Our hospital system has approximately 166 facilities that offer dialysis services. Of those 166 facilities, 46 utilize a 3rd party vendor to provide dialysis services in-house. These 3rd party vendors often utilize their own documentation systems for dialysis treatment documentation. We are unable to obtain the data from these vendor systems. 

As the measure specifications state that the measure assesses the number of inpatient hospitalizations for patients age 18 and older who have an acute kidney injury (stage 2 or greater) that occurred during the encounter. Acute kidney injury (AKI) stage 2 or greater is defined as a substantial increase in serum creatinine value, or by the initiation of kidney dialysis (continuous renal replacement therapy (CRRT), hemodialysis or peritoneal dialysis). 

While the valueset does specify SNOMEDCT codes that provide the "Hospital Based Dialysis Services", and often these are obtained through the facility EHR documentation, we lack the timing component attributing it to the encounter. We utilize the dialysis documentation to provide treatment initiation date/time.  However, when the treatment is documented outside of the facility EHR, such as in a 3rd party vendor system, we cannot obtain that data. 

We are seeking guidance on how "Hospital-Based Dialysis Services" is defined; 

• Does this mean the hospital provides the dialysis services with in house staff, equipment, and documentation systems?
• Or does this mere mean that the dialysis services are performed within the inpatient setting vs. outpatient, regardless of what entity is performing the service?

And also, guidance would be needed on how to navigate vendor-provided services if they are included in "Hospital-Based Dialysis Services".