CROWNWeb: Next-Generation CPM Reporting

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The Centers for Medicare and Medicaid Services' new Internet-based data-collection system is designed to provide the end-stage renal disease community with timely reports that will advance the overall quality of patient care.

For more than four decades, the Centers for Medicare and Medicaid Services (CMS) has had as its mission the advancement of effective, up-to-date health-care coverage and the promotion of quality care for beneficiaries. Toward this end, CMS will launch a new data-collection system called CROWNWeb that allows end-stage renal disease (ESRD) facilities to report relevant data in an accurateand timely manner.1

This Internet-based application will debut February 1, 2009. CROWNWeb is designed to facilitate the mandated entry and update of electronic data and to provide the ESRD community a new means of accessing key patient-care data summaries, such as Clinical Performance Measures (CPMs)2 and the Fistula First Breakthrough Initiative.

In this article, we will explore CROWNWeb's core functionalities and reveal how these features will evolve the current CPM data-collection process, which has been a part of the renal community for more than eight years, from paper-based to an all-digital “always on, always available” Web-based system of patient data.

Overview

The requirement for electronic data collection was officially announced on April 15, 2008, as one element of CMS' updated Conditions for Coverage for ESRD Facilities.3 CMS developed CROWNWeb to meet this new requirement. In the past, the slower and highly manual process in place required facilities to complete and mail patient forms and data to their geographically assigned ESRD Network.

Under CROWNWeb, facilities are given ownership of the electronic entry and accuracy of the ESRD data for the patients under their care. With CROWNWeb, facilities will have the ability to manage their personnel data, patient roster, and clinical data, such as CPMs, on an ongoing basis.

Clinical performance measures

CMS established the Clinical Performance Measures Project in January 2000 in response to Section 4558 (b) of the Balanced Budget Act, which required a method to measure and report on the quality of care administered to dialysis patients under the Medicare program.4

CMS originally approved 16 measures focusing on hemodialysis adequacy, peritoneal dialysis adequacy, vascular access, and anemia management based on the National Kidney Foundation's Dialysis Outcome Quality Initiative (DOQI) Clinical Practice Guidelines. In 2008, CMS expanded on these existing 16 CPMs with the development of 26 new measurements. These new measures focus on the following topic areas:

  • Anemia
  • Dialysis adequacy (hemodialysis and peritoneal Dialysis)
  • Vascular access
  • Mineral metabolism
  • Influenza vaccination
  • Mortality
  • Patient education, satisfaction, and quality of life

While CROWNWeb will present the ESRD community a new approach to processing measurements, the initial steps and information required to complete the process will remain the same.

For example, initiating the patient data collection process will still require completion of a CMS-2728 form, and the regular submission of clinical data will still be mandated. However, now dialysis providers can complete this form electronically and immediately submit the data to their ESRD Network with a click of the mouse. 

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