AJRR and CJRR Form Affiliation

On April 1, 2015, the California Joint Replacement Registry (CJRR) and the American Joint Replacement Registry (AJRR) announced the transfer of the CJRR to AJRR. Both registries collect clinical information about hip and knee arthroplasties. This new relationship will help advance the mission to provide better outcomes for California and throughout the U.S. 

Approximately 45 hospitals and their affiliated surgeons contribute data to CJRR. These hospitals perform more than one third of the total volume of hip and knee replacements in the state. AJRR has 30 participating sites in California, 18 of which participate in CJRR.

"CJRR brings a wealth of knowledge and expertise in collecting and reporting robust,
standardized patient-reported outcomes, which we are excited to see integrated into AJRR," said Daniel J. Berry, MD, Chair of the AJRR Board of Directors. "This affiliation will help us to provide the best service possible to all participating institutions and surgeons throughout the country." 

The agreement continues a tradition of collaboration between the two organizations. Over several years, the two registries have worked to align data elements, share resources, and support shared policy objectives. In addition, there is significant overlap among leadership.

"Since CJRR's founding in 2009, we have always had the vision that CJRR would become park of the national total joint replacement registry effort when mature," said Kevin Bozic, MD, MBA, founding Chair of CJRR and current Vice Chair of AJRR. "This union will allow AJRR to capitalize on the expertise in measuring patient-reported outcomes that we have developed in California over the past six years, and allow Californians to have an impact on the national effort to improve total joint replacement patient outcomes." 

For a list of frequently asked questions, click here. More information can also be found at www.ajrr.netwww.caljrr.net or by contacting Kate Witherspoon, MPA at witherspoon@ajrr.net.


AJRR at the 2015 AAOS Annual Meeting

AJRR attended the 2015 AAOS Annual Meeting in Las Vegas, Nev. at the Venetian/Sands EXPO where the AJRR Board of Directors Meeting and the first User Group Meeting took place. Our staff was on site all week during exhibit hours and enjoyed getting to meet with many current and future AJRR users. Shown below are a few pictures taken during the User Group Meeting. If you would like more information about the AJRR or would like to become a member of the User Group Network, 

please contact Terra Miller at miller@ajrr.net


Ms. Cecily Fromeke from Providence Health & Services asks a question of the panel (Karla Baber, Judy Casper, and Susan Mehle
AJRR Secretary Treasurer Dr. David E. Mino, MBA addresses the crowd
AJRR Board Member Mr. Colin Nelson discusses perspectives on the AJRR


ISAR 4th International Congress of Arthroplasty Registries

AJRR will be in attendance at the 4th International Congress of Arthroplasty Registries taking place May 23-25, 2015 in Gothenburg, Sweden, home of the Swedish Hip Arthroplasty Register. Dr. Caryn D. Etkin, Director of Analytics will be giving podium presentations on the AJRR Level II Pilot Study and an overall update on the progress of AJRR. Dr. David G. Lewallen will be moderating a session on statistical methodologies in registry studies. For more details on registration rates, hotel accommodations, and deadlines, click here.

AJRR currently has 468 participating hospitals in all 50 states! Click here for a full list of all participating sites.

From the Hill
By Judi Buckalew, BSN, MPH

AJRR Applauds Congress for Enacting SGR Repeal and

Medicare Provider Payment Modernization Act

Rosemont, Ill. - April 15, 2015 - The American Joint Replacement Registry (AJRR) applauds Congress for enacting the SGR Repeal and Medicare Provider Modernization Act of 2015. AJRR appreciates the hard work and difficult decisions that have resulted in a bipartisan solution for a better solution for providing Medicare payments to physicians. The legislation contains provisions of importance to Qualified Clinical Data Registries (QCDR) and clinical data registries that will greatly improve the ability of these organizations to provide improved patient care and safety...Read more.

Data Chat

This feature of The Register is where we will address your IT issues and concerns. Feel free to send your questions to miller@ajrr.net.
Q: How many procedures does AJRR have in the database?

A: There are 468 hospitals participating in the AJRR. These hospitals are located in all 50 states of the U.S. Each week, we receive approximately 4,500 procedures from hospitals completing monthly data submissions. This brings the total number of procedures in the Registry to 249,800. 

