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

As we begin 2015, I would like to acknowledge the progress AJRR has seen this past year. AJRR was designated as a Qualified Clinical Data Registry (QCDR) by the Centers for Medicare & Medicaid Services (CMS) this past May and can now report Physician Quality Reporting System (PQRS) measures for all Eligible Professionals (EPs). AJRR surpassed its recruitment goal and expanded to have participating hospitals in all 50 states! Many participating hospitals were given access to our Demand Reporting & Electronic Dashboard System and can now run reports as well as access national benchmarking on their submitted data. AJRR also relocated to a beautiful suite within the new AAOS building located just blocks from our old building in Rosemont, Ill.

The New Year brings about exciting times anticipated for AJRR in 2015. We have refreshed The Register format; bringing you informative and useful news you can use to keep up-to-date on our happenings. The electronic format will make it easier for you to read and link to our content. We also encourage you to engage with us on our various social media platforms where we have the ability to be timely with updates. At the AAOS Annual Meeting in March, we will be hosting our first User Group meeting, so save the date and watch for more information. We would also like to welcome our 2015 Board of Directors and thank the ones who have made the AJRR what it is today - we could not have done it without you!

We look forward to continued growth and expansion in 2015 thanks to the increasing support of the orthopaedic community and the hard work put in each day by AJRR staff (as pictured in the photo below). A very wonderful and prosperous New Year to all our leaders, volunteers, and hospital staff members who realize the importance of a national arthroplasty registry.

Many thanks,

Jeffrey P. Knezovich, CAE
Executive Director


Congratulations to Our 2015 AJRR Board of Directors!
Executive Committee
Chair - Daniel J. Berry, MD, Hip Society Representative
Vice Chair - Kevin J. Bozic, MD, MBA, AJRR Representative
Secretary Treasurer - David E. Mino, MD, MBA, Payer Representative
Industry Observer - Pamela L. Plouhar, PhD

Michael R. Dayton, MD, AAOS Representative
Craig J. Della Valle, MD, Knee Society Representative 
Blair Fraser, Industry Representative
Robert L. Krebbs, Payer Representative
Gregory B. Krivchenia, II, MD, AAOS Representative
Kristen Murtos, AHA Representative
Colin Nelson, Patient/Public Representative
E. Anthony Rankin, MD, AAOS Representative
Scott M. Sporer, MD, AAOS Representative
Bryan D. Springer, MD, AAHKS Representative

Jeffrey Knezovich, CAE, Ex-Officio
David G. Lewallen, MD, Ex-Officio

A special thanks to the Board Members whose terms have come to a close: Chair William J. Maloney, MD, AAOS Representative,Terence J. Gioe, MD, Knee Society Representative, Secretary Treasurer Steven H. Stern, MD, MBA, Payer Representative, and Eric Rugo, MBA, Industry Representative. We appreciate your services and efforts in advancing the AJRR mission! 

AJRR at the 2015 AAOS Annual Meeting

AJRR will be in attendance at the 2015 AAOS Annual Meeting in Las Vegas, Nev. at the Venetian/Sands EXPO from March 23-28, 2015. The AJRR Board of Directors meeting will be held on March 23. On March 25 from 10:30 a.m. - 12:30 p.m we will be hosting our first User Group Meeting (during our info session). Our staff will be on site all week during exhibit hours. Please stop by our booth in Academy Hall G if you are in town! Look for more Annual Meeting updates in our upcoming newsletter that will be released in early March and on our social media sites!


ISAR 4th International Congress of Arthroplasty Registries

AJRR will be in attendance at the 4th International Congress of Arthroplasty Registries that will take place from May 23-25, 2015 in Gothenburg, Sweden. For more details on registration rates, hotel accommodation, and deadlines, click here or contact ISAR at isar2015@registercentrum.se

AJRR currently has 423 participating hospitals in all 50 states! Click here for a full list of all participating sites.

From the Hill
By Judi Buckalew, BSN, MPG

In 2014, AJRR realized the rewards of an intense legislative and regulatory advocacy effort focused on two goals: to convince the HHS Office of Human Research Protection (OHRP) to issue a guidance clarifying the applicability of the Common Rule to clinical data registries and to introduce legislation granting QCDR access to Medicare claims data.

On August 7, 2014, Representative Kevin Brady (R-TX), Chair of the House Ways & Means Health Subcommittee introduced the Protecting Integrity in Medicare Act. The bill included the AJRR language sponsored by Representative Bill Pascrell (D-NJ) directing OHRP to issue guidance clarifying applicability of the Common Rule to clinical data registries. In October 2014, OHRP posted clarification on applicability of the Common Rule to clinical data registries on their website. Click here to read more.

In late November 2014, the House Ways & Means Committee released the
Hospitals Improvements for Payment Act which contains language sponsored by the incoming Chairman Paul Ryan (R-WI) granting Qualified Clinical Data Registries access to Medicare claims data for purposes of research. AJRR will make enactment of this legislation a priority in 2015.

Data Chat

This is a new feature to The Register where we will address your IT issues and concerns. Feel free to send your questions to miller@ajrr.net

Q: Does AJRR work with all electronic medical record (EMR) systems?

