Introduction

Since its national implementation in June 2012, the Centers for Medicare & Medicaid Services’ CROWNWeb data collection system has been continually modified and enhanced as part of routine application updates to support federal data reporting guidelines, and to help meet the data collection needs of 19,000 users in approximately 6,300 Medicare-certified chronic dialysis facilities and hundreds of transplant centers.

Like any computer system or software, CROWNWeb is regularly updated through a series of major and minor releases to help optimize the system’s functionality and usability. During minor CROWNWeb releases, changes are not typically made to the system’s layout, but processing logic and maintenance are the primary focuses. CROWNWeb’s major releases, however, have brought substantial changes that have expanded the system’s overall purpose and functionality by incorporating data-capturing capabilities that support the Conditions for Coverage for End-Stage Renal Disease facilities and CMS initiatives such as the ESRD Quality Incentive Program.

Change request and updates process

More than 100 updates and enhancements have been added to the CROWNWeb system since its release. These include changes ranging from ensuring the system displays the proper acronym for hemoglobin, to the full-scale introduction of new screens, such as the inclusion of a Patient Attributes History screen used to assist users with ensuring that accurate data are reflected on the CMS-2744 Annual Facility Survey forms.

All CROWNWeb updates and enhancements are initially evaluated by the development teams, and then go through multiple phases as per a typical software development lifecycle—which calls for a review and analysis of requirements and design, development and testing, implementation, and maintenance. CMS employs a variety of CROWNWeb data support contractors to oversee various aspects of the system’s development lifecycle, and updates must ultimately be approved by CMS before being included in a release.

CMS enables the community to submit change requests via the agency’s help.projectcrownweb.org web address. When submitting a request, users are asked to provide specifics regarding the system’s current behavior and the change that should occur. All updates are reviewed for user and system impact, scored to determine both the level of importance and potential implementation timeframe, tested to determine if the development meets the identified need, and then reviewed and/or approved by CMS for release. (See Figure 1 for an overview of the CROWNWeb Updates review and deployment process.)

Latest CROWNWeb Update

CMS continuously monitors CROWNWeb’s performance, considers federal data submission requirements, and reviews user feedback when considering potential changes to the system’s current layout. On February 25, 2014, CMS released an updated version of CROWNWeb – Version 4.3.4. Considered a minor release, this implementation included more than 12 updates to CROWNWeb’s back-end and modifies a previous system behavior. (For a complete list of CROWNWeb Version 4.3.4 system updates, visit http://projectcrownweb.org/crownweb-version-4-3-4-released-on-february-25-2014/.)

Things to come

Since the early developmental stages of CROWNWeb, CMS has always reviewed each screen to determine how to capture data essential to ESRD quality improvement projects, while striving to improve the data entry experience for end users. CMS has prioritized the evaluation and redesign of CROWNWeb’s Clinical section, which provides a means for users to enter monthly treatment and lab results for hemodialysis and peritoneal dialysis patients. In late 2012, shortly after the CROWNWeb national release, CMS updated the Clinical screen to allow users to enter multiple infection and hospitalization admissions as a means to indicate any factors that may have impacted or interrupted a patient’s course of treatment.  

As part of CROWNWeb’s next major release, users will notice substantial changes to the Clinical screen. Many fields will be altered to streamline the data collected, and minimize the data entry experience for users who must manually enter data.

Figure 1

More information

For more information on CROWNWeb and the system’s features, visit the Project CROWNWeb website at http://projectcrownweb.org/, or visit the CMS CROWNWeb website at https://www.qualitynet.org/and click on 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. Publication Number: FL-OCT-2014OCTT2-3-254