CJRR is pleased to provide you with information and news you can use
pertaining to your participation in the Registry.
CJRR Medical Director 
James I. Huddleston, III, MD
Letter from CJRR's Medical Director

It is a pleasure to welcome you to the first issue of the Golden Register, the California Joint Replacement Registry's (CJRR) newsletter dedicated to providing information to its users and participants. 2015 was an exciting year for CJRR, and 2016 is off to a similar start. 

Enrollment continues to grow exponentially, as we now have 41 participating institutions in the CJRR. Also, we have begun a project with the Yale Center for Outcomes Research and Evaluation (CORE) to help develop performance metrics based on patient-reported outcome (PRO) instruments. With the April 1 deadline for implementation of the Comprehensive Care for Joint Replacement (CJR) program rapidly approaching, we have increased our recruitment efforts to assist the joint replacement community in facilitating collection of PRO measures.

Lastly, we hope you will take the time to join us for the CJRR Annual Meeting, a status update webinar on February 12 from 9:00 am -12:00 pm Pacific Standard Time. The proposed agenda is provided in the article below. Please let us know if you have any additional items that you would like to see covered in the meeting.


James I. Huddleston, III, MD
Join Us for CJRR's Annual Meeting Webinar

The 2016 CJRR Annual Meeting will be held via webinar on February 12 from 9 am to noon, PST. All CJRR hospital staff are welcome to attend. As of now, the meeting will be split into six sessions, lasting around 30 minutes each. The proposed meeting agenda is as follows:
Dr. Huddleston will moderate the meeting. In attendance will be staff from CJRR participating hospitals and members of the California Data Use Group (CDUG) staff and leadership. The first session will review the 2014 data presented in the CJRR 2014 Annual Report. Discussion will then move on to the CJRR/Yale Collaborative, which will be the focus of Session II. The participating institution and goals of the collaborative project will be announced.
Session III will cover public reporting activities and the California Hospital and Reporting Task Force (CHART), and Session IV will cover patient-reported outcome collection methods. AJRR's PQRS platform will be discussed, along with how PROs can help meet the CJR initiative. Session V will lay out CJRR's vision and upcoming goals, and Session VI will be a 30-minute question and answer session.
For more information on the upcoming meeting or to propose additional items of discussion, please contact Phil Dwyer at dwyer@ajrr.netTo register, click on the black box below. 
CJRR Annual Report

CJRR released the 2014 Annual Report in November 2015. It consists of data collected between April 1, 2011 and May 20, 2015. 163 surgeons at 26 hospitals contributed the 8,130 knee replacements and 6,023 hip replacements in the report. CJRR is at the forefront of nationwide registries that routinely collect PROs and clinical information and data about implanted devices, so the data presented in the report is very comprehensive.
Some of the sections included in the report include overall results, patient-reported outcomes, procedural data metrics, and principal diagnoses for hip and knee replacements. Length of stay and comorbidities and adverse events also have their own sections. The next report will be released in November 2016.
To download an electronic copy of the CJRR 2014 Annual Report, click here.
YNHHSC/CORE and CJRR Collaboration
As you know, the collection of PROs are of utmost importance to the CJRR effort. As part of our work, we have entered in to a collaborative arrangement with Yale New Haven Health Services Corporation (YNHHSC) to advance the science of PROs at a national level. The Centers for Medicare & Medicaid Services (CMS) has contracted with YNHHSC/Center for Outcomes Research and Evaluation (CORE) to develop a Hospital Level Performance Measure(s) of Patient-Reported Outcomes Following Elective Primary Total Hip and/or Total Knee Arthroplasty (THA/TKA PRO-PM). The remaining measure development work involves finalizing the measure specifications. To accomplish this, CORE is partnering with CJRR to obtain relevant PRO data to help finalize the measure specifications. These data will enable CORE's team, supported by a nationally convened Technical Expert Panel (TEP), to explore the most meaningful and understandable ways to use PRO data to assess hospital-level performance.
We have asked CJRR hospitals submitting an ample volume of PRO data to assist with the work CORE is undertaking. Communication pertaining to this initiative was distributed earlier in January. Specifically, CORE is asking for access to pre-operative and post-operative PROs, comorbidity data, and sociodemographic risk factor data for CJRR patients. Ideally, CORE hopes to receive data from approximately 1,200-1,500 patients from between nine and 20 CJRR participant hospitals. The transfer of data to CORE will be handled by the CJRR technology partner, Ortech. 
No hospital or patient identifying data will be shared with third parties other than CMS (if requested) and CORE project leadership. Hospitals and patients will be de-identified prior to measure development, so that no team member developing the measure has access to identified data. CORE will share de-identified summary level data from their analyses with participating hospitals, CJRR, CMS, and the TEP. No identified data will be made available to others. All information regarding preliminary and final measure specifications will be shared with CJRR and participating hospitals when publicly posted.
If you have additional questions, please contact Caryn Etkin, PhD, MPH, AJRR Director of Analytics at etkin@ajrr.net or Lisa Suter, MD, Associate Director, Quality Measurement Program, YNHHSC/CORE at cmshipkneeprom@yale.edu
Check Out the CJRR Webpage

