Putting Together an Orthopedic Outcomes Registry: One Health System's Approach

Efficient and accurate outcomes data collection and analysis is a way for hospitals to improve quality and reduce costs by allowing for evidence-based care, particularly when it comes to expensive orthopedic procedures. Using outcomes data, hospitals can analyze and account for cost and quality in orthopedic procedures and ensure that physicians can provide more effective and personalized care.

Outcomes registries help physicians and administrators make better decisions on how to serve patients, says Doug Ardoin, MD, CMO of HCA's TriStar Health System. However, collecting the data to create such a registry has been a challenge for health systems since, for many years, it had to be done manually. Manual data entry also meant that hospitals or other organizations would receive outcomes data that wasn't standardized, making it more difficult to analyze.

Despite these challenges, having data that compares outcomes to costs is necessary to collaborate around significant changes in care delivery — the first step in improving outcomes and reducing cost, says John Bass, COO of InVivoLink, a company that creates electronic orthopedic data collection and outcomes registry tools.

What data is collected?
According to Dr. Ardoin, some of the most important data points to collect for orthopedics are patient characteristics, the types of implants chosen, the manufacturers of the implants, the type of surgery performed (whether it was standard or minimally invasive, for example) and the outcome of the post-operative period. It would also be useful to know the OR times of surgeons, he said.

Efficient modes of creating an outcomes registry
Electronic data collection tools are one way to ensure that hospitals have a standardized and accurate registry. TriStar recently implemented InVivoLink's solutions to aid in collecting and analyzing orthopedics outcomes data. Before electronic collection tools were available, there wasn't a great way to collect data efficiently, explains Dr. Ardoin. It was all done on paper. Questionnaires were sent to physicians' offices in the hopes that they or someone in their office would fill it out. Now, electronic data collection tools make it easier on both the physicians and the hospitals, he says. Physicians can record data at the point of care. The data provided is accurate, and the hospital receives it in a standardized manner.

Also, using electronic data collection tools for outcomes registries ensures that physicians and administrators are on the same page. "It makes conversations easier, because everyone has the same data," says Dr. Ardoin, "It helps administrators and physicians better design the performance improvement activity that is necessary to move toward better quality and cost control."

Improving quality of care for orthopedic procedures
Administrators and physicians can use outcomes registries to improve quality of care. Knowing the patient's characteristics through an outcomes registry will ensure that physicians are providing the right kind of surgical care, medication and implants specific to their patients needs, said Dr. Ardoin, particularly as the data will have information about the manufacturers of implants as well. Administrators can also use it to compare the OR times of the surgeons and educate them so as to ensure that needlessly long surgeries that can be risky do not happen often, he says.

According to Dr. Ardoin, in the next few years there will be a number of changes in the landscape of the healthcare industry. Physicians and administrators will have to work together increasingly to reduce costs and improve quality, and outcomes registries will be one way providers will tackle these goals.

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