AJRR User Discussion Forum Coming Soon

Unet, the AJRR User Group Network, held a
conference call on June 16, 2016 at 12 p.m. Central Time. The call attendees were welcomed by Lori Boukas, our Director of Marketing and Communications. She went on to introduce the staff members that had been hired since the last Unet call, including Program Assistants Maria Gomes, Monica
Moore, and Jason Thomas, Data Submission Analyst Stephanie Palaguachi, and Chief Technology Officer Paul Haisman. 

The first discussion was led by Paul, and consisted of a Registry technology update and future roadmap. Paul spoke about the Registry dashboard reports, and how the front end of reporting has value for subscribers. There are processes underway to improve how the data are presented and used for further analytics opportunities, and these will evolve as AJRR moves into collecting Level II and III data. A user asked if AJRR would ever do API integration with third party data sources. It's part of our long term plan to integrate with industry and patient-reported outcome (PRO) collecting services. We've been talking to major electronic health record (EHR) vendors about collaboration and expect to see many more partnerships come to fruition in the near future.
Paul also mentioned that AJRR is launching an online discussion forum in early July. The forum will be opened up to all AJRR users in a private group that will allow users to ask questions, share lessons learned, and connect directly with each other. Users will soon be able to register and gain access to this rich and rewarding resource.
Additional topics included addressing quality programs concerns, and we shared our plan of mapping exported data for the Comprehensive Care for Joint Replacement (CJR) model hospitals into the Centers for Medicare & Medicaid Services (CMS) format so that they are able to easily submit to CMS. The conference call ended with a Q & A session. Unet calls are held on a quarterly basis. The next calls will take place on September 15 and December 15 at 12 p.m. Central Time.
If you would like to sign up for Unet communications, click here.
How Secure and Compliant Is AJRR Data?

Our facilities have no reason to be uncertain about the Registry's data security. We're a Health Information Portability and Accountability Act of 1996 (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) Act compliant organization. This has led to us documenting and implementing policy, as well as training employees according to the regulations. Some of the data we collect will qualify as protected health information (PHI) under HIPAA Privacy and Security rules. We take data security seriously and employ several steps to safeguard patient privacy for all of our participating institutions.
Our facilities can also be confident about their institution's data integrity. To ensure that our data and reporting are as accurate as possible, every year we undergo a third-party audit of a sample of our participating hospitals. West Virginia Medical Institute (WVMI) is a non-profit organization that works with numerous medical specialty organizations and the federal government on a variety of quality initiatives. They have audited our data since 2013, finding it to be over 90% accurate.
For more information on our data security and quality, click here.
From the Hill

Visit the Advocacy & Public Affairs Section of our website to learn more
Comments on the Medicare Access and CHIP Reauthorization Act (MACRA) were due on June 27. We submitted a letter requesting that the Centers for Medicare & Medicaid Services (CMS) reconsider the stance they took on a few matters in their proposed rule; namely, Qualified Clinical Data Registries (QCDRs) like AJRR would like access to real-time Medicare claims data and for the data error rate to be at a more feasible number. To read the entire letter, click here.

For previous comment letters and position statements, click here.
Follow Us on Social Media

Recently, we distributed a survey among our User Group Network (Unet) to discover the best way to reach our audience through social media. After sifting through the results, we identified the platforms and content that would be the most useful when dispersing AJRR information. "Like" our Facebook, Twitter, and LinkedIn pages to stay up to date on the
newest AJRR guides, quality initiative news, and other content that reflects the interests of professionals in the orthopaedic Registry community like you.

To visit the AJRR Facebook page, click here.
To visit the AJRR Twitter page, click here.
To visit the AJRR LinkedIn page, click here.
Champion of the Quarter

Each quarter, we highlight 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 our staff. To view our past Champions, visit our Champion of the Quarter section on our website. To nominate someone from your hospital, please contact Erik Michalesko at michalesko@ajrr.net.

This quarter, we would like to recognize Dr. John Tongue from Legacy Health System in Oregon, and Ms. Cheryl Dykstra from National Surgical Healthcare, Inc. in Chicago, IL.
Dr. John Tongue
Legacy Health System

Dr. John Tongue is an Adjunct Associate Professor at Oregon Health & Science University in Portland, and is the President of Cascade Orthopaedic Group, a private practice in Tualatin, OR. Dr. Tongue has served as the President of the American Academy of Orthopaedic Surgeons (AAOS), North Pacific Orthopaedic Society, Oregon Association of Orthopaedists, and the Western Orthopaedic Association. He also serves as a trustee for the Orthopaedic Research and Education Foundation (OREF), and is a member of the American Association of Hip and Knee Surgeons (AAHKS). Dr. Tongue writes reviews for three journals, and teaches AAOS Communication Skills Workshops across the country.
Q: Do you enjoy working with AJRR staff? If yes, why?

A: Yes, I've collaborated with AJRR Medical Director Dr. David Lewallen on many projects over the years. He's a great 'idea guy' and an innovative thinker. Last fall I realized that Legacy Health System's five hospitals still had not joined the Registry. I arranged for Dr. Lewallen to speak at our Oregon state meeting, and then with Legacy's decision-makers in Portland. He did a masterful job, addressing everyone's issues and skepticisms. That session led to our Legacy hospitals finally choosing to sign AJRR contracts.
Q: What do you like most about AJRR?

