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California Joint Replacement Registry

The California Joint Replacement Registry (CJRR) was a longitudinal database for total-hip and total-knee replacements performed in California. The goals of the registry were to support device surveillance, quality measurement, and effectiveness research. Between 2011 and 2016, the registry collected data from participating sites regarding patient demographics, surgical risk factors, implanted devices, complication rates, and subjective outcome measures. A centralized, secure hosting platform aggregated these data into uniform data structures and makes them available for reporting and analysis.

The Pacific Business Group on Health and the California HealthCare Foundation engaged Sujansky & Associates to develop the functional requirements for the CJRR platform and to oversee the technical development, deployment, and operation of this resource.

The CJRR was acquired by the American Joint Replacement Registry in 2016.

Relevant documents:

Functional Requirements for the California Joint Replacement Registry (PDF)
More information about this project is available at

Sujansky & Associates' role in this project included:

  • Analyzing and documenting the functional requirements for the CJRR hosted technology, including its data-collection mechanisms, information model, reporting capabilities,
    and security features.

  • Designing the standardized file formats to collect data from participating health care organizations and providing technical support to these organizations as they developed the processes to populate the files from their legacy data stores.

  • Developing a Request-for-Proposal to identify, select, and retain the software vendor that would build and operate the CJRR technology platform.

  • Overseeing the implementation of the CJRR hosted technology and the collection of data from participating sites.

  • Evaluating the results and lessons learned from the early operations of the registry, including an assessment of data quality, and incorporating these learning into ongoing enhancements.



The California Joint Replacement Registry was the first regional
level-3 registry in the United States. Level-3 registries include objective and subjective information about patient outcomes, as well as the surgical procedures, risk factors, and implanted devices associated with those outcomes.

Data collection for the CJRR relied on a combination of modalities, including the submission of formatted data files, the completion of web-based surveys, and the automated reading of faxed/scanned paper forms.

The CJRR's security model sequestered patient-specific data in a protected repository that was not exposed to the internet, while enabling participating organizations to access aggregated and de-identified reports via an online data mart.