select Never.
In the 2. Select criteria section, do any of the following:
- To add a criterion to identify the pre- or post-anchor activity, click Criteria. For instructions, see Using the Filter Wizard.
- To edit a criterion, click the existing filter name.
- To delete a criterion, click X next to the criterion name.

In the 3. Define timeframe section, complete the following:

Field	Description
Date type	Select Admit or Discharge.
Operator	Select Less than or Less than or equal to.
Value	Type a value.
Units	Select a unit type.
Date type	Select Admit or Discharge.

For example, let's say that you need to find return episodes that occurred a week after the patient was discharged. In this case, you would you select the following:

Date type - Admit (a date when patients were readmitted)
Operator - Less than or equal to
Value - 7
Units - Days (this defines a week period)
Date type - Discharged

Axiom will identify the episodes when a patient returned in a week or less after being discharged after the anchor encounter.

In the Details section on the right side of the page, complete the following:
- Notes- (Optional) Type your own description to help you identify the definition.
- Active - Click the toggle to activate or deactivate the definition. Only active definitions can be processed.
- Bundle - Click the toggle to allow the episode to be grouped with other episodes as a bundle of services.
Click Save.
To process the definition now, click Process. Follow the instructions in Processing an episode or return definition.

NOTE: You can process the definition later from the Encounter measures main page.