SPOC-CO
Synthetic data prototype — no PHI. Numbers, names, and IDs are fabricated for design review only.

Executive Overview

Executive Overview

TCM to PCM bridge pilot performance, revenue capture, outcomes, containment, and data completeness.

Filters

Patient Journey Funnel

Eligible → Reached → TCM → PCM → Billed

50 eligible
Eligible50·100%
Reached44·88%88%
TCM Accepted34·68%77%
TCM Completed33·66%97%
PCM Enrolled25·50%76%
PCM Active23·46%92%
Billed23·46%100%

Weekly Pilot Trend

Eligible episodes, TCM completed, PCM enrolled

Pilot 2026 Q1

Revenue Realization

Expected vs paid by month

$2.6k / $4.8k

Network Containment

USC capture vs external leakage

30 referrals
USC (Captured)

25 · 83%

External (Leaked)

5 · 17%

Outcomes

ED · readmits · complications

8% readmit
ED Visits6
Readmissions4
Complications2

ED rate

12%

Satisfaction

4.35/5

Top Operational Risks

Open exceptions by severity & age

12 open
SeverityStageOwnerDue
High

TCM Overdue

OutreachFelix Stone47d overdue
High

Referral Leakage Risk

PCM ActiveLiam Chen25d overdue
High

Referral Leakage Risk

PCM ActiveElena Rivera8d overdue
High

Billing Defect

PCM ActiveCarmen Ortiz3d overdue
High

TCM Not Scheduled

OutreachSofia Diaz7d
Medium

No Discharge Feed

OutreachAisha Patel53d overdue
Medium

Outreach Overdue

OutreachElena Rivera45d overdue

Recent Patient Journey Activity

Latest discharged episodes with stage, NBA, and billing

8 shown
PatientEpisodeStageNext ActionRiskBilling
Vincent RomeroUSC-900042EPI-2026-0042

DC Mar 26, 2026

PCM EnrolledLog additional PCM time this monthLowPaid
Patricia EvansUSC-900005EPI-2026-0005

DC Mar 25, 2026

OutreachResolve exception: TCM Not ScheduledMediumDraft
Xavier ThompsonUSC-900044EPI-2026-0044

DC Mar 25, 2026

OutreachHighDraft
Peggy LopezUSC-900037EPI-2026-0037

DC Mar 23, 2026

OutreachResolve eligibility for PCMMediumDraft
Irene DelgadoUSC-900029EPI-2026-0029

DC Mar 17, 2026

TCM CompleteComplete TCM documentation for billingMediumDraft
Grace BrooksUSC-900027EPI-2026-0027

DC Mar 15, 2026

OutreachResolve eligibility for TCMLowDraft
Laura HayesUSC-900033EPI-2026-0033

DC Mar 12, 2026

OutreachSubmit IPC consult reportMediumDraft
Karen ParkUSC-900015EPI-2026-0015

DC Mar 10, 2026

PCM ActiveRework denied claim(s)LowSubmitted

EPIC Workflow Operations

EPIC Workflow Operations

Workflow mix, intake triggers, program assignment, order sets, AI activation, pathways, and task health — synthetic.

EPIC Workflow Mix

Episodes by EPIC workflow

50 total
Specialist Post-Surgical

20 · 40%

Generalist Hospital-Initiated

20 · 40%

Office-Based Provider

10 · 20%

Intake Trigger Volume

Top trigger types

38% AI-detected

Program Assignment Mix

Recommended programs

73.1% accepted

Order Set Activations

By activation status

54.5% reviewed
Activated24
Cancelled2
Pending Review5
Partially Activated6

EKG / RPM

11 · 14

DME / IPC

23 · 8

AI Activation Score

Distribution across cohort

avg 75%

Care Pathway Distribution

Order set activations by pathway

7 pathways
Urology Post-Surgical Recovery23
Syncope / Arrhythmia Pathway8
Cardiology SOB Pathway3
PCP Chronic Disease APCM3