Letter from the Executive Director
AJRR Executive Director
Jeffrey P. Knezovich, CAE

As announced during last month's newsletter, we are in the process of migrating our platform and consolidating efforts from the California Joint Replacement Registry (CJRR) and AJRR into one platform. Our continued growth and ability to provide expanded services comes down to our ability to adapt to the growing big data environment and being able to support orthopaedic quality initiatives. For all of these reasons, we will be updating and enhancing our platform over the course of the next year. This digital transformation effort will result in a completely new and innovative solution architecture. The results will provide a uniquely different environment that is secure, scalable, and highly adaptable to meet the evolving and changing needs of the health care industry.

This evolution facilitates AJRR's expansion and support of quality initiatives such as the government's Comprehensive Care Joint Replacement (CJR) model, as well as, insurers quality distinction programs. These changes foster a powerful environment to collect patient-reported outcome data directly from the patient using the device of their choosing, and the capability to capture outcome data from third party vendors collecting data on behalf of participating providers. Most importantly, AJRR is launching a new reporting and analytics platform that provides a user-friendly interface that allows participants to run a multitude of comparisons and drill-down functionality against national benchmark data including risk adjusted patient outcome data.
Each month in The Register, I will provide an update on our efforts and what it means to you. We're feverishly working away to be able to all be on one platform by January 1, 2017, with future enhancements coming in the first half of 2017. To be extremely transparent during this process, we are providing ongoing communications to help address any issues that you may have. The following resources are available to you now that might address some of your questions:
We are extremely thankful for each and every institution that provides data to the largest Registry of hip and knee arthroplasty procedures in the United States. Just hitting the half million mark of procedures this past month has been an exciting milestone and we intend to continuously enhance and improve our platform so it can grow and expand with us.

Welcome to the AJRR, Reagan Bayer
AJRR Director of Project Management and
Business Analysis

Ms. Reagan Bayer
We would like to welcome Ms. Reagan Bayer to the AJRR staff. She started in the newly created position of  Director of Project Management and Business Analysis on August 22.
Ms. Bayer received her Bachelor of Arts in History from Wayne State University in Detroit, MI. She went on to graduate with a Master of Business Administration from Western Governors University in Salt Lake City, UT. Ms. Bayer's project management experience goes back almost 15 years.  Most recently, Ms. Bayer worked as the Sr. Director of Strategic Program Management at the YMCA of the USA (Y-USA). At Y-USA, she developed and implemented a robust change management plan to support the business process transformation from a highly manual, disparate business process to a fully automated, custom developed, self-service, web-based training portal. She has received the Project Management Professional (PMP) certification from the Project Management Institute.

We look forward to leveraging Ms. Bayer's skills and experience to coordinate and lead the work efforts to expand our role as a quality Registry and build technology capacity.
2016 Reporting Launched for AJRR PQRS and Meaningful Use Platform

2016 reporting is now available for the AJRR Orthopaedic Quality Resource Center. The platform offers an improved web portal that allows for eligible professionals (EPs) and institutions to participate in both the Physician Quality Reporting System (PQRS) and Meaningful Use programs. Through collaboration with the American Association of Hip and Knee Surgeons (AAHKS), the American Orthopaedic Association (AOA), and CECity, a Premier Inc. Company, we are able to deliver a comprehensive solution to several quality needs in the 2016 calendar year.
Our collaboration with AOA and AAHKS this year adds extra measures, bringing our total to 38 PQRS and custom measures. AOA's quality improvement program Own the Bone supports the expansion of the platform by including two additional PQRS post-fracture measures. The AAHKS partnership adds four additional custom measures documenting process and outcomes for hip arthroplasty patients.
To access the AJRR Orthopaedic Quality Resource Center, click here. On September 7 at 1:00 p.m. EDT, AJRR and CECity are providing an overview on the benefits of the platform in the form of a webinar. Register for it here.
Register Today for the 26th AAHKS Annual Meeting

The American Association of Hip and Knee Surgeons (AAHKS) 26th Annual Meeting is only two months away. Register now to secure your attendance.

Each year, the Annual Meeting attracts more than 1,300 attendees. The 2016 meeting will be held from November 10 - 13 in Dallas, Texas. Some of the topics covered will include  implant design, outcomes, surgical techniques, and complications of primary and revision total joint arthroplasty (TJA) for hip and knee surgeons, and the latest socioeconomic issues in health care. Special courses are also offered for residents, non-physician team members, and hospital administrators. The topics of these courses are as follows: the 8th Annual Resident Arthroplasty Course, the 8th Annual Orthopaedic Team Course, and the Business of Total Joint Replacement: Surviving and Thriving.

