New Registry Enhancements in 2023 and Beyond

As AAOS Registry Program technology improves, sites will be able to better utilize their data to make decisions and deliver high-quality patient care. We will be deploying RegistryInsights® updates in 2023 and 2024 to improve the user experience for our participants.

After gathering feedback from our users in 2022, we identified the capabilities that were most requested and have started launching updates to make them a reality.

This webpage will be updated with current information and dates for these new Registry enhancements. Feel free to bookmark this page and refer to it throughout the next year as more specific details are added.


Data Element Quality and Coverage Dashboard

AAOS Registries Impacted: American Joint Replacement Registry (AJRR) and Shoulder & Elbow Registry (SER)

Deployment Date: AJRR - August 30, 2023; SER Levels 1 and 2 - November 30, 2023

The AAOS Registry Program launched a new initiative in 2023 to provide increased transparency to participating sites to understand the quality and status of their data submissions to their respective Registry modules. AJRR and SER participants can access this information within the Data Element Quality and Coverage Dashboard tabs.

The Registry Program has three different file layouts for three different episodes of care. These episodes of care include:

  • Procedure - intended to capture the primary or index procedure
  • Post-op - created to capture complications that occur within 90 days of index surgery (both surgery-based and not)
  • Patient-reported outcome measures (PROMs) - several different PROMs are collected at multiple intervals (pre-op and post-op)

We identified four levels of data submission quality for these three episodes of care for our Data Element Quality and Coverage Dashboard. For SER, Levels 1 and 2 have released and Levels 3 and 4 will be released in the first quarter of 2024. The dashboard will help to improve completeness, inform outcome analysis, and enhance the overall quality of Registry Program data.

These levels are:

  • Level 1 – Minimum Data Set

    The Minimum Data Set is the minimum number of elements that are utilized to identify a procedure with basic information on the patient, performing surgeon, and procedure details. The visuals in this level will help your site know why data may not be populating on your dashboards.

    • Required for a submission to be accepted
    • Includes fields such as Patient First and Last Name, DOB, Surgeon NPI, and procedure and diagnosis codes

  • Level 2 – Enhanced Data Set

    The Enhanced Data Set includes research-relevant data elements. Reporting is not required. However, it is needed for recognition as an enhanced reporting site.
    • Enhanced reporting sites will be recognized in the AJRR and SER Annual Reports and the recognition may be required for centers of excellence designation or credit for the American Board of Orthopaedic Surgery (ABOS) Maintenance of Certification
    • Includes fields such as BMI, anesthesia type, surgical technique and approach, and robotic use

  • Level 3 – PROMs

    PROMs data reflect the patient’s perspective on the outcome of surgery, and in conjunction with other clinical measures can provide a fuller picture of the impact of care.

    • Includes accepted general health scores and joint specific scores
    • There will be additional recognition for sites consistently submitting PROMs

  • Level 4 - Remaining Elements

    The Remaining Elements encompass any data elements not included in the other levels.

Data completeness is displayed in dashboards like the screenshot above. For Level 1 data elements, completenesses display as green if your site’s data for that field is entered in the acceptable format, or red if it doesn’t meet that requirement. The dashboards also show your site’s data quality progress over time. As for the other levels (2, 3, and 4), the completeness displays as green if it’s above the national benchmark and orange if it’s below the national benchmark.

An AJRR Data Element Quality and Coverage Dashboard quick reference guide, full user guide, and FAQs document are available in the Tools & Resources section of RegistryInsights. Guides for the SER Data Element Quality and Coverage Dashboard will be available soon.

For more information about the new SER Data Element Quality and Coverage Dashboard, attend one of our informal office hours sessions this month.


Surgeon Dashboard Integration with the AAOS Website

AAOS Registries Impacted: AJRR, Fracture & Trauma Registry (FTR), Musculoskeletal Tumor Registry (MsTR), SER

Collaborative Registry Impacted: American Spine Registry (ASR)

Deployment Date: August 30, 2023

AAOS members no longer need to log in to RegistryInsights separately – they can view case-level data submitted to the Registry by logging into their MyAAOS Customer Account on the AAOS website.

The AAOS Registry Program is always looking for ways for our participants to save time and ease the burden of registry participation so that they can focus on what matters most: delivering quality care to patients. AAOS members are now able to access their Surgeon Dashboards directly through the AAOS website.

Surgeons that champion the Registry Program are critical to its success, and we are increasing transparency into the data for our surgeons to improve the quality. In addition to the new data completeness dashboards described in the section above, we implemented this dashboard integration to improve the registry data that will inform practice change and drive outcomes.

However, AAOS members are only able to log into their dashboards if their site sets up an account for them in the Registry platform. Ask your site’s Registry Authorized User to create a Surgeon Authorized User account for each of your site’s surgeons or reach out to to identify your site’s Authorized User. This document details how to set up a Surgeon Authorized User account.