A: AJRR works with all EMR systems. Some of the EMR system organizations we work with, such as EPIC, have created templates for AJRR data submission that can be accessed by contacting your EPIC representative. Cerner is also in the process of developing similar templates. AJRR IT staff regularly works with other EMR vendors and have developed best practices for hospitals that will need to create their own reports to pull the data. For more information, please contact miller@ajrr.net

By Caryn Etkin, PhD, MPH

AJRR is collaborating with CMS to facilitate data submission for the PQRS. We have partnered with CECity, a provider of cloud-based registry platforms and certified PQRS vendor, to create a custom platform for PQRS data submission directly to CMS. Through our partnership, the system can aid EPs who wish to submit data pertaining to Total Knee Replacement only. We anticipate measures pertaining to Total Hip Replacement will be available in 2015.

It should be noted that submitting Level I data to AJRR does not satisfy PQRS reporting requirements. The PQRS submission process is designed to be a separate procedure covering data elements not currently included in the AJRR Level I platform. Successful submission requires EPs to submit data on nine PQRS measures and one patient reported outcome measure for at least 50% of eligible patients. The deadline to submit 2014 measures is Friday, March 13, 2015. To register and/or submit your 2014 measures related to Total Knee Replacement, please visit www.medconcert.com/ajrr.


Champions of the Quarter

Each quarter, AJRR highlights individuals from participating hospitals who have championed AJRR enrollment and have demonstrated outstanding cooperation and professionalism while helping to implement the registry into their institutions. Selections for Champions of the Quarter are made based on nominations and are voted on by AJRR staff. To nominate someone from your hospital, please contact miller@ajrr.netThis quarter, AJRR would like to recognize Ms. Gwen Gratto-Cox from Southeast Georgia Health System in Brunswick, Ga. and Ms. Cheryl Talamo from Doylestown Hospital in Doylestown, Pa.
Ms. Gwen Gratto-Cox

Ms. Gratto-Cox has been working for Southeast Georgia Health System for two years overseeing daily research activities and ensuring compliance with research protocols while enjoying the opportunity to assist physician investigators in offering cutting edge treatment options to patients in their own community.

Q: What do you enjoy most about AJRR?

A: AJRR has provided the orthopaedic community with a versatile and invaluable tool. With the option to enter data electronically, manually, or a combination of both, it is well suited for use with electronic health record systems of varying capability.

Q: Would you recommend enrollment with AJRR to others?

A: Absolutely! This is the best initiative for improving the outcomes of total joint replacement on both the local and national level. 

Ms. Cheryl Talamo
Ms. Talamo has been working for Doylestown Hospital for the past 16 years and is currently the Director of the Orthopaedic Institute. She enjoys the challenge that coordinating a joint program presents. Ms. Talamo holds a Master's degree in Physical Therapy from the Philadelphia College of Pharmacy and Science, and her participation has been integral in AJRR's pilot studies.

Q: What made you decide to enroll your site in AJRR?

A: One of our physicians went to a national conference and encouraged us to explore joining the AJRR, even though it was still in its infancy phase. Without hesitation, we wanted to be involved in the registry. AJRR's purpose of improving quality of care was strategically in line with our Joint Program and Doylestown Hospital

Q: What benefits have you seen since joining the registry?

A: By being a pilot facility for Level II and Level III data, I have had the ability to see firsthand the benefits of the Registry. The Registry not only provides a database for implant tracking, but will have the ability for facilities to collect quality measures throughout the continuum for benchmarking.
AJRR in the News

In November of 2014, AJRR released its first Annual Report on total hip and knee arthroplasty dataModern Healthcare also recognized our Annual Report. To access the full article, click here.

AJRR and Operation Walk USA - Surgeons provided free hip, knee replacements in December. Learn more

Inroads made tracking patient progress as seen in The Examiner -Learn more
Publications of Interest

Jameson SS, Mason J, Baker P, Gregg PJ, Porter M, Deehan DJ, Reed MR. Have cementless and resurfacing components improved the medium-term results of hip replacement for patients under 60 years of age? Patient-reported outcome measures, implant survival, and costs in 24,709 patients. Acta Orthopedica. 2014 Oct; [Epub ahead of print].

Lindberg-Larsen M, Jorgensen CC, Hansen TB, Solgaard S, Kehlet H.
Early morbidity after aseptic revision hip arthroplasty in Denmark a two-year nationwide studyBone Joint J. 2014 Nov; 96-B(11):1464-1471.

Mohaddes M, Rolfson O, Karrholm J. Short-term survival of the trabecular metal cup is similar to that of standard cups used in acetabular revision surgery: Analysis of 2,460 first-time cup revisions in the Swedish Hip Arthroplasty RegisterActa Orthopaedica. 2014 Nov; [Epub ahead of print].  

For a full list of publications of interest, click here.
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 Terra Miller, Marketing and Communications Specialist at miller@ajrr.net

The Register editor: Terra Miller, MS
Contributing authors: Lori Boukas, Caryn Etkin, PhD, MPH, Judi Buckalew, BSN, MPG.

2015. All rights reserved.