In addition to courses, relevant orthopaedic organizations will have booths at the meeting. Our staff members will be at a booth, providing information about the National Registry and offering dashboard demonstrations to interested attendees. Be sure to stop by to grab a hard copy of our 2016 Annual Report!
If you would like to register and plan your trip to the AAHKS Annual Meeting, click here.
2017 ISAR Annual Meeting in San Francisco
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 in San Francisco, CA. The conference will be held at the PARC 55 San Francisco hotel. Each year, the AJRR and the California Joint Replacement Registry (CJRR) sends representatives to present research and display posters. The 2016 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 to a Napa Valley wine tasting on May 19. The California Joint Replacement Registry (CJRR) Annual Meeting will also be held in San Francisco during this time.
To register for the 6th Annual International Society of Arthroplasty Registers Congress, look for a sign up link on the ISAR website this fall.
CJRR Q & A Webinar Next Week
The California Joint Replacement Registry (CJRR) is in the process of finalizing the merger into the AJRR with a planned completion date of January 1, 2017. There will be changes for both CJRR and AJRR participants, but we are working to make it as seamless as possible. If you have any questions or concerns about this transition, attend our CJRR Q & A Webinar on Wednesday, September 14 at 10:00 a.m. Pacific Time. During the webinar, California Program Coordinator Phil Dwyer and the AJRR executive staff will answer any questions you may have. If you are unable to attend, a recording will be made available afterwards.
To register for this webinar, click here.
Half Million Procedures Milestone Reached
As of August 2016, we've reached the milestone of 500,000 hip and knee procedures within our system. This brings us closer to our goal of collecting 90% of all hip and knee replacement procedures performed in the United States. We have over 800 participating hospitals, ambulatory surgery centers, and private practice groups, and data from nearly 5,500 surgeons. 

We began with 15 pilot hospitals in 2010. In six years, we've increased our participants by more than 50 times. About a million hip and knee procedures are performed in America; we currently increase at a rate of about 4,000 procedures a week, so although we have had tremendous growth, we still have a long way to go.

For a press release announcing this milestone, click here.
Authorized Vendor Profile 

Company Name: Q-Centrix
Company Website: www.q-centrix.com
AJRR Vendor Since: June 2016
General Description: Q-Centrix aims to measurably improve the quality and safety of patient care in the U.S. through the use of its market-leading technology platform, Q-Apps, coupled with the industry's largest and broadest team of nurse-educated, quality information specialists. Processing in excess of one million quality data transactions annually, Q-Centrix is a comprehensive quality partner to hundreds of hospitals, providing quality data management solutions, including quality data capture, surveillance, measure calculations, analysis, reporting, and improvement solutions. Ultimately, Q-Centrix empowers clinical teams to focus on data-based quality improvement initiatives rather than simply reporting the data.
Solutions Offered:
Retrospective Solutions
  • Client-specific registries
  • Commercial health plans
  • Custom protocols
  • National registries
  • Mortality reduction
  • Peer review
  • Regulatory measures
  • State-specific registries
Real-Time Solutions
  • Concurrent review of regulatory measures
  • Concurrent review of registries
  • Custom quality protocol surveillance
  • electronic Clinical Quality Measures (eCQM)
  • Infection prevention
  • Readmission reduction
  • Q-Insights
  • Q-Registries
Integration with AJRR: The greatest barrier to Registry participation is the data abstraction and reporting. Q-Centrix has a team of more than 600 nurse-educated, quality information specialists who work remotely to abstract and report Registry data including the AJRR's. Thanks to their deep bench of quality expertise and unique technology platform, Q-Apps, Q-Centrix helps hospitals break down this barrier to participation more efficiently than any other organization.
Fun fact: 83% of the Q-Centrix team of 600 nurse-educated, quality information specialists have 10+ years of experience within a hospital. Their combined experience equals more than 5,000 years within a hospital environment.

A full list of AJRR's Technology Partners can be found  here .
Data Corner

Our 2014 Annual Report has a wealth of information on procedural and component data. Figure 27 (pictured above) contains some interesting findings.  Dislocation and infection were the leading causes of early revision procedures following total hip arthroplasty. A peri-prosthetic fracture around the prosthetic joint was a close third, while other mechanical complications of prosthetic joint implants and mechanical loosening of prosthetic joints had significantly fewer incidences among AJRR patients.

Slides with all the tables and figures from the 2014 Annual Report can be found on our website .
Upcoming Webinars

Introductory Webinars
AJRR staff has once again begun hosting 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:
  • September 28, 2016 at 12:00 p.m. CT
  • October 12, 2016 at 12:00 p.m. CT
  • November 16, 2016 at 12:00 p.m. CT
To register for one of these sessions, click here.

