Defining Anesthesia Excellence

Anesthesia Excellence

How is Anesthesia Excellence Measured?

Patients, hospitals, and providers may define “excellence” in seemingly different ways. While their individual questions may sound different, they all center on the same raw data set


  • Was I safe? Was my case on-time?
  • How was recovery?
  • Was I treated with respect?
  • Were my questions answered?


  • Are our first case delays improving?
  • Are our surgeon’s turn over times within goal?
  • How well are we using our daily block time?
  • Are we staffed appropriately?
  • Are there systemic quality issues?
  • Are charts complete? Are we ready for TJC?


  • Am I providing safe, efficient care?
  • How do I compare to my peers?
  • Is CMS going penalize me?
  • Is my documentation complete?
  • Is my RCM partner billing correctly?

Designing Intelligent Data Storage

While the questions may be different, the raw data is all the same: Start and Stop Times, Surgeons, Anesthesiologists, CRNAs, Locations, Outcomes, Process, ASA Status, Date of Birth, etc. Actionable clarity to the above questions require both an intelligently designed, anesthesia-specific data warehouse, complex algorithms, and highly informed user interface. For example, calculating the estimated lost revenue from an underutilized primetime block is best handled with SQL searches, and not in an Excel Spreadsheet.

4 Broad Categories for Excellence

So what reports allow you to measure Anesthesia Excellence and solidify your partnership with your hospital administrations? Let’s break down Anesthesia Excellence into the following 4 categories and review the desired reports for each.


1. MACRA Compliance

CMS will assign each of your providers a “Composite Provider Score” (CPS), ranging from 0-100. This score will be publicly available via CMS website. The higher your score, the more money you make and the better you’re perceived by the public and hospitals.

MACRA Compliance:

  • Individual Anesthesiologist Compliance
  • Individual CRNA Compliance
  • Facility Level Compliance
  • Chart Completion Compliance


2. Anesthesia Quality Program

While MACRA Compliance provides a mechanism to lower individual provider compensation in the name of “quality”, a more robust approach to tracking Anesthesia Quality will provide more value to your practice, with very little increased effort.

Anesthesia Quality Program:

  • OPPE/FPPE Support
  • Automated TJC Quarterly Quality Reports
  • Individual Provider Scorecards
  • Major Complication and Minor Observation Rates
  • Participate in PSO for National Benchmarking

3. Operational Excellence

Now we’re getting closer to better defining the surgical patient experience. It’s more than just how many people felt nauseated in the PACU!

Operational Excellence:

  • Daily Analytic Emails
  • Total Cases/Minutes vs Budgeted
  • Turn-over-Times (Surgeons, Anesthesia, Wo/Wi)
  • Anesthesia Ready Time
  • Prime Time Utilization (7a-3p)
  • Lost Revenue due to Underutilization First Case On-Time Start Lost Revenue due to Delays Same Day Cancellation and Same Day Add-Ons
  • Staffing Location Reports and Heat Maps

4. Revenue Cycle Management Integration

Avoiding lost claims and eliminating inherent inefficiencies associated with any paper-based process will provide you with demonstrable ROI.

Revenue Cycle Management:

  • ADT Interface (Patient Demographics)
  • Point of Care Collection of CPT, ICD 10, Additional Procedures, Modifiers, Risk Factors, ASA justification
  • Custom outbound interface to your RCM Partner

What’s the cost of Intelligent MACRA compliance?

MACRA Simple

Graphium ONE™ offers MACRA Simple compliance with use of our iOS app for $459 per provider per year. This includes QCDR registration fees and does not require an interface with either your facility or billing company.


Operational Excellence and a more robust approach to Anesthesia Quality are included at no additional charge – except for any interface feeds.

MACRA Charge Capture

All of the above features, plus the addition of Revenue Cycle Management integration and electronic Charge Capture is a simple per case fee of $2.99/case, plus interface charges. Simply download our app in the Apple App Store, and your providers will be ready for intelligent MACRA compliance with included Anesthesia Quality Program and Operational Excellence.

We also offer a host of other services, including paper-based data collection, Full tablet-based EHR, and EHR interfacing.

What steps do I need to take?

  1. Call us to register you.
  2. Select use of our Mobile App or Paper Form.
  3. Start recording your quality data.
  4. We’ll handle the rest.


Disclaimer: MACRA Compliance is an ever-moving target. We spend our days and nights reading, listening, and discussing the details of a complex program with many bureaucratic moving parts – so that you don’t have to. Our mission is to educate our clients and provide clarity in times of confusion. Your success is our success. While we strive each day to be the technology partner of choice for your anesthesia group, we have not yet found a crystal ball. The information above is always subject to change, courtesy of CMS.