A guide on how to access the Surgeon Dashboards from the AAOS website is available in the Tools & Resources section on RegistryInsights.


File Encryption for Every Registry Report Download

AAOS Registries Impacted: AJRR, FTR, MsTR, SER

Collaborative Registry Impacted: ASR

Deployment Date: August 30, 2023

We have updated RegistryInsights to improve the security and encryption process of the exportable reports. Any file or report containing PHI is protected and requires a user password going forward.

The Registry Program takes data security seriously, and we continue to implement additional safeguards to protect confidential patient information. All RegistryInsights reports now require a personalized password to be accessed. When this update has been implemented, you will need to visit the new “RegistryInsights Report Password” section in the platform and copy your password to open downloaded Excel files.

If you have any questions about the new file encryption process, please view the guide in the Tools & Resources section of RegistryInsights or reach out to the Registry Support team at


The Next Generation of RegistryInsights Dashboards

AAOS Registries Impacted: AJRR, SER

Collaborative Registry Impacted: ASR

Deployment Date: AJRR - November 1, 2023; ASR - Early Winter, 2023; and SER - Mid-winter, 2024

The Registry Program collected feedback through user surveys and day-to-day conversations with our participants, and we are happy to announce that we are making significant enhancements to the RegistryInsights dashboards based on user input. The next generation of dashboards will make it easier to utilize your data to improve the quality of patient care.

The next generation of RegistryInsights dashboards will improve:

  • Access to data

    • Data drill downs are available for graphs displaying rates to show record-level data submitted by the site

    • New tables to the left of graphs were added to show numerators of each Procedure or Diagnosis type

  • Benchmarking, trends, and analysis

    • Five new filters were added

    • Institution Type characters were acquired from the AHA Database

  • Aesthetics and usability

    • Navigation tabs are now available at the top of the page for easier access

      • Easily toggle between tabs to follow the episode of care

    • Removed National-Level tabs for each episode of care

      • Integrated into Authorized User and Surgeon User dashboards for ease and efficiency

  • Actionable quality improvement measures

    • The Performance Measures Tab now includes data for sites supporting Quality Payment Programs

      • QCDR Measures, e.g. Postoperative Ambulation (Hip)

      • MIPS CQMs, e.g., CQM 376

    • Data automatically populate in the Measures

    • Data in the Performance Tab populates for four programs regardless of site participation

This information can be found in the document, "AJRR Dashboard Updates and Enhancements for 2023," which is also available in the Tools & Resources section of RegistryInsights too. We are looking forward to sharing these updated dashboards with ASR and SER participants as well. 


New Epic SmartForm Version and Dashboard Enhancements for the Musculoskeletal Tumor Registry

AAOS Registries Impacted: MsTR

Deployment Date: Early Fall, 2023

This year, the MsTR is receiving a significant resource update aimed at enhancing and standardizing data collection for Epic sites nationwide. The new MsTR SmartForm version will enable surgeons to input exclusive data concerning their sarcoma patients at the point of care, which cannot be readily extracted from the EHR automatically. The new version will be accessible through a turbocharger package available for download from the Epic community library, allowing for facilitated implementation into the surgeon's clinical workflow.

We would like to thank Benjamin J. Miller, MD, MS, FAAOS, MsTR Steering Committee Chair, and Matthew Watson, MBA, RN, Sr. Application Developer, at the University of Iowa for their work on the new MsTR SmartForm version.

Several dashboard enhancements have been introduced for MsTR in 2023. These enhancements expand the existing MsTR dashboards to include visual representations of data elements captured beyond the initial baseline visit where patients are assigned their histological diagnosis of sarcoma. The new graphs provide information on recurrent follow-up encounters such as complications, recurrence, and additional OR visits, offering a more comprehensive and perpetual view of sarcoma care over time.

Visit this webpage later in the fall for more information on the new Epic MsTR SmartForm version. A guide for using the new dashboard will be available at a later date.


New Epic SmartForm Version for the American Spine Registry

Collaborative Registry Impacted: ASR

Deployment Date: Early Fall 2023

The ASR, a collaborative effort between the American Association of Neurological Surgeons and AAOS, is also receiving a new Epic ASR SmartForm version this year. Similar to the new MsTR SmartForm version, it will be accessible through a turbocharger package. The new ASR SmartForm version will allow surgeons to input spine data that cannot be extracted from the EHR automatically.

We would like to thank Oren N. Gottfried, MD, FAANS, Co-chair of the ASR Data Operations Committee, and Edward Peterson, RN, Application Analyst, at Duke University Health System for assisting in the creation of the new ASR SmartForm version. Visit this webpage in the fall for more information about the Epic ASR SmartForm.



If you have any questions about the upcoming Registry technology enhancements, feel free to reach out to User Guides and Frequently Asked Questions will be available for participants after each update.