Previous Webinars

Patient-Reported Outcomes Informational Webinar
Our Analytics team hosted an informational webinar about the AJRR Level III/patient-reported outcomes (PRO) platform on both December 9, 2015 and January 6, 2016. Recommended PRO measures were discussed, as well as the reasons for why starting a PRO data collection program is beneficial. Our Director of IT demonstrated how to use the new dashboard system, and along with the Analytics team, fielded questions on how to get started reporting.  To listen to a recording of the webinar, click here. To view the slides, click here.
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 Register:

#741 - Mercy Hospital Fort Smith in Fort Smith, AZ
#742 - Mercy Orthopedic Hospital Fort Smith in Fort Smith, AZ
#743 - Advocate Eureka Hospital in Eureka, IL
#744 - Mercy Medical Center in Cedar Rapids, IA
#745 - Tradition Medical Center in Stuart, FL
#746 - Martin Medical Center in Stuart, FL
#747 - Martin Hospital South in Stuart, FL
#748 - Northside Medical Center in Columbus, GA
#749 - Regional Hospital of Scranton in Scranton, PA
#750 - Signature Healthcare Brockton Hospital in Brockton, MA
#751 - Wake Forest Baptist Health - Lexington Medical Center in Lexington, NC
#752 - Wake Forest Baptist Medical Center in Winston - Salem, NC
#753 - Wake Forest Baptist Health - Davie Medical Center in Bermuda Run, NC
#754 - Fresno Surgical Hospital in Fresno, CA
#755 - St. Joseph Regional Medical Center in Mishawaka, IN
#756 - St. Mary's Hospital in Athens, GA
#757 - St. Mary's Medical Center in Langhorne, PA
#758 - Mercy Medical Center in Dubuque, IA
#759 - St. Agnes Medical Center in Fresno, CA
#760 - St. Mary's Hospital in Waterbury, CT
#761 - Johnson Memorial Hospital in Stafford Springs, CT
#762 - Mercy Medical Center of Sisters of Providence in South Hadley, MA
#763 - Saint Francis Healthcare in Wilmington, DE
#764 - Holy Cross Hospital in Fort Lauderdale, FL
#765 - St. Mary's Good Samaritan Hospital in Greensboro, GA
#766 - St. Joseph Plymouth Medical Center in Plymouth, IN          
#767 - Gottlieb Memorial Hospital in Melrose Park, IL
#768 - Loyola University Medical Center in Maywood, IL
#769 - Mercy Hospital and Medical Center in Chicago, IL
#770 - Mercy Medical Center - Mason City in Mason City, IA
#771 - Mercy Medical Center - Clinton in Clinton, IA
#772 - Mercy Medical Center - New Hampton in New Hampton, IA
#773 - Mercy Medical Center - Sioux City in Sioux City, IA
#774 - Baum Harmon Mercy Hospital in Primghar, IA
#775 - Oakland Memorial Hospital in Oakland, NE
#776 - Dunes Surgical Hospital in Dakota Dunes, SD
#777 - Holy Cross Hospital in Silver Spring, MD
#778 - Holy Cross Germantown Hospital in Germantown, MD
#779 - Mercy Health Muskegon in Muskegon, MI
#780 - Mercy Health Saint Mary's in Grand Rapids, MI
#781 - Mercy Health Hackley in Muskegon, MI
#782 - Mercy Health Lakeshore in Shelby, MI
#783 - Mercy Health Southwest in Byron Center, MI
#784 - Mercy Medical Center in Springfield, MA
#785 - Lourdes Medical Center of Burlington County in Burlington, NJ
#786 - Our Lady of Lourdes Medical Center in Camden, NJ
#787 - Saint Michael's Medical Center in Newark, NJ
#788 - St. Francis Medical Center in Trenton, NJ
#789 - Mount St. Mary's Hospital in Lewiston, NY
#790 - St. Mary Hospital in Amsterdam, NY
#791 - Albany Memorial Hospital in Albany, NY
#792 - Mount Carmel East in Columbus, OH
#793 - Mount Carmel West in Columbus, OH
#794 - Mount Carmel St. Ann's in Westerville, OH
#795 - New York-Presbyterian/Queens in Flushing, NY
#796 - Genesis Hospital in Zanesville, OH
#797 - St. Luke's Medical Center in Phoenix, AZ
#798 - Tempe St. Luke's Hospital in Tempe, AZ
#799 - Mountain Vista Medical Center in Mesa, AZ
#800 - Chan Soon-Shiong Medical Center in Windber, PA
#801 - Clovis Community Medical Center in Clovis, CA
#802 - Confluence Heath in Wenatchee, WA
#803 - Cape Coral Hospital in Cape Coral, FL
#804 - Gulf Coast Medical Center in Fort Myers, FL
#805 - Lee Memorial Hospital in Fort Myers, FL

AJRR currently has   805   participating hospitals in all 50 states! Click here for a full list of all participating sites.

AJRR in the News

AAOS Now published an article about our new User Group Forum in their August issue:

Our press release about reaching a half million procedures received coverage from a few orthopaedic publications:

We collaborated with Q-Centrix to create a press release announcing how we are working together to help hospitals. Press release distributor Marketwired published it:

To view all of our p ress releases, click here .

Special Thanks to All of Our Contributors!
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
Contributing author: Lori Boukas

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