Q: When can I submit Level II and Level III data?

A: Beginning on July 1, 2015 we will be able to accept your Level II data and warehouse it within our registry. However, with the upcoming transition to ICD-10, an adjustment to replace the ICD-9 triggering codes with ICD-10 will be necessary. Our IT staff is in the process of preparing our database to be compliant with the October 1, 2015 deadline imposed by CMS. Once this is completed, any Level II data submitted to the AJRR will be available on the reporting dashboards.

We continue our Level III data pilot and will make refinements to the platform based on results from the pilot. We are also in the process of adding new measures to our system, including the VR-12, PROMIS-10, HOOS Physical Function Shortform (HOOS-PS), and the KOOS Physical Function Shortform (KOOS-PS). We are anticipating an end-of-year rollout for Level III data submission. 
AJRR Total Joint Replacement Risk Calculator

AJRR recently received the Total Joint Replacement (TJR) Risk Calculator by Ortho Apps, a collaborative of Massachusetts General Hospital, Mayo Clinic, and the University of California, San Francisco. The TJR Risk Calculator is intended to assist surgeons in assessing risk associated with each patient undergoing a procedure in relation to their comorbidities and demographics.

Surgeons input the data into the calculator, and the risk is displayed in two graphs: Patient Mortality within 90 Days and Periprosthetic Joint Infection within Two Years. Each graph displayed contains a comparison between the patient with the selected demographics and comorbidities, a patient with similar demographics but no co-morbidities, and the Medicare population average. 

There is no fee associated with accessing the TJR Risk Calculator. Click here to start utilizing this great tool! For more information, contact Randy Meinzer, Director of Information Technology at meinzer@ajrr.net


As a QCDR, AJRR now has the opportunity to provide a new standard for eligible professionals (EPs) to satisfy PQRS requirements. AJRR partnered with CECity, healthcare's leading provider of cloud-based registry platforms for performance improvement, value-based payment, and professionalism, to create a custom PQRS reporting platform specifically for AJRR participants to submit data to CMS. This platform ensures that all participating EPs meet all requirements before submitting their PQRS reports to CMS for payment.


By participating in PQRS reporting through the AJRR Orthopaedic Quality Resource Center, EPs have a mechanism to report to CMS their Medicare patient data, while being provided with timely, continuous performance monitors, performance gap analysis and patient outlier identification, access to patient care management tools, targeted education, and various resources used to close performance gaps, and registry benchmarks. 


Beginning in 2015, the program will apply a negative payment adjustment to EPs and PQRS group practices who did not satisfactorily report data on quality measures for covered professional services in 2013. Those who report satisfactorily for the 2015 program year will avoid the 2017 PQRS negative payment adjustment. 


For more information on PQRS or the payment adjustment, visit the PQRS webpage at www.CMS.gov.

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.net

This quarter, AJRR would like to recognize Ms. Karla Barber from Centura Health in Lakewood, Colo.Ms. Judy Casper from Midwest Orthopedic Specialty Hospital (MOSH) in Franklin, Wis., Ms. Kim Kimberling from Texas Health Harris Methodist Hospital Southwest Fort Worth in Fort Worth, Texas, and Ms. Susan Mehle from HealthEast Care System in St. Paul, Minn.
Ms. Karla Barber

Ms. Barber has been working for Centura Health for the past 17     years and is currently the Director of Clinical Value Analysis. She         serves as a liaison with physicians, clinical areas, and vendors to         facilitate the resolution of clinical issues and is an integral part of       the facility-based senior leadership decision making body. She also served as a panelist for the first AJRR User Group Meeting.

Q: Do you enjoy working with the AJRR staff?

A: Absolutely! They are easily accessible, positive, encouraging, and extremely knowledgeable!

Q: What do you like most about your job?

A: I enjoy serving as a patient advocate from a corporate level and impacting our whole patient population from a system perspective. 

Ms. Judy Casper
Ms. Casper has been working for MOSH for the past two years as the Clinical Data/Research Coordinator. In this position, Ms. Casper manages all data entry, submission, abstraction, management, and reporting for all internal and external orthopedic databases and registries. Ms. Casper was also on site at the AJRR User Group Meeting as a panelist.

