The American Joint Replacement Registry's The Register
Letter from the Executive Director
AJRR Executive Director
Jeffrey P. Knezovich, CAE

When so much has happened in such a short period of  time, sometimes it's a good idea to  think back and  reflect. In 2016, the final terms of our merger with the California Joint Replacement Registry (CJRR) were decided upon, and as you're reading this, CJRR is now considered a State Registry and sub-committee of AJRR. The Centers for Medicare & Medicaid Services (CMS) was busy implementing quality initiatives, as the Comprehensive Care for Joint Replacement (CJR) model went into effect in the spring and the Medicare Access and CHIP Reauthorization Act (MACRA) final rule was released in October. The National Registry will continue adapting to remain valuable as the field of orthopaedic shifts its focus to quality.
 
Part of this adaptation includes a more efficient way to house and display our data. We've done a complete overhaul of our Registry system in the last few months and developed a platform that provides more flexibility and scalability to support the Registry's overarching goals. Our new dashboards are sleeker and provide improved analysis and mobile support. New data specifications will be released in February that require the collection of Level II data. We've also reached the point where data files that are submitted into our system are able to show up in the Registry in 48 hours. This nearly real-time access to procedural data can give an improved picture of the current state of arthroplasty at your institution like never before. And don't forget - our patient-reported outcomes platform not only collects the data, but administers the surveys to your patients - all included in your annual subscription fee.
 
Even if your institution isn't subscribing to our dashboards, AJRR's upgrades will provide an added benefit. The standard Yearly Report that each participating institution receives will now be accessible through the dashboard system. With all of the new improvements to our system, now is a great time to get a subscription.
 
Although the Registry accomplished great things in 2016, we couldn't have done any of it without the support of our stakeholders and participating institutions. The now 869 hospitals and over 6,000 surgeons are what got us to where we are today, and the AJRR could not be more proud. We've collected more than 780,000 hip and knee procedures and continue to grow at an incredible rate. I'm positive that 2017 holds great things for the AJRR community, and look forward to achieving them with all of you.
 
Best regards,

Contact AJRR Support for IT Assistance

The technology isn't the only aspect of AJRR that has changed in 2017. Our Information Technology department has made it easier to address any IT issues with you. We've implemented a support ticket system that will allow for faster response times. Please direct any IT related issues or inquiries to support@ajrr.net.
Welcome, Mr. Timothy M. Mojonnier

A unique aspect of the AJRR is that our Board is comprised of
AJRR Public Advisory 
Board Member
Mr. Timothy M. Mojonnier
many different stakeholders. One of these stakeholders maintain that the public voice is represented in the Registry through the  AJRR Public Advisory Board (PAB). We welcome Mr. Timothy M. Mojonnier as a new member to the PAB. He is a professional educator who currently teaches project, supply chain, and operations management as an Adjunct Professor at both DePaul University and Loyola University in Chicago, IL. Mr. Mojonnier has over 30 years of business experience, and is President of Mojonnier & Associates Inc. where he provides consulting services to distribution and manufacturing companies throughout the nation. He's served on the Board of Directors of George F. Marchant Co., and as consultants and managers at other corporations throughout Illinois. Mr. Mojonnier received his B.A. in Philosophy at Lafayette College in Easton, PA, and his M.B.A. in Finance and Accounting at the University of Chicago.
 
We look forward to receiving Mr. Mojonnier's input on the future endeavors of the PAB.
MACRA and How AJRR Can Help

The Medicare Access and CHIP Reauthorization Act (MACRA) went into effect on January 1, 2017. Replacing the Sustainable Growth Rate formula, it serves as the way for Medicare to adjust payments to providers for the value and quality of their care. AJRR will be able to help with both tracks of the program: the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (APM).
 
We collect the measures for the Comprehensive Care for Joint Replacement (CJR) model, an APM, so we'll be able to help with the APM track Our Orthopaedic Quality Resource Center is a Qualified Clinical Data Registry (QCDR), so it satisfies measures or gives bonus points for the "Quality," "Improvement Activities," and "Advancing Care Information" categories of MIPS. Both tracks have different requirements for participation, but AJRR is dedicated to helping our participants no matter what track they choose.
New Data Specifications Coming Soon
 
We'll be releasing new data specifications on February 15, 2017. These specs will impact the elements you submit to us on a regular basis, so be on the lookout for them. New to our repertoire of required data will be Level II patient risk factors, comorbidities, and complications data. The new specs will have an easy format that will simplify integration with several major electronic health record (EHR) vendors.