After CJRR became affiliated with AJRR at the end of March 2015, CJRR's web presence was merged into AJRR's website. The CJRR page includes topics of interest for both California patients and hospitals.
CJRR was the first orthopaedic Registry in the U.S. to publicly publish patient-reported outcome measures (PROMs) data collected from participating hospitals. The CJRR webpage includes public reporting based on data collected from surgeries in the 2014 Annual Report that only consist of patients that completed both a pre-surgical survey and a one year follow-up survey. The data assigns each participating hospital a performance rating out of five stars, and reveals the percentage of patients who reported meaningful improvement in their surveys. A complete list of FAQs regarding CJRR public reporting is provided as well. CJRR Leadership is listed towards the bottom of the page, and electronic copies of past CJRR annual reports and progress reports are available for viewing.
On the top of the page is a map of the 41 CJRR hospitals. This map has a zooming feature that allows website users to identify the specific hospitals in an area. The map is significant, for it shows users which hospitals are participating in the CJR.
With an AJRR-provided username and password, CJRR hospital staff are able to access and download all of the CJRR templates and brochures to use in daily operations.
To access the CJRR page, click here. If you are a hospital looking for log-in information, please contact AJRR at info@ajrr.net.
The Benefits of the AJRR

AJRR and CJRR are affiliated now, which means you can easily enjoy the many perks to participating in the AJRR as well. These occur at the hospital, surgeon, and patient levels, and can put hospitals in a better position locally and nationally.
Instead of just comparing your institution's data to other California hospitals, AJRR provides national demographic data from large cities to rural towns across all 50 states. Also, AJRR can help surgeons meet quality initiatives like PQRS, CJR, and Meaningful Use. Unet, the AJRR User Group Network, is a resource for AJRR participants to share ideas with other users, discuss best practices, and learn ways to optimize and promote Registry participation. Through participating in the group, hospital staff members will be able to help shape the orthopaedic Registry community through their insights and contributions.
Another benefit of participating in the AJRR is access to the Demand Reporting & Electronic Dashboard System. This system allows users to view Registry data and make reports. The AJRR Level III PRO platform was integrated into the system, and allows for users to view individual dashboards for recommended PROMs. The data is presented visually in charts and graphs, presenting it in a way that is easy to understand.
Many of these benefits are free of charge; participation in the Registry is free, with only a small annual subscription fee for access to the Demand Reporting & Electronic Dashboard System. AJRR participants also receive free Yearly Reports of national and local data collection statistics.
For information about joining the AJRR, please contact Phil Dwyer at dwyer@ajrr.net.
California Joint Replacement Registry is Affiliated with the American Joint Replacement Registry
www.ajrr.net/cjrr | 847-292-0530