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

A: It was a really easy decision. MOSH's physicians and management set a very high standard for themselves and for the facility. Participation in AJRR supports that standard.

Q: What do you like most about the AJRR?

A: The potential for data-driven change that it affords. The AJRR has taken on a monumental task, and I believe they even surprise themselves when it comes to how successful they have been. It speaks to a well-conceived plan that is being effectively executed.

 Ms. Kim Kimberling
Ms. Kimberling has been working for Texas Health Harris Methodist Hospital Southwest Fort Worth for the last nine 
years as the Orthopedic Service Line Coordinator and has been working for the Texas Health Resources system for the last 10 years. In this position, Ms. Kimberling oversees the operational management, strategic planning, quality management, and customer engagement for our Orthopedic Service Line.

Q: Are you still involved with AJRR participation and data submission? If so, what is your role?

A: Once I receive a data file, I perform some formatting changes, check for any missing fields or inaccuracies, and submit the data to AJRR. I also run reports AJRR has available through their site and share the information with our Orthopedic Quality and Data Management Committee.

Q: What do you like most about the AJRR?

A: Their great staff! They have been very responsive to any questions I had during the enrollment and data submission process.

Ms. Susan Mehle
Ms. Mehle has been working for HealthEast Care System
for 19 years and is currently the Director of Data Science. She analyzes large organizational data sets to answer specific questions and improve outcomes for patients and their families. Ms. Mehle also served as the Moderator at the first AJRR User Group Meeting in Las Vegas, Nev. last month. 

Q: What is your favorite thing about your job?

A: I really enjoy sitting down with my internal customers - surgeons, clinicians, administrators, etc. - and reviewing what my team has found in the data that we can use to improve what we do.

Q: Would you recommend enrollment with AJRR to others?

A: YES! The more coverage we have across the U.S., the better our results will be. It becomes a matter of public health, and as keepers of that data, it is our responsibility to see it's used to improve the health of our communities.The data that comes back is also useful and important in operations for the hospital as well. 

AJRR in the News

Here are some more articles detailing the AJRR and CJRR affiliation!

AJRR Launches New User Group Network 

The 2015 AJRR Board of Directors was formally announced. To find out more about the members, click here

AAHKS Update

The American Association of Hip and Knee Surgeons (AAHKS) has published the first issue of Arthroplasty Today! The journal brings totgether the clinical and scientific foundations for hip and knee replacements and solicits manuscripts of the highest quality from all areas that relate to joint replacements or the treatment of complications.

Visit www.arthroplastytoday.org to read the open-access articles, sign-up for automated alerts when new articles are in press, and submit manuscripts for publishing. 

Publications of Interest

Kandala N-B, Connock M, Pulikottil-Jacob R, Sutcliffe P, Crowther MJ, Grover A, Mistry H, Clarke A. Setting benchmark revision rates for total hip replacement: Analysis of registry evidence. BMJ. March 9, 2015; 350:h756.

Naranje S, Lendway L, Mehle S, Gioe TJ. Does operative time affect infection rate in primary total knee arthroplasty? Clin Orthop Relat Res. January 2015, 473(1): 64-69. 

Robertsson O, W-Dahl A. The risk of revision after TKA is affected by previous HTO or UKA. Clin Orthop Relat Res. January 2015; 473(1): 90-93. 

Sabah SA, Henckel J, Cook E, Whittaker R, Hothi H, Pappas Y, Blunn G, Skinner JA, Hart AJ. Validation of primary metal-on-metal hip arthroplasties on the National Joint Registry for England, Wales and Northern Ireland using data from the London Implant Retrieval Centre: A study using the NJR dataset. Bone Joint J. January 2015; 97-B(1): 10-18. 

Torosyan Y, Kurtz SM, Mihalko WM, Marinac-Dabic D, Rimnac CM. Editorial: Arthroplasty devices: Registries and Beyond. Clin Orthop Relat Res. February 2015; 473(2): 403-405. 

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, MPH.

2015. All rights reserved.