We understand the complexities of adopting new specs, so there will be a grace period until January 1, 2018 where we will be accepting both versions. However, we highly encourage participants to adopt the new specs, and any institution that joins the Registry after the new specs are released must submit the new version.
Visit Our Booth at the AAOS Annual Meeting and 
Attend Our Unet Luncheon
 
San Diego, California
The American Academy of Orthopaedic Surgeons (AAOS) is hosting their 2017 Annual Meeting at the San Diego Convention Center in San Diego, California from March 14-18. Among the activities offered are instructional courses, scientific program paper symposia, guest speakers, and a career center. Our staff will have a booth during the Annual Meeting, so be sure to stop by for a free demonstration of our new dashboards and patient-reported outcome (PRO) platform. We'll be in  the Ballroom 6 Lobby on Level 2. The AJRR Board of Directors are scheduled to meet in San Diego the day before the Annual Meeting begins.
 
Like last year, we'll also be hosting a free luncheon meeting for our User Group Network (Unet). This session will take place on Wednesday, March 15, and will serve as a way for Registry users to connect face-to-face with people experiencing similar challenges. An online option to listen in to the meeting will be offered for those that can't attend in person. Stay tuned for more information on the location. 

Click here to RSVP to the Unet meeting.
ISAR Annual Meeting in San Francisco This Year

The 6th Annual International Society of Arthroplasty Registers Congress, the Annual  Meeting  of the   International Society of Arthroplasty Registries (ISAR) , will be held from May 20-22, 2017, in San Francisco, CA. The conference will be held at the Parc 55 San  Francisco, a Hilton Hotel. 

Parc 55 San Francisco,  a Hilton Hotel
Each year, the AJRR and the  California State Registry Committee send representatives to present research and display  posters. The 2017 featured meeting topics include: cost effectiveness/health care economics, translating research into clinical practice, innovations in registry statistics/methodologies, electronic health records and big data analytics transforming the future, and the most up-to-date clinical findings from international orthopaedic registries. Also, attendees that arrive early are able to go on optional Napa Valley wine tours on May 19. The California State Registry Committee Annual Meeting will be held in San Francisco during this time as well.
 
Visit the  ISAR website for more information. You can register for the ISAR Annual Meeting  here. Visit the  AJRR website for links to posters from past ISAR meetings. Registration for the California State Registry Committee Annual Meeting will be forthcoming.
Authorized Vendor Profile

Company Name: Epic
 
Company Website: www.epic.com
 
General Description: Epic is a privately-owned developer of health software for providers and patients.
 
Features Offered: They build integrated software for clinical care, administrative functions, analytics, and patient activation - together providing a flexible foundation for quality improvement and cost reduction.
 
Integration with AJRR: EpicCare Orthopaedics, the Epic electronic medical record system module for the field of orthopaedics, includes support for AJRR's data elements and reporting. The system automatically finds patients who have had procedures that qualify them for the Registry. Users can report on patients in the Registry and have access to a template included in the system that makes it easy to submit data to the AJRR.
 
Fun Fact: Epic has a working farm on its Wisconsin campus - including corn fields, alfalfa crops, and grazing livestock.
 
A full list of AJRR's technology partners can be found here.
Data Corner
 

Our  2016 Annual Report   contains a wealth of information on procedural and component data. According to the report, arthroplasty for femoral neck fracture remains a commonly performed procedure with an aging but active demographic in the United States. Analyses were conducted for hemiarthroplasty in 2012-2015, although the reported incidence of this procedure was small in 2012 (Figure 14, above). Within our sample, hemiarthroplasty as a percentage of all total hip arthroplasty (THA) remains at approximately 10 percent. As additional studies report advantages in pain relief, functional outcomes, and reoperation rates for total hip arthroplasty for femoral neck fractures, our sample shows a marginally significant increase in the percentage of THAs performed for this diagnosis over the last four years (Figure 15, below).

Slides with all the tables and figures from the AJRR 2016 Annual Report can be found on our website. Feel free to use them in any talks, presentations, or lectures that you may have.
 

Upcoming Webinars and Calls
AJRR In-Person User Group Network Meeting
The AJRR User Group Network will host an in-person meeting during the 2017 AAOS Annual Meeting in San Diego. There will be a dial-in option for those that can't make it. The agenda for the meeting will be released soon.

The meeting and call will be held on:
  • March 15, 2017 at 11:30 a.m. Pacific Time
Register here to attend in-person or online.

Introductory Webinars
AJRR staff hosts monthly introductory webinars for those who are interested in joining the Registry and would like a basic overview of what we offer. If your institution resides in one of the CJR metropolitan statistical areas, this webinar should be of special interest to you! A demonstration of the new dashboards will be provided. Introductory webinars will be held at the following times this year:
To register for a session, click here.

