AAOS Now

Published 10/1/2016

AJRR Update

New features, future plans
As the official registry of the American Association of Hip and Knee Surgeons (AAHKS), the American Joint Replacement Registry's (AJRR) mission is to collect data on 90 percent of the hip and knee replacement procedures performed in the United States. Under the direction of Paul Haisman, AJRR's first-ever chief technology officer, the national registry has begun making several technological enhancements that will enable it to meet that goal.

For example, as a result of the merger agreement between AJRR and the California Joint Replacement Registry (CJRR) in the spring of 2015, CJRR will be fully transitioned into the AJRR on Jan. 1, 2017. The CJRR will bring 10 hospitals to the AJRR, as well as their data collection platform, which offers several opportunities for growth and upgrades. AJRR has already begun the process of transferring its current participants to the new platform.

"We wanted to introduce a technology solution architecture that provided for more flexibility, scalability, and adaptability to support the AJRR's overarching goals," said Mr. Haisman. "Part of the desired solution will be to implement a data management initiative resulting in improved data governance, quality, and integration capabilities. At the center of the solution will be a new AJRR data warehouse that will be used to feed a more powerful reporting and analytics platform."

In addition to consolidating AJRR and CJRR under a single system, AJRR plans to introduce more robust dashboards that feature improved analysis and mobile support. It also plans to help expand technology vendor partnerships, with a services layer for vendor data integration. AJRR's new data collection platform will enable submission of Level II complications, comorbidities, and risk factor data. Variation in patient characteristics can drastically alter surgical outcomes, and the ability to compare current patients to past complications will provide surgeons with extra information that could prevent the need for a revision procedure.

Enhanced data collection capabilities will also help AJRR better address the quality initiatives of participating institutions. AJRR will be able to satisfy federal programs like the Medicare Access and CHIP Reauthorization Act and Merit-Based Incentive Payment System, along with objectives from certifying boards like Maintenance of Certification. It will also support Level III patient-reported outcome data collection and reporting with full Comprehensive Care for Joint Replacement model support. Distinction programs, operated by insurers like Blue Cross and Cigna, and accreditation organizations such as The Joint Commission also have specific requirements or standards that the AJRR will help institutions meet. These initiatives often provide payment reimbursements for the institutions and surgeons that perform the arthroplasty surgeries.

"Every enhancement that we make to the registry platform serves one ultimate purposeā€”to improve orthopaedic care through data," said Jeffrey P. Knezovich, executive director of the AJRR. "If more informative dashboards and support for quality initiatives result in institutions making better healthcare decisions for patients, we know that we've done our job."