QualityNet Exchange

1. QualityNet Exchange Collins Gibson, MS Carolina Medical Review 250 Berryhill Road Suite 101 Columbia, SC 29210 803-731-8225 800-922-3089

2. What is QualityNet Exchange? • Interactive, secure web site that allows the direct exchange of files over the Internet • Only CMS approved method of exchanging confidential information over the Internet • Purpose is to improve the quality of care for Medicare beneficiaries through increased efficiencies in information exchange • Accomplished by providing secure, real-time communication and data exchange

3. Benefits • Secured Data Interchange: through the use of data encryption and decryption, data is exchanged securely and swiftly • System Back-Up: all data is stored in one database that is backed up daily, thus promoting integrity and accuracy • Speed of Data Interchange: when files are exchanged the data is immediately accessible • Security: secured connections through a single point of entry, digital certificates, the use of personalized soft tokens, and TecSec encryption integration serve to ensure the security of the data

4. Public Pages • Public Home Tab Page: What’s New section provides information regarding the latest changes to the site, Log In link is available for registered users to log into the secured pages of QNet Exchange • Background Tab Page: background information regarding the QNet Exchange web site, links are available for information regarding the QIO program • Getting Started Tab Page: information regarding the registration process for QualityNet Exchange • CART Tab Page: information regarding the CMS Abstraction and Reporting Tool

5. Public Pages continued • HDC Tab Page: information regarding Hospital Data Collection • Contact Us Tab Page: information necessary to obtain help desk support for the QualityNet Exchange site • FAQ Tab Page: link to the QNet Quest application where all Frequently Asked Questions relevant to QualityNet Exchange, CART and HDC topics are stored

6. Login Page • First page registered users will access • Login ID and Password fields are available to log into QualityNet Exchange

8. QNet Exchange Administrator • Complete and/or approve each new user online registration form • Update user information and assign appropriate roles for QNet Exchange users • Remove access and/or approve the removal of access for users who are no longer active or no longer require access to QNet Exchange • Monitor QNet Exchange usage to maintain proper security and confidentiality measures • Validate users and what type of functionality each user should have within QNet Exchange • Serve as the point of contact at your organization for information regarding QNet Exchange

9. QNet Exchange Roles • File Exchange and Search: users with this role can exchange files • QIO Clinical Warehouse Data Upload: users with this role are able to upload data files and view QIO Clinical Warehouse Submission Reports • QIO Clinical Warehouse Feedback Reports: users with this role are able to request and view feedback reports regarding data submitted to the QIO Clinical Warehouse (provides access to Hospital Data Validation Reports and QIO Clinical Warehouse Comparison Reports)

10. File Exchange • Section of QNet Exchange where data can be sent securely over the Internet • Files are encrypted (scrambled so that they are unreadable) automatically before they leave the sender’s hard drive or network and stay encrypted until the receiver decrypts (unscrambles) and downloads the data to their hard drive or network. The data is exchanged in real-time. • To access the File Exchange and Search section, click on the File Exchange and Search link in the My Work section of the Home page. • The File Exchange and Search page is divided into two sections. The Inbox section provides access to all files you have received. The Outbox section provides access to all files you have sent.

12. File Inbox • New tab of the File Inbox section displays files you have received that have not yet been downloaded • Downloaded tab of the File Inbox section displays files you have received and downloaded • Default display is for all files sent in the last 7 days

14. File Outbox • Unopened tab of the File Outbox section displays files you have sent that have not yet been downloaded by any of the recipients • Opened tab of the File Outbox section displays files you have sent that at least one recipient has downloaded • Archived tab of the File Outbox section displays files you have sent that have been archived • Default display is for all files sent in the last 7 days

16. Uploading a File Click Here

17. Click on Group and Show users at … Users move over Highlight person to send file to Name moves down Click here, browse to file and click Open

18. Downloading a File Select this box Then, click here Finally, designate where file should be saved and click save

19. QIO Clinical Whse Data Upload

20. Chooses files/directory for upload, browse to file/directory, click open

21. QIO Clinical Warehouse Submission Reports The QIO Clinical Warehouse Submission Reports provide information on the data submitted through QualityNet Exchange to the QIO Clinical Warehouse for the submitter of the data. The QIO Clinical Warehouse Data Upload role is necessary in order to access these reports. Only the submitter of the data can view the feedback provided on the Submission Reports.

22. QIO Clinical Warehouse Comparison Reports

23. Comparison Reports Available • Case Status Summary: summary (submitted, accepted, and rejected) of cases submitted to the QIO Clinical Warehouse by topic; displays most recently submitted case • Measure Status Summary: summary of the number of cases indicated per quality measure (included or excluded) for the cases accepted into the QIO Clinical Warehouse • Data Submission Detail: detail report of cases submitted to the QIO Clinical Warehouse; includes all submissions for a particular case and edit violations

24. Comparison Reports Available continued • Heart Failure (Facility Only) • Acute Myocardial Infarction (Facility Only) • Pneumonia (Facility Only) • Surgical Infection Prevention (Facility Only) • These reports display data for individual facilities on select quality measures for the four clinical topics. The reports also include demographic information by age and race.

27. Hospital Data Validation Reports

28. Hospital Data Validation Reports continued • On a quarterly basis, a small sample of the data that hospitals submit to the QIO Clinical Warehouse is validated by the Clinical Data Abstraction Centers (CDACs) • As the CDACs complete validation review of the medical records, they submit the data to the QIO Clinical Warehouse • Validation rates are calculated on a weekly basis (Monday) for the validation records that were abstracted by the CDAC and submitted to the QIO Clinical Warehouse the previous week • Providers that had validation rates calculated will be notified with an email message Monday mornings that validation reports generated following CDAC reabstraction are available on QualityNet Exchange • The QIO Clinical Warehouse Feedback Reports role is required to receive the email notifications and access the reports

29. Validation Reports Available • Case Selection: detail list of the cases that were selected for hospital validation (includes the topic, patient information, admit and discharge dates, the date by which the medical record should be submitted to the CDAC, and whether the medical records have been received) • Overall Results: overall reliability rate across all five cases and indicates whether the provider passed or failed validation • Case Detail: comparison of the hospital abstraction to the CDAC reabstraction results • Reliability by Topic: detail list of cases by topic, and the reliability rate for each case and each topic • Results by Abstractor: reliability rates for each case and for each abstractor

31. Annual Payment Update Reports

32. Affected Provider Participation Status • Provides information on the status of participation in the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) Initiative • expected sample size, total cases accepted into the QIO Clinical Warehouse, and total cases accepted into the QIO Clinical Warehouse with required measures by topic for a selected quarter. The Affected Provider Participation Status report also includes if the provider is JCAHO accredited, and if the Notice of Participation Form, the Notification of Zero Cases Form, or the Withdrawal of Participation Form have been signed.

33. Reports Viewer Allows you to view and/or download reports you have previously generated. The New tab displays reports you have generated, but have not downloaded. The Downloaded tab displays reports you have generated and have downloaded to your hard drive or a network drive.

35. Additional Information • A “QualityNet Exchange Overview Training” recorded session is available on the public “CART” page of QualityNet Exchange. The left side of the “CART” page has a menu selection under “Training” of QualityNet Exchange Demonstration – Recorded Sessions. • QualityNet Exchange Users Guide is available on the secure page. It is located at the bottom of the left hand section.