Electronically Reporting Impacts on Patient Care Efforts

Each year, more than 36,000 people in the United States die because of the flu (influenza). Additionally, complications from infections are the second leading cause of hospitalization in the end stage renal disease (ESRD) population.1 Lack of complete and accurate documentation of vaccinations, infections, and hospitalizations can limit a dialysis facility’s ability to administer and record a dialysis patient’s prescribed treatment. For years, facilities have utilized worksheets and various other data review methods to collect and maintain patients’ vaccination, infection, and hospitalization information at the facility level. However, beginning in February 2012, the Centers for Medicare & Medicaid Services (CMS) will enhance facilities’ ability to examine this data by providing them with a means to report and analyze this data on a national scale.

CMS understands that in order to improve the quality of ESRD care nationwide, it is important that dialysis facilities be provided the tools and data needed to document key incidents, assess trends, and review other significant findings related to the ESRD patient population. With this in mind, CROWNWeb will give facilities the ability to monitor dialysis adequacy, vascular access, mineral metabolism, and anemia treatment, as well as review data associated with patients’ influenza, pneumococcal, and hepatitis vaccinations; site of dialysis access infection; and cause of hospitalization.
By grouping these factors with the facility’s clinical performance data, CMS, the ESRD Networks, and dialysis facilities will have an opportunity to better analyze additional components that can improve patient care and patient outcomes.

About CROWNWeb and CPMs
CROWNWeb is a Web-based data-management system that allows Medicare-certified dialysis facilities to securely access and submit facility and patient data to CMS at any time. In addition to administrative and demographic data, CROWNWeb collects clinical performance data that can be used by dialysis facilities to compare their performance and patient care efforts against other facilities in their state, ESRD Network area, and the nation. Since 1994, CMS has collected Clinical Performance Measures (CPM) data on ESRD patients that have been used by the renal community to measure hemodialysis and peritoneal dialysis patients’ treatment outcomes. Moving forward, CMS will generate the CPM reports utilizing the data that dialysis facilities enter into CROWNWeb.

Patients and CROWNWeb
Patients will not be required to use CROWNWeb. However, ESRD patients who want to obtain more information on the CROWNWeb system or learn about how their treatment information will be reported can visit the Project CROWNWeb website at www.projectcrownweb.com. Information regarding the system is also available at the CMS’ CROWNWeb site at www.qualitynet.org via the ESRD tab.

The work on which this publication is based was performed under Contract Number HHSM-500-2011-00157G, 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: FL-OCT-2011OTCT22-10-12469

1. Collins AJ, Foley RN, Gilbertson DT, Chen SC. The State of Chronic Kidney Disease, ESRD, and Morbidity and Mortality in the First Year of Dialysis. Clin J Am Soc Nephrol. Dec 2009; 4 ( Suppl): 1:S5-11. Available at: ttp://cjasn.asnjournals.org/content/4/Supplement_1/S5.full. Accessed October 5, 2011.