By Kasia Michalik
The National Renal Administrators Association (NRAA) launched the NRAA HIE (health information exchange) in April in order to assist those dialysis clinics submit CROWNWeb data that are not part of the "big three"—Fresenius, DaVita and DCI.
CROWNWeb is what the Centers for Medicare & Medicaid Services (CMS) is calling "the information," Marc Chow, MS, NRAA executive director said. It is also CMS' requirement to collect as much data as possible from dialysis facilities across the country.
The original problem the NRAA saw was that only the big three were able to batch submit data electronically to CMS. All the independent, regional and community-based dialysis providers were left out in the cold. Well, they really weren't left out in the cold, but they had to submit data manually.
"We had concerns that the manual process was labor intensive and took a lot of work to do," Chow said. "At that point of time there were concerns that it took up to 25 to 30 minutes to input data per patient. We also saw that if a provider had the capability—meaning either have a home-grown EMR or have an EMR system, or another way to collect data electronically—it would make a lot of sense not to have to duplicate the process by doing it manually."
The 25 to 30 minutes per patient to input data is about six months old and might have improved but newer data would be needed to figure out the exact time it takes to input the necessary data per patient.
"In our opinion you would probably have to hire people to do this—otherwise you will be using your current staff—and it would seem hard to manage everything you are trying to do with your current staff, and then adding on this," Chow said.
The NRAA did not know who or how many providers out there had an electronic medical record (EMR), they just knew that there were enough providers out that to where something could be done.
"This wasn't going to be easy to swallow by the NRAA members, and it wasn't something that we thought was done appropriately," Chow said. "We felt like the labor, time and potential errors with a manual process would potentially lead to not great data."
With lots of discussions with CMS, NRAA was able to move forward and the NRAA HIE for CROWNWeb was born.