By Oniel Delva, BA
In early 2011, the Centers for Medicare & Medicaid Services (CMS) will move one step closer to allowing all Medicare-certified end-stage renal disease (ESRD) dialysis facilities to manage their clinical and administrative data via CROWNWeb, with the release of CROWNWeb 2.0.
Approximately 650 Medicare-certified dialysis facilities will use CROWNWeb 2.0 to directly submit their patient and facility data to CMS. Once this installment is complete, CMS will transition CROWNWeb into its full national release (CROWNWeb 3.0), with more than 5,500 Medicare-certified dialysis units using the system.
CROWNWeb will essentially change the method by which facilities report their clinical and administrative data by allowing facilities to manage data entry efforts at the facility level, an approach that offers both increased control and local data ownership when compared to submitting the information through geographically designated ESRD Networks. Using CROWNWeb, facilities will be able to review their data for accuracy and completeness prior to submitting it to CMS. To help ensure that the information reported by facilities is accurate, CMS will include two data validation processes with the release of CROWNWeb 2.0:
- Systematic evaluation based on guidelines specified in CMS’ Kidney Data Dictionary (KDD), which provides formatting and acceptable range information for each data element in CROWNWeb;
- Data tracing and verification based on a process developed by Healthcare Management Solutions (HMS), a CMS-sponsored contractor tasked with creating a system to evaluate the quality of the information entered into CROWNWeb.
CROWNWeb’s Systematic Evaluation
Since its initial release, CROWNWeb has featured a built-in evaluation process that has helped ensure that the information entered into the system meets quality requirements and falls within valid collection ranges. As users enter data into CROWNWeb, the application applies edit checks to ensure that the data conforms to the data definitions, formats, and ranges outlined in the KDD. CROWNWeb alerts a user with an error message if he/she attempts to submit a form or treatment information that is missing required data, and displays a warning message if the user enters a value that is outside an expected range in the system. Users must correct erroneous data or approve entry for out-of-range values before submitting data to CMS.
CROWNWeb’s systematic solution helps users determine required fields and pre-established acceptable ranges for clinical data, based on the information that they enter throughout the system. Various fields can become required based on values in other fields, and users must populate all required fields before successfully submitting their data. For example, CROWNWeb will require a patient’s Iron Saturation Percentage field to be populated if the Iron Saturation Percentage Collection Date is populated. Similarly, if data entered into the Iron Saturation Percentage field is outside of the system’s pre-determined acceptable range, CROWNWeb presents the user with an opportunity to review the information and indicate the accuracy of the entered data by simply clicking a bypass checkbox.
Data Tracing and Verification
Beginning with CROWNWeb 2.0, the system’s built-in logical evaluation procedure will be augmented by a data tracking process that will further assist CMS with ensuring the validity and reliability of the information provided via CROWNWeb. CMS has contracted with Healthcare Management Solutions (HMS), a quality management company that performs market surveys and analysis, to develop and implement this process. HMS will validate CROWNWeb data by tracing data elements to their original source documents. In order to implement this process, HMS will request hard copies of results on clinical performance measures documents from randomly selected dialysis facilities. The company will use its medical review team to abstract data from these source documents, and will then use its internal reliability evaluation procedure to assess the quality of the review results. Once the abstraction is complete, HMS will use its validation team to compare the abstracted data to the information that was entered into CROWNWeb.
“HMS' goal is to evaluate the quality of the administrative and clinical data that is being entered into the CROWNWeb system,” stated Chris Wright, HMS’ project manager during an e-mail interview. “Using our validation results, we plan to provide CMS and the ESRD community with feedback and suggestions regarding current processes that are utilized, and offer recommendations for improvements.”
HMS will be focusing its review on two core areas of the CROWNWeb system: CMS forms data (i.e., the CMS-2728 and CMS-2726 Forms) and Clinical Performance Measure (CPM) data. RBT
More Information
For more information on CROWNWeb, visit the Project CROWNWeb website at www.projectcrownweb.com, or go to www.qualitynet.org and click on the ESRD tab.
The work on which this publication is based was performed under Contract Number HHSM- 500-2010-00261G, titled “CROWNWeb Outreach, Communication, and Training,” funded by the Centers for Medicare & Medicaid Services, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government. The author assumes full responsibility for the accuracy and completeness of the ideas presented. The author welcomes comments on the ideas presented; please send comments to CRAFT@ProjectCROWNWeb.org. Publication Number: FL2010OTCT22912042
