Kaiser Permanente National Total Joint Replacement Registry: Aligning Operations With Information Technology
- 1 October 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 468 (10), 2646-2663
- https://doi.org/10.1007/s11999-010-1463-9
Abstract
A Total Joint Replacement Registry was developed in a large community-based practice to track implant utilization, monitor revisions and complications, identify patients during recalls and advisories, and provide feedback on clinical practices. We describe the development, implementation, and integration of this Total Joint Replacement Registry, highlighting critical steps in aligning information technology and operations. The primary Total Joint Replacement Registry data source consists of standardized electronic health record forms developed by consensus. The Total Joint Replacement Registry forms are integrated into the clinical workflow (preoperative, intraoperative, and postoperative) and produce a standardized progress note for electronic health record documentation. Secondary data are extracted from other electronic data sources using standard terminologies (ie, ICD-9 codes) to supplement the Total Joint Replacement Registry forms. Electronic screening algorithms are applied to identify complications, in combination with chart review validation and quality control mechanisms. Three hundred fifty surgeons voluntarily contribute to the registry with 90% participation. The registry has been used for implant recalls and advisories, contract decision making, and identification of patients at risk for revisions (eg, younger patients having total knee arthroplasty). Tracking of overall survival of implants influenced clinical practice, with feedback resulting in the reduction of the number of unicompartmental and uncemented knee arthroplasties performed, usage of femoral head sizes < 28 mm, and the number of minimally invasive surgical procedures performed. The Total Joint Replacement Registry has effectively aligned operations with information technology and leveraged that to enhance our ability to respond to recalls and advisories as well as improve quality of care, cost-effectiveness, and create research opportunities.Keywords
This publication has 18 references indexed in Scilit:
- Future Young Patient Demand for Primary and Revision Joint Replacement: National Projections from 2010 to 2030Clinical Orthopaedics and Related Research, 2009
- Knee replacement: epidemiology, outcomes, and trends in Southern California 17,080 replacements from 1995 through 2004Acta Orthopaedica, 2008
- Early and Late Manipulation Improve Flexion After Total Knee ArthroplastyThe Journal of Arthroplasty, 2007
- Projections of Primary and Revision Hip and Knee Arthroplasty in the United States from 2005 to 2030The Journal of Bone & Joint Surgery, 2007
- An Analysis of the Risk of Hip Dislocation with a Contemporary Total Joint RegistryClinical Orthopaedics and Related Research, 2006
- Why Are Total Knee Replacements Revised?Clinical Orthopaedics and Related Research, 2004
- The Norwegian Arthroplasty Register: 11 years and 73,000 arthroplastiesActa Orthopaedica, 2000
- Long-term registration has improved the quality of hip replacement: A review of the Swedish THR Register comparing 160,000 casesActa Orthopaedica, 2000
- Guideline for Prevention of Surgical Site Infection, 1999Infection Control & Hospital Epidemiology, 1999
- Prognosis of total hip replacement in Sweden: Follow-up of 92,675 operations performed 1978–1990Acta Orthopaedica, 1993