Use Your Data to Your Advantage: Registry Participation Helps Show ASCs' Value
The Ambulatory Surgery Center Association (ASCA) has entered into a collaborative relationship with the AJRR. ASCA believes participation in the Registry is vital to its continued efforts to move total joint replacements to Medicare's ASC-payable list, and expand the number of private payers willing to reimburse its facilities for these procedures. During the webinar, AJRR Program Coordinators will provide an overview of clinical data registries, including: their history, what they are used for, and how the data can help ASCs in general. The Program Coordinators will walk through the AJRR enrollment process and discuss best practices for secure data submission and viewing data on the online dashboards.

This webinar is sponsored by the ASCA, and will be held on February 1, 2017 at 12:00 p.m. Central Time. Register here.

Previous Webinars
AJRR Orthopaedic Quality Resource Center: What You Need to Know  
If you were unable to attend AJRR Orthopaedic Quality Resource Center: What You Need to Know, a webinar we hosted with CECity, a Premier Inc. Company, we have a recording that you can view. Click  here to view the recording.

Registry Participation 101: A Simple Step-by-Step Guide to Understanding What You Really Need to Know from AJRR 
If you were unable to attend Registry Participation 101: A Simple Step-by-Step Guide to Understanding What You Really Need to Know from AJRR, a Wellbe, Inc. sponsored webinar, we have a recording that you can view. Click  here to view the recording.

Recordings and slides from all other previously held webinars can be found on our  website .
Our Newest Hospitals

We've welcomed these participants into the Registry since the last volume of the The Register:

#832 - Tallahassee Memorial Healthcare, Inc. in Tallahassee, FL
#833 - Lahey Hospital and Medical Center in Burlington, MA
#834 - IU Health Arnett Hospital in Lafayette, IN
#835 - The Beltway Surgery Centers in Indianapolis, IN
#836 - Eagle Highlands Surgery Center in Indianapolis, IN
#837 - IU Health Bedford Hospital in Bedford, IN
#838 - IU Health Blackford Hospital in Hartford City, IN
#839 - IU Health Bloomington Hospital in Bloomington, IN
#840 - IU Health Jay County Hospital in Portland, IN
#841 - IU Health Methodist Hospital in Indianapolis, IN
#842 - IU Health Morgan Hospital in Martinsville, IN
#843 - IU Health North Hospital in Carmel, IN
#844 - IU Health Paoli Hospital in Paoli, IN
#845 - IU Health Saxony Hospital in Fishers, IN
#846 - Saxony Surgery Center in Fishers, IN
#847 - IU Health Tipton Hospital in Tipton, IN
#848 - IU Health University Hospital in Indianapolis, IN
#849 - IU Health West Hospital in Avon, IN
#850 - IU Health White Memorial Hospital in Monticello, IN
#851 - Riley Hospital for Children at IU Health in Indianapolis, IN
#852 - Senate Street Surgery Center in Indianapolis, IN
#853 - Indiana Hand to Shoulder Surgery Center in Indianapolis, IN
#854 - Meridian South Surgery Center in Indianapolis, IN
#855 - Moses Taylor Hospital in Scranton, PA
#856 - Howard County General Hospital in Columbia, MD
#857 - Suburban Hospital in Bethesda, MD
#858 - The Johns Hopkins Hospital in Baltimore, MD
#859 - Alta Bates Summit Medical Center, Alta Bates Campus in Berkeley, CA
#860 - Alta Bates Summit Medical Center, Summit Campus in Oakland CA
#861 - Cedars-Sinai Medical Center in Los Angeles, CA
#862 - St. Mary Medical Center in Long Beach, CA
#863 - Stanislaus Surgical Hospital in Modesto, CA
#864 - Mills-Peninsula Medical Center in Burlingame, CA
#865 - Novato Community Hospital in Novato, CA
#866 - Sutter Medical Center, Sacramento in Sacramento, CA
#867 - Tahoe Forest Hospital in Truckee, CA
#868 - St. Joseph's Medical Center Stockton in Stockton, CA
#869 - St. John Broken Arrow in Broken Arrow, OK
AJRR currently has 869 participating hospitals in all 50 states and the District of Columbia! Click here for a full list of all participating sites.


AJRR in the News

Media publications continue to cover the release of the AJRR 2016 Annual Report:

Special Thanks to Each of Our Supporters!



The Register is the official newsletter of the American
 
Joint Replacement Registry serving to connect the 
orthopaedic community. For questions, comments, 
or concerns, please contact Erik Michalesko, Marketing 
and Communications Specialist at michalesko@ajrr.net.

The Register editor: Erik Michalesko
©2017. All rights reserved.