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William J. Maloney, MD


Published 12/1/2017
William J. Maloney, MD

The Academy Takes First Steps Toward Building National Family of Orthopaedic Registries

The initiative is significant and reinforces the Academy's commitment to quality
As you may already know, in October, the Academy announced its intent to create a national family of clinical data registries for a broad range of orthopaedic conditions and procedures. This initiative is by no means a small endeavor. In fact, it is one of the Academy's boldest moves in recent history, and it reinforces our on-going commitment to quality.

To demonstrate our resolve, the Academy simultaneously announced that the American Joint Replacement Registry (AJRR), a national hip and knee joint replacement registry with 970 participating U.S. hospitals and 40 ambulatory surgery centers, integrated into the AAOS, giving us a running start in what will certainly be a marathon.

Additionally, the AAOS Board of Directors created a multiyear business plan and committed the resources—both financial and talent-wise—necessary for this endeavor to be successful. I want to stress that the Academy is in an advantageous position, given our internal resources, which will enable us to execute such a grand undertaking.

First, we have our CEO Thomas E. Arend Jr, Esq, CAE, and COO Dino Damalas, who have had first-hand experience building data registries during their tenures at the American College of Cardiology (ACC). We also have Nathan Glusenkamp, the Academy's new director of orthopaedic registries. Mr. Glusenkamp previously served as president of provider solutions at FIGmd, a rapidly growing health information technology vendor delivering registry services to medical societies and boards. Prior to joining FIGmd, he oversaw the ACC's PINNACLE Registry, the largest observational outpatient cardiovascular registry in the world.

From within the Academy's leadership, we have the board of directors, which unanimously supports this venture. More specifically, the Academy's presidential line—David A. Halsey, MD, first vice-president, and Kristy L. Weber, MD, second vice-president—and Gerald R. Williams Jr, MD, past president, and Ronald A. Navarro, MD, member-at-large, have demonstrated an unwavering commitment to quality throughout their careers and will continue to champion this effort in the years ahead.

Outside of the board, I want to credit David S. Jevsevar, MD, MBA; Kevin G. Shea, MD; and Kurt P. Spindler, MD, for their service to the registry task force, which laid the ground work for this effort.

And, of course, it goes without saying that the Academy will greatly benefit from the years of experience and overall expertise within the AJRR, starting with Daniel J. Berry, MD, board chair; and Kevin J. Bozic, MD, MBA, board vice-chair. It is impressive that the AJRR has captured and analyzed data on more than one million procedures since its creation in 2010. Clearly, it has a proven model and infrastructure, both of which the Academy will use as cornerstones when developing registries in other orthopaedic specialty and procedural areas.

I'm more than confident that this combination of talent and resources will put us in a position to positively impact the orthopaedic community and the patients we treat.

A forward-thinking commitment to quality
Although launching a clinical data registry, let alone multiple registries, is an incredibly complex and layered process, the core of this initiative is simple—it's about quality. We are simply—yet strategically—reinforcing our mission, which is "serving our profession to provide the highest quality musculoskeletal care." In doing so, we are taking proactive steps to define quality in the emerging value-based healthcare landscape in a way that benefits our profession and our patients. In the end, we want to define these areas and then make sure that we, as surgeons, deliver on clear and concise expectations.

As I said when we announced our initial plans, a central group of orthopaedic registries, which provide standardized and consistent data, will allow us to optimally measure performance and value, create and recommend informed reimbursement and treatment standards, develop education programs that address practice and treatment deficiencies, and, most importantly, continually and collectively improve patient safety, treatment, and outcomes. In addition, related benchmarking services will provide participants with compelling comparisons of multiple levels of aggregation and highlight opportunities for further performance improvement.

Participation is key
For this endeavor to be successful, we need support from hospitals and individual physicians. We understand that our partners' resources, time, and availability are limited, and we need a system that is easy to navigate and seamlessly integrates into their business operations.

To overcome this challenge, we will use the efficiencies already established within the AJRR platform as a launching point. In the future, we want to explore how we can further integrate with electronic health records systems, enabling participants to upload data with very little effort. We also want to encourage hospitals to participate in multiple registries. We cannot be a burden to our participants and ask them to take on duplicative work. It must be turnkey to upload data—for one registry or several.

Next steps
Again, this initiative is a marathon, not a sprint. After our launch and partnership with the AJRR in October, we are off to a phenomenal start. To continue the momentum, the board of directors recently approved the registry task force's recommendation for a registry oversight committee, which will oversee the registries at an enterprise level, as well as provide a supporting governance model. This significant step will help us scale as we increase our footprint in the registry space. That registry oversight committee will also help us better define our long-term mission and vision and it will establish processes for how to create new registries, how to determine datasets, and how best to partner with specialty societies.

In the near future, we will identify orthopaedic specialty and procedural areas we want to pursue for registry product development in 2018. This effort could include partnering with other pre-existing registries and orthopaedic specialty societies. Obviously, we are not the first in this space; however, we see great value in collaboration.

These kinds of efforts will pick up speed once the registry oversight committee is finalized. From there, things are going to get even more exciting. I foresee this effort paying great dividends for the Academy, our members and related stakeholders, and patients.

Members can expect the Academy to provide updates regarding its progress through AAOS Now and other member communications.