With a commitment to advance the quality of care for ESRD patients, CMS is improving the renal community's ability to view important patient treatment data by changing dialysis facilities' data submission methods.
By: Oniel Delva, BA
Accurate patient care analysis.Flawless transfer of treatment records.Improved communicationwith the End Stage Renal Disease (ESRD) patient population. These are just three of the many factors that inspired the Centers for Medicare & Medicaid Services (CMS) to transform the method by which Medicare-certified dialysis facilities submit and access vital patient treatment data.
CMS has a longstanding mission to improve the quality of care for ESRD beneficiaries through the timely collection and analysis of treatment data and development ofa clearer communication channelabout the patient population. To help with this effort, CMS in 2009 released CROWNWeb, a Web-based data-collection system that is changing how CMS and dialysis facilities are able to access patient information. CROWNWeb is giving CMS and dialysis care providers throughout the nation a way to better analyze trendsand identify information that could be used to improve patient outcomes. While CROWNWeb will not be used directly by patients, the system contains many features that are designed to benefit the ESRD patient population.
What is CROWNWeb?
CROWNWeb is a data-management system that allows Medicare-certified dialysis facilities to safely submit facility and patient data to CMS. It is also designed to reduce the time it takes for dialysis facilities to evaluate clinical performance, thereby providing facilities with up-to-date health care information for their patients. Data obtained from CROWNWeb will also help empower patients with a way to identify better healthcare value and quality. CROWNWeb could help eliminate potential treatment interruptions, such as those caused by missing treatment data, by giving facilities a system to access a patient's records once that patient is admitted to another facility.
Making an Informed Decision
In 2001, in an effort to assist persons who have (or may develop) ESRD and their caregivers with making educated decisions regarding treatment options, CMS developed and launched Dialysis Facility Compare (DFC)—an online tool that provides information on facility characteristics and quality measures for more than 5,600 dialysis facilities in the United States (available at www.medicare.gov). Since its release, DFC has been used by patients to find and compare information about the services and quality of care provided at dialysis facilities in all states. CMS intends to use CROWNWeb to enhancethe quality of information available via the DFC website by incorporating facility quality measures data. Since CROWNWeb will reduce the time it takes CMS to receive patient treatment data, the information via the DFC website canbe a more timely and accurate representation of the quality of care available in the dialysis community.
Transfer of Treatment Records
CROWNWeb helps improve facilities' ability to access clinical data for patients who were previously dialyzed at another clinic.The system maintains an archive of treatment data and seamlessly transfers that informationfrom one unit to another if the patient relocates to another facility. This immediate access to treatment data providesthe admitting facility with up-to-date information on the type of treatment the patient was receiving. The new facility can now determine whether the patient was receiving hemodialysis (HD) or peritoneal dialysis (PD) treatment, review details on weekly sessions, and identify whether care was being administered in a facility or at home.
Transient Patient Data
In 2005, Hurricane Katrina forced thousands of ESRD patients on life-sustaining dialysis out of New Orleans and the surrounding region of the United States. Dialysis centers across the country immediately took in thousands of evacuees who needed treatment, but in the days and weeks following the catastrophic event, hundreds of those patients were unaccounted for. Through the efforts of ESRD Networks and dialysis providers, the majority of the displaced patients were eventually located. However, this took months to accomplish.
Hurricane Katrina is a prime example of major events that can have a dramatic impact on dialysis patients in a short period of time.Learning from this catastrophe, CMS designed CROWNWeb with a "Transient Patient" feature. This feature assists facilities with their ongoing patient care efforts by providing a better means of tracking their patients' temporary whereabouts. This feature offers the ability to admit patients to a facility on a short-term basis. For example, in the case of a disaster such as Hurricane Katrina, receiving facilities will be able to admit displaced patients via CROWNWeb as transients.This will enable patients' original dialysis units, the ESRD Networks, and CMS to better track their location and confirm that the displaced patients are still receiving treatments. With little time to evacuate an area due to an emergency, dialysis patients often leave behind key information, such as treatment records and other essential paperwork. CROWNWeb will also assist these patients by housing an electronic archive of critical information. Once a receiving facility admits a patient via CROWNWeb, it will have immediate access to the patient's treatment summary. While it is ideal for patients to provide their own treatment information when relocating to new facilities, this system will help ensure that patient treatments are not missed due to insufficient or missing data.
Patients and CROWNWeb
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 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 toCRAFT@ProjectCROWNWeb.org.