A: I've been a proponent for all registries for a long time now. I have followed the difficulties posed by our U.S. legal system that initially slowed development of AJRR. Perseverance by our leaders and the lessons learned from registries in England and Australia have had finally given us 'critical mass' to accelerate our registry development. It's essential to have this type of health care data, especially with the Centers for Medicare & Medicaid Services (CMS) and other payers demanding quality initiatives.
Q: What is the best vacation you've been on?

A: The best vacation I've ever been on was Africa with other orthopaedic leaders for meetings, safari camps, and game drives, as well exploring cities like Cape Town. On the first trip our son and his wife were able to join us; that was probably the best trip.
Q: If Hollywood made a movie about your life, who would you like to see cast as you?

A: Whoever my wife Nancy says she likes best. She would probably go for either Robert Redford or Tom Hanks.
Q: Tell us something about yourself that would surprise us.

A: I love water, and live by a beautiful lake near Portland. I've been a flat water canoe racer, white water kayaker, and am an avid fly fisherman. I'm also swimmer, but Nancy swims circles around me. Oregon lakes and streams are some of the perks of living in the Great Northwest.
Q: If you could pass on one piece of information to a new AJRR participant, what would it be?

A: People's initial reaction to change is often skepticism or just plain "no." They find a reason to disagree. If you're sold on the value of the AJRR's research and data, and want your hospital to join, you have to be persistent. This isn't an easy process; it may take 6-8 months or more. Multiple groups within each hospital need to buy in. The benefits are clear, but the choice to actively participate requires a surgeon to step up and be an AJRR champion.

Ms. Cheryl Dykstra
National Surgical Healthcare, Inc
Ms. Cheryl Dykstra is the Director of Information
Systems Applications at National Surgical Healthcare, Inc. in Chicago, IL. She coordinates the main electronic records operations in 11 surgical facilities across the country. Ms. Dykstra has a team at the corporate level, but also works with employees at the hospital level. She is responsible for educating, providing resources, giving standards, and laying out a roadmap for these 11 institutions. Her favorite aspect of her job is that she gets to talk to people from all over the United States; she isn't confined to one city or region. She also enjoys her commute; by taking the "L" train to work in the Chicago Loop, she is able to multitask and read or check emails. Ms. Dykstra has been working with National Surgical Healthcare, Inc. for three years.
Q: Are you still involved with AJRR participation and data submission? If so, what is your role?

A: We're still getting the last facilities at National Surgical Healthcare, Inc. up and running with the Registry, so I've been working with sites and answering any questions they may have about data submission. Some of the work has been taken over by on-site employees, but I still act as a resource to these new AJRR participants.
Q: What do you like most about AJRR?

A: The best part about AJRR is that they are a very thorough company. Everything is written down; there are guides and documents for the major processes, which makes things very easy to follow.
Q: If Hollywood made a movie about your life, who would you like to see cast as you?

A: I would like Sigourney Weaver to be cast as me. She plays smart, strong women, and I would like to think that that's how people see me.
Q: Tell us something about yourself that would surprise us.

A: I play the bass clarinet in two concert bands. I also used to be in a marching band, but I had to give that up.
Q: What is your favorite movie or book?

A: My favorite book series is Outlander. I recently started watching the Outlander TV show as well; I appreciate the Scottish history in the story. If I had to choose a movie, I would go with Victor Victoria, starring Julie Andrews. I like all of her work.
Q: If you could pass on one piece of information to a new AJRR participant, what would it be?

A: Make sure that you read all of the materials that AJRR provides. There may be certain Registry processes that seem unintuitive that are explained in a guide featured on their website.
Authorized Vendor Profile 

Company Name: Wellbe, Inc.
Company Website: www.wellbe.me
AJRR Vendor Since: March 2016
General Description: Wellbe believes that engaging patients to be active partners in their care is a key to transforming health care. In today's rapidly-changing healthcare environment, patients simply don't have the right tools to become participants in their own health journeys. Wellbe's mission is to unleash the full value of patient-provider partnerships to make healthcare more accessible, effective, and affordable. Wellbe's track record at hospitals across the U.S. shows that engaging patients in a coordinated plan of care across the continuum results in reduced episode costs, higher patient satisfaction, fewer readmissions, and improved outcome scores.
Components Offered: High-performing health systems use Wellbe to move from fragmented silos of care to value-driven service lines. Wellbe's PRO Collection capabilities have helped hospitals get functional outcomes from many hip and knee replacement patients automatically, with no additional staff effort.
Wellbe's PRO Collection solution includes:
  • Online pre-surgery PRO collection
  • Post-surgery PRO collection at intervals of your choice
  • In-practice patient enrollment
  • Automated patient reminders and care team alerts on uncompleted surveys
  • Monthly PRO data reports for surgeons and administrators
Integration with AJRR: Wellbe can collect PROs on behalf of hospitals and extract data for Registry submission thanks to an authorized data partnership with the American Joint Replacement Registry (AJRR), the official registry of the American Association of Hip and Knee Surgeons (AAHKS).
Fun Fact: Wellbe sponsors a free professional resource called OrthoServiceLine.com, designed to give orthopaedic service line leaders actionable insights and ideas to grow and streamline their program through articles, reports, webinars and ebooks.

