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12/7/2010
02:12 PM
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KP Follows Data To Better Hip, Knee Replacements

By developing registries and tapping e-medical record data, Kaiser Permanente is improving outcomes for hip and knee implant patients.

Through analysis of the patient data, KP researchers found the three most common reasons for re-operations of ACL reconstruction of the knee were meniscus injury, stiffness and device removal.

The risk factors and outcomes also demonstrate how a registry can improve quality of care by providing feedback to physicians, said Paxton.

The registries also helping KP to more quickly spot potential implant device trouble. For instance, when a KP surgeon suspects a problem with an implement device based on trouble a patient is having, KP researchers can analyze EMR data to assess how other patients with the same device are faring.

In one situation, the analysis confirmed “a hunch” that a doctor had about a specific hip replacement device, that was eventually recalled, said Paxton.

KP’s orthopedic implant registry also was used to track eight recalls and advisories during the study period, which were critical in immediately identifying and following up with patients that were impacted.

The findings are helping in the development of best practices for KP doctors to consider when treating patients. “Surgeons rely on the information in the registry,” said Paxton. That includes findings showing that patients who had full knee replacements often fared better and needed fewer subsequent surgical revisions than patients who had only partial knee replacements.

Based on the success of the hip and knee replacement registry, KP has launched additional registries, including those tracking data for other types of implants, such as heart valves and stents. “Implants are high volume procedures where there are high risks and recalls,” said Paxton. On the horizon is a registry for OB-GYN clinicians to use for pelvic mesh patients.

KP’s work with its registries illustrates how tech savvy organizations can tap the power of EMRs can help their patients stay out of the hospital and get on the road to recovery sooner.

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