Kaiser Permanente National Total Joint Replacement Registry: aligning operations with information technology.
Background: 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.Questions/purposes: We describe the developm...
| Publicado en: | Clinical Orthopaedics & Related Research® Vol. 468; no. 10; pp. 2646 - 2664 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Oct2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105104817&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105104817 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0009921X 23N jtl: Clinical Orthopaedics & Related Research® issn: 0009921X maglogo: N pubinfo: dt: Oct2010 vid: 468 iid: 10 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 105104817 NLM20652461 2010796504 10.1007/s11999-010-1463-9 NLM20652461 105104817 ppf: 2646 ppct: 18 formats: tig: atl: Kaiser Permanente National Total Joint Replacement Registry: aligning operations with information technology. aug: au: Paxton EW Inacio MC Khatod M Yue EJ Namba RS Paxton, Elizabeth W Inacio, Maria C S Khatod, Monti Yue, Eric J Namba, Robert S affil: Surgical Outcomes & Analysis Unit of Clinical Analysis, Kaiser Permanente, 3033 Bunker Hill Street, San Diego, CA 92109, USA sug: subj: Arthroplasty, Replacement Adverse Effects Arthroplasty, Replacement Utilization Health Maintenance Organizations Medical Informatics Outcomes (Health Care) Data Collection Algorithms Data Mining Health Care Delivery, Integrated Electronic Health Records Health Services Research Human Product Recall Program Development Reoperation Systems Integration Time Factors Treatment Outcomes United States ab: Background: 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.Questions/purposes: We describe the development, implementation, and integration of this Total Joint Replacement Registry, highlighting critical steps in aligning information technology and operations.Methods: 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.Results: 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.Conclusions: 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. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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