A full list of AJRR's Technology Partners can be found here.
In Case You Missed It: New AJRR Orthopaedic Quality Resource Center Measures Available

A few months ago we aligned our quality initiatives and
reporting with the American Orthopaedic Association (AOA) and the American Association of Hip and Knee Surgeons (AAHKS) in the form of the AJRR Orthopaedic Quality Resource Center. Since the Centers for Medicare & Medicaid Services (CMS) has once again designated AJRR as a Qualified Clinical Data Registry (QCDR), our Orthopaedic Quality Resource Center platform is able to help physicians submit measures for the Physician Quality Reporting System (PQRS), a CMS program.
Additional measures have been added to the AJRR Orthopaedic Quality Resource Center in order to support both AOA and AAHKS programs, including two post-fracture PQRS measures that cater to AOA's Own the Bone program and five custom measures documenting process and outcomes for hip arthroplasty for AAHKS members. This brings the grand total to 38 PQRS and custom measures in 2016.
For more information on AJRR's Orthopaedic Quality Resource Center, click here.
Data Corner


Our 2014 Annual Report has a wealth of information on procedural and component data. Figure 20 (pictured above) contains some interesting findings. There has been an increase in the use of ceramic femoral heads (versus cobalt chromium), which may be due both to the appeal of the improved wear properties of ceramic on conventional polyethylene but also very likely because of recent corrosion concerns with metal heads. Available AJRR data shows that in this sample of the U.S. experience there has been a steady and relatively rapid increase in the use of ceramic heads over the past three years, with ceramic heads currently utilized for nearly half of all hip arthroplasties.
Slides with all the tables and figures from the 2014 Annual Report can be found on our website.
Upcoming Webinars

Introductory Webinar for Ambulatory Surgery Centers
The AJRR is providing this complementary webinar specifically for Ambulatory Surgery Centers (ASCs) to show them how participation in the AJRR can benefit their centers. In this webinar, AJRR Program Coordinators Alyssa Burns, MHA, Phil Dwyer, and Savana Martin will provide an overview of clinical data registries and touch on topics such as their history and what they are used for. If your surgery center performs hip and knee procedures, you should consider submitting data to the AJRR. During this session, AJRR Program Coordinators will walk through the AJRR enrollment process and discuss best practices for secure data submission and report generation.

The webinar is being hosted by the AJRR in partnership with the Ambulatory Surgery Center Association (ASCA) on Wednesday, July 6 at 12:00 p.m. CT. Register here.

Introductory Webinars
AJRR staff continues to host 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! Introductory webinars will be held at the following times this year:
To register for one of these sessions, click here.

Patient-Reported Outcome Training Webinars
Our analytics team hosts training webinars on the AJRR Level III patient-reported outcome (PRO) platform. The training takes users through the AJRR Demand Reporting & Electronic Dashboard System as it pertains to our Level III/PRO data and will cover tasks like assigning PROs and navigating the patient portal. This is a great webinar to attend if your institution is subscribing to the AJRR Demand Reporting & Dashboard System and plans to submit PROs! This webinar is held monthly and lasts for about an hour. Register for one of the sessions below:
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:

#704 - Seton Southwest Hospital in Austin, TX
#705 - Seton Highland Lakes Hospital in Burnet, TX
#706 - Shasta Regional Medical Center in Redding, CA
#707 - Hutchinson Regional Medical Center in Hutchinson, KS
#708 - Tomah Memorial Hospital in Tomah, WI
#709 - Houston Methodist Hospital in Houston, TX
#710 - UPMC Presbyterian in Pittsburgh, PA
#711 - UPMC Shadyside in Pittsburgh, PA 
#712 - UPMC Mercy in Pittsburgh, PA
#713 - UPMC East in Monroeville, PA 
#714 - UPMC McKeesport in McKeesport, PA
#715 - UPMC St. Margaret in Pittsburgh, PA 
#716 - Children's Hospital of Pittsburgh of UPMC in Pittsburgh, PA
#717 - Magee-Women's Hospital in Pittsburgh, PA
#718 - UPMC Passavant in Pittsburgh, PA
#719 - UPMC Jameson in New Castle, PA 
#720 - UPMC Horizon in Greenville, PA 
#721 - UPMC Northwest in Seneca, PA 
#722 - UPMC Hamot in Erie, PA
#723 - UPMC Altoona in Altoona, PA
#724 - UPMC Bedford in Everett, PA

AJRR currently has 724 participating hospitals in all 50 states! Click here for a full list of all participating sites.

AJRR in the News

Becker's Spine Review published an article written by AJRR staff about the facts that surgeons should know about clinical data registries:

Data from our 2014 Annual Report was quoted in an article last month:

To view our press 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

2016. All rights reserved.


AJRR | 9400 West Higgins Road | Suite 210 | Rosemont | IL | 60018