When caring for dialysis patients, facilities must consider many treatment-impacting factors that could affect their ability to administer and record patients’ prescribed treatments.

Some of these factors, which include complete and accurate documentation of vaccinations, infections, and hospitalizations, allow dialysis facilities to be better attuned to their patients’ needs. To assist with collecting and managing these data, facilities have historically used worksheets and various data review methods maintained at the facility level. 

For years, facilities have employed these custom developed methods of monitoring their patients’ vaccination, infection, and hospitalization data.

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However, beginning in 2012, the Centers for Medicare & Medicaid Services (CMS) will enhance facilities’ ability to examine this information by providing a means to report and analyze data against a national point of reference. CMS’ CROWNWeb data-collection system will be able to report these factors along with other key elements of patient clinical data.

CROWNWeb Update

CROWNWeb is a secure, Web-based system that captures clinical and administrative data from dialysis facilities across the country. The system will replace CMS’ current paper-based data-collection method and provide the renal community with a continuous method of accessing and reporting patient-based data.

Approximately 300 dialysis facilities are using CROWNWeb to electronically submit data to CMS during a usability study period known as the Phase II Expansion Pilot. CMS plans to release CROWNWeb for use by all Medicare-certified dialysis facilities in 2012.

As part of that release, CROWNWeb will boast a myriad of enhancements and modifications that are designed to improve the user experience and expand the system’s functionality.

Clinical Enhancements

Most of the new data that are entered into CROWNWeb will be in the CROWNWeb Clinical section. These data will be used to support CMS’ ESRD Clinical Performance Measures (CPMs). CROWNWeb currently gives facilities the ability to monitor and report dialysis adequacy, mineral metabolism, vascular access, and anemia treatment.

CMS understands that to improve the quality of end-stage renal diease care nationwide, it is important that dialysis facilities have an opportunity to capture and analyze issues impacting treatment or patient outcomes. CROWNWeb will allow facilities to begin to report data regarding vaccination status, site of dialysis access infection, cause of hospitalization, and fluid weight management.

Reporting Vaccination Updates

Each year, thousands of people die as a result of the flu, pneumonia, and hepatitis. Kidney failure weakens dialysis patients’ immune systems, and makes it easier for them to contract a disease or illness that could potentially present complications or lead to a patient’s death.

CROWNWeb will allow facilities to update patients’ records by providing the facility with the ability to detail whether patients are receiving vaccinations for influenza, pneumococcal, and hepatitis.

Figure 1 illustrates the “Vaccination” fields included in CROWNWeb. Some of the system’s vaccination data include:

  • Vaccination dates
  • Vaccination sites
  • Test types

Figure 1 – CROWNWeb’s “Vaccination” data

The data fields for these new elements follow CROWNWeb’s “Progressive Disclosure” format, in which selecting one item on the screen may enable or disable other fields on the screen. The system will enable only the required fields; irrelevant fields will remain “grayed out” or unavailable.