AAOS Registry Program Blog

EHR and Registry Interoperability

Jun 20, 2018 3:53:00 PM

EHR and registry interoperability is possible with vendors like these 6

As the Electronic Health Record (EHR) becomes the primary interface for physicians and other health care workers, the American Joint Replacement Registry (AJRR) must increasingly work through EHRs for greater interoperability to be achieved.


Providers’ EHR Challenges

Today many hospitals, ambulatory surgery centers, and clinicians’ offices use more than one data capture system. In other words, more than one EHR within a single provider system may be utilized to support registries like AJRR. As a result, data capture can be awkward and time consuming for clinicians and their staff. While some of this can be overcome without interoperable systems, for example by uploads from these systems to AJRR of specific standard file formats, AJRR continues to pursue improvements aligned with the overall industry effort.

“Since its inception, AJRR has been committed to a multi-stakeholder governance model and to delivering value across the health care enterprise,” said AAOS Director of Registries Nathan Glusenkamp. “Technology vendors play an important role in extracting, organizing, and transmitting data to AJRR on behalf of our participants. We are proud to work with participant hospitals and surgeons to leverage their existing investments in health information technology and their vendor capabilities, making data collection more comprehensive and reliable, without workflow disruption.” 

Providence St. Joseph Health is a system that has succeeded in implementing a single EHR (Epic Systems) throughout most of its 50 facilities and integrating it with a single orthopaedic registry (AJRR). Paul Duwelius, MD, an orthopaedic surgeon at Providence St. Vincent Hospital said, “One of the main reasons AJRR is successful is because of its alignment with and support from industry [EHR companies, AdvaMed, and others].” This alignment and compatibility helps ensure that the providers' EHR of choice will work smoothly with AJRR.


Evolution of the EHR Marketplace

While the EHR marketplace remains fragmented, some of the leading vendors include Cerner, Epic, Allscripts, Meditech, and for ambulatory settings, NextGen and AmkaiSolutions. The adoption of electronic records by providers was greatly aided by incentives supplied by the United States federal government. Continuing federal oversight of EHR standards is guided by the need to ensure benefits from the market-building impact of provider incentives. Those benefits must continue to serve the broader public purpose for which the American Recovery and Reinvestment Act (2009) was intended. Ideally, EHR standards will lay the groundwork for what the Institute of Medicine (IOM) has called the “learning health care system.” The goal of such a system is a transformation in the way evidence is generated and used to improve health care. It is a system in which registries, with their trending and benchmarking capabilities, will play a pivotal role.


To consider criteria for selecting your EHR vendor, read more at HealthIT.gov.


A Practical Vision of Interoperability and Provider Next Steps

From an EHR and registry perspective, a vision of functional interoperability could be described as a standards-based solution that achieves the following set of requirements:

“The ability of any EHR to exchange valid and useful information with any registry, on behalf of any willing provider, at any time, in a manner that improves the efficiency of registry participation for the provider and the patient, and does not require significant customization to the EHR or the registry system.” (Source: Bookshelf ID - NBK208625) 

The health care industry has not yet achieved this vision. The successive development, testing, and adoption of open-standard building blocks (HITSP TP50, C76 an IHE RFD, CRD, and DSC) — which improve functional interoperability and move us incrementally toward a solution — is a bridging strategy that provides benefits to providers, patients, EHR vendors, and registries.

As a provider today, the next steps that enable your organization to thrive in an increasingly interoperable world include:

  • Choosing one EHR solution with the features/benefits needed across your entire organization. If you have multiple EHRs already in use, moving to your single choice will be a phased process.
  • Choosing a registry that has the data elements, analytical abilities, and security you need and is also highly compatible with your EHR of choice
  • Ensuring that you are properly staffed for data capture and analysis
  • Engaging with other providers through a vibrant registry user group network that focuses on best practices
  • Keeping current on all legal and regulatory requirements for the protection of patient privacy



Interfacing Registries With Electronic Health Records, Bookshelf ID: NBK208625.



For information about the AJRR RegistryInsights™ platform, speak with a Business Development Representative at (847) 292-0530 or Request A Demo today!


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Topics: Registry Participation

A Message for Our Readers

This blog was created by the American Joint Replacement Registry (AJRR), part of the American Academy of Orthopaedic Surgeons (AAOS) Registry Program. The blog is part of our commitment to improve orthopaedic care through the collection, analysis, and reporting of actionable hip and knee arthroplasty data. Our purpose is to communicate with others in the orthopaedic field who share the same commitment. Watch for weekly news alerts, quick tips, actionable checklists, best practices, and research findings posted to this blog. It will be information you can use each week!

The more interactive you are, the greater the value shared. Visit us at www.AJRR.net, speak with a Business Development Representative at 847-292-0530, or follow us on Twitter.

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This Week's Blog

  • Wednesday, June 20, 2018 - EHR and Registry Interoperability


This Week’s References

Electronic Health Record (EHR) 

An EHR is an electronic record of health care related information on an individual that conforms to nationally recognized interoperability standards, and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization.


A registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease or condition, and serves one or more predetermined scientific, clinical, or policy purposes.


In health care, the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged.


AJRR RegistryInsights™

As a health care provider of orthopaedic services, you can access information about joining AJRR and RegistryInsights by visiting www.ajrr.net or speaking with a Business Development Representative at (847) 292-0530.  New Call-to-action

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AJRR Staff Writers

AJRR Blog posts are researched and created by AJRR staff writers: Karen Metropulos, Erik Michalesko, and Lori Boukas. If you would like to contact the writing staff, email us at AJRRinfo@aaos.org


This blog shares health care information from a variety of independent expert sources. Some sources offer opinions that may be of interest to other professionals facing similar challenges. Our approach helps ensure diverse, well-rounded presentation of important, often complex health care content. Shared content does not necessarily represent AJRR or AAOS findings and practices.