Data Validation Overview

Hospitals-Inpatient

To verify the accuracy of information collected, each quarter a small sample of the data that hospitals submit to the QIO Clinical Warehouse is validated. All hospitals that have submitted abstracted data for six or more cases (discharges) across the four CMS national inpatient measure sets—Acute Myocardial Infarction (AMI), Heart Failure (HF), Pneumonia (PN), and Surgical Care Improvement Project (SCIP)—during the previous quarter are included in the process.

For each hospital, cases from across the four (4) inpatient measure sets are randomly selected for validation review by the CMS Clinical Data Abstraction Center (CDAC). The CDAC requests copies of the medical records for reabstraction, then submits data from that validation review to the CDAC Clinical Warehouse. A hospital's data is considered to be "validated" if its overall validation (agreement) result is greater than or equal to 80 percent. If the overall validation result is less than 80 percent, the hospital has 10 (ten) business days (from the date the result was posted) to submit an appeal to its Quality Improvement Organization (QIO).

*QIOs: See QIOnet for related Hospital Data Validation documents (e.g., Hospital Data Validation Appeal Form - Part 2, Instruction Guide, etc.)

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