Professionals

Validation

The Centers for Medicare & Medicaid Services (CMS), as part of the Quality Improvement Organization (QIO) program and in support of the National Voluntary Hospital Reporting Initiative, is conducting quarterly retrospective validation for all hospitals submitting data to the QIO Clinical Warehouse. Once the data have been submitted, they will be subject to the following sampling and validation process.

The chart audit validation process is performed to ensure the information collected is accurate. Qualidigm will work with Connecticut hospitals to help them achieve a passing score (80 percent accuracy) on data validation. The CMS validation approach is as follows:

• For each calendar quarter, all hospitals submitting abstracted data will be identified.
• For each hospital, all abstracted charts will be enumerated.
• A simple random sample of five charts will be identified from all hospitals with a minimum of six discharges in the QIO Clinical Warehouse. The sample is selected from all the cases submitted and is not topic-specific.
• The CMS Clinical Data Abstraction Center (CDAC) will request the paper medical records for each of the sampled charts.
• The CDAC will re-abstract the chart using the CMS Abstraction & Reporting Tool (CART). The relevant differences will be identified, and the CDAC will assign a reason code to each difference noted.
• The results of the re-abstraction will be stored in the QIO Clinical Warehouse and made available to the QIO to provide feedback to each hospital.
• Hospitals will receive educational feedback including an overall reliability rate and case details on each abstraction.
• Based upon the CDAC re-abstraction, the percent agreement at the element level will be calculated. Hospitals that reach or exceed the 80 percent pre-determined threshold will be considered to be supplying valid data for that quarter.
• Measures for which significant errors are found may not be posted on the website.