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California Joint Replacement Registry

The California Joint Replacement Registry (CJRR) is a longitudinal database for total-hip and total-knee replacements performed in California. The goals of the registry are to support device surveillance, quality measurement, and effectiveness research. Since 2011, the registry has been collecting data from participating sites regarding patient demographics, surgical risk factors, implanted devices, complication rates, and subjective outcome measures. A centralized, secure hosting platform aggregates 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.

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.

Relevant documents:

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



The California Joint Replacement Registry is 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, preceding risk factors, and implanted devices associated with those outcomes.

Data collection for the CJRR relies 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 sequesters patient-specific data in a protected repository that is not exposed to the internet, while enabling participating organizations to access aggregated and de-identified reports via an online data mart.