Dialysis Data Submission Migrates Online

The next generation in electronic records management will arrive at all Centers for Medicare & Medicaid Services (CMS)–certified end stage renal disease (ESRD) dialysis clinics by February 2012, affecting facilities, clinicians, and patients. The new system, CROWNWeb, promises to streamline the data submission process for dialysis providers and provide up-to-the-minute clinical and facility information to assist nephrologists, help improve oversight, and guide patient care decisions.

As highlighted in the January 2011 issuse of Kidney News, CROWNWeb was developed for CMS-certified dialysis facilities to help them comply with the electronic submission guidelines in the updated Conditions for Coverage (CfC) for ESRD. The program is entirely web-based and adheres with federal security requirements to ensure the confidentiality of patient and facility records.

Certified dialysis providers will be able to submit and track patient admission history and forms, required CMS facility documentation, and clinical dialysis data online anytime. Due to the sensitive nature of this information, CROWNWeb incorporates a tiered security structure to ensure that the site and its critical data remain safeguarded. In addition to login credentials, users must obtain a unique one-time system-generated pass code each time they visit CROWNWeb, which is delivered via email or text message, valid for a 12-hour session before gaining access to the site. This security measure is a second layer of protection that goes beyond what’s offered in many web sites.

Originally unveiled in 2009 to a test group, CROWNWeb has undergone constant improvements in preparation for national release. The test group ultimately comprised some of the largest dialysis organizations, and they were able to use the program’s unique batching capabilities. However, many small and medium-sized dialysis organizations may not be able to utilize this technology, which led the National Renal Administrators Association to collaborate with the CMS to fill the gap. A pilot project will allow these providers to use a third-party Health Information Exchange to access the Nationwide Health Information Network and deliver data to CROWNWeb and the CMS, an infrastructure that still meets the stringent security requirements of the National Institute of Standards and Technology.

Patient care and accountability

The impact of the new data submission and management system will be felt beyond the dialysis clinic. Patients and clinicians will benefit in several different ways from the new program. For one, the dramatic reduction in time needed to process CMS forms and analyze data with CROWNWeb, compared with the current paper-based system, will increase the efficiency of the CMS in addressing provider accountability in meeting patient care goals.

One of the quality initiatives for ESRD patients, Dialysis Facility Compare, will now have real-time facility and clinical data to enhance the search results patients and caregivers use to make informed decisions when choosing a dialysis provider. Moreover, instead of a small fraction of patient information currently accessible, the CMS will now have access to data from all certified dialysis facilities, giving researchers and clinicians a more complete picture of the ESRD population.

An additional advantage for patients is the continuity of care that a central database like CROWNWeb affords. The system creates a centralized archive of the patient’s records after admission to a facility. With this archive, CROWNWeb reduces potential treatment interruptions owing to missing treatment data and provides for a seamless transition if a patient relocates to another clinic. Once a transfer is initiated, the new facility will receive a report from CROWNWeb outlining whether the patient is receiving hemodialysis or peritoneal dialysis; a summary of their weekly sessions data; and whether they are at-home or in-clinic patients.

If a natural disaster or other event prevents a patient from accessing his or her current facility, the system also provides a new “transient patient” feature, supplying an interim provider with the patient’s treatment summary and their recently submitted CMS forms.

Notes

[1] For more information about CROWNWeb, please visit www.projectcrownweb.org.

October-November 2011 (Vol. 3, Number 10 & 11)