AAOS Registry Program Data Submission Frequently Asked Questions


  1. What data elements are collected by the AAOS Registry Program?

The AAOS Registry Program collects procedural data, post-operative data, and patient-reported outcome measures (PROMs) data. Some anatomical registries may collect additional types of data. View each AAOS Registry’s individual webpage for the specific data elements it collects. All Registry Program participants are provided with Data Specifications and a Data Dictionary with definitions of the data elements appropriate for each AAOS Registry.


  1. Are there any tips for successful data submission?

For existing participants, we offer documentation in the Tools & Resources section of RegistryInsights® that outlines how to prevent files from being rejected by the Registry. For best practices, we highly recommend using the most current version of the Data Specifications in Tools & Resources.

When submitting data, the procedural file is always submitted first. Post-op and/or PROMs files are submitted 24 hours after submitting the corresponding procedural file to ensure proper processing. All post-op and PROMs submissions must reference the corresponding procedure to link to the patient record. Lastly, patient data must match identically with each submission to ensure proper linking. An example would be adding a middle name or suffix to an existing record will not be linked properly.

If these steps are followed, your data and dashboard will accurately populate. Visit Tools & Resources to a reference the document that describes the data elements that are required for appropriate linking.


  1. What are the error messaging definitions?

“Registry Data Submission - Enhanced Error Messaging for File Processing Issues” is a guide within the Tools & Resources section of RegistryInsights® that provides an overview of the enhanced error messaging associated with deficient file submissions. The messaging gives new message flags and details to easily identify the status of a submitted file and information related to correcting file processing issues submitted to the Registry. The error messaging guide is a self-service tool to accurately understand deficiencies when data is not submitted properly according to the Data Specifications. 


  1. Are all data elements required?

Not all elements are required, but there are certain fields that must be completed or the submission will not be accepted. There are also conditional fields that are not necessary to be completed for all uploads. Any field that is not required must be populated with either “Not Reported” or “NR.” A complete listing of non-required and required fields are designated in the Data Specifications and Data Dictionary documents.


  1. How much time should I estimate for getting set up with the data submission process?

Getting set up to continuously submit data to the Registry Program takes approximately 60 business days. An AAOS Registry Support Specialist will be assigned to work on your Registry implementation and walk you through the entire process.


  1. How do I submit data to the Registry Program?

The data submission process involves extracting procedures from your site’s electronic health record (EHR) system, then submitting data through the RegistryInsights® data upload process via a secure file transfer protocol (SFTP) or hypertext transfer protocol secure (HTTPS).


  1. In what format should I upload data to the Registry Program?

Data is uploaded via Excel or CSV file. 


  1. If my site is using a third-party vendor to collect data, is it necessary to collect and submit the same data twice?

That is not necessary if the third-party vendor is one of our Authorized Vendors. Our Authorized Vendors know our data requirements and we have established agreements allowing them to submit on your behalf. Please visit this link for a list of our Authorized Vendors.

If the vendor you are using is not an AAOS Registry Program Authorized Vendor, we will be happy to work with the vendor to execute an agreement and avoid the burden of doubling your data collection and submission.


  1. How often should my site submit data?

We recommend monthly submissions. If this does not work for your workflow or case volume, we suggest a quarterly upload at a minimum.


  1. Is retrospective data accepted?

Yes, we accept retrospective data for all our registries. The time interval for retrospective data depends on which Registry you are submitting for. Contact Registry Support at RegistrySupport@aaos.org for specific Registry information.


  1. Are my patients’ data secure?

We take data security seriously and follow all Health Information Portability and Accountability Act of 1996 (HIPAA) and Protected Health Information (PHI) regulations. Our PHI is secured, maintained, and released in accordance with all applicable federal and state laws, rules, and regulations, including HIPAA regulations. All our personnel who process, generate reports, or otherwise have contact with PHI must uphold the patient’s rights to confidentiality. This policy refers to all information resources, whether written, verbal, or electronic, and whether individually controlled, shared, stand-alone, or networked. Additionally, our staff have been trained in HIPAA privacy and security.


  1. What are your notification requirements in the event of a breach?

We will report any breach well before the 60-day HIPAA breach notification requirement.


  1. Will other sites be able to see my data?

Only your Authorized Users and PROM Site Administrator can see your site-wide data. Surgeon Users can only see their procedures. De-identified data on the national level can be seen in the aggregate.


  1. How do you manage the integrity and quality of the data in the Registry Program?

We utilize strict protocols for data migration, security, privacy, review, and implementation. We also conduct an annual audit with the sites who are providing the data.


  1. Who do I reach out to for data submission support?

Our Registry Support Specialists will be happy to assist you. Contact them at RegistrySupport@aaos.org.


  1. Can I access Registry Program data for clinical investigation?

We understand our colleagues may want to access the data in the Registry Program to conduct further analyses and address specific hypotheses beyond our national benchmarks. Clinical scientists can apply to use analyses from the AAOS Registry Analytics Institute™ (RAI).

The goal of the AAOS RAI is to provide a resource to the scientific community to further understand and improve orthopaedic and musculoskeletal care by making analyses available to examine outcomes related to orthopaedics. The Institute gives clinicians and clinician-scientists the opportunity to submit proposals for analytic insights that are contained within its various registries. 

To learn more about the application process and participate in a data analysis collaboration with the American Joint Replacement Registry (AJRR), click here.


  1. Does the AAOS Registry Program collect COVID-19 patient data?

Yes, all AAOS registries collect COVID-19 data through the capture of the ICD-10 code for COVID-19 confirmed diagnosis, U07.1. Tracking this information will help analyze the impact of COVID-19 on outcomes, trends of surgery based on the pause in elective surgery, and the trends of patient-reported outcomes (PROMs) due to delayed procedures. It will also track the potential impact on Centers for Medicare & Medicaid Services (CMS) value-based payment models and coverage for patients recovering from COVID-19. Key findings will be delivered to participants, the orthopaedic community, and the broader public throughout the years.

Hospitals, health care systems, practice groups, and ambulatory surgery centers already participating in the registries will not need to join a new registry or engage in a new way to submit their data. Capturing this code will not change the site’s workflow since it was added as an accepted value for existing diagnosis or comorbidity code files. The ICD-10 code can be submitted as a pre-operative comorbidity or prior diagnosis present on admission and as a reason for readmission. Learn more here.