title: Kaiser Permanente implant registries benefit patient safety, quality improvement, cost-effectiveness.
abstract: BACKGROUND
  In response to the increased volume, risk, and cost of medical devices, in 2001 Kaiser Permanente (KP) developed implant registries to enhance patient safety and quality, and to evaluate cost-effectiveness.
  
  
  METHODS
  Using an integrated electronic health record system, administrative databases, and other institutional databases, orthopedic, cardiology, and vascular implant registries were developed in 2001, 2006, and 2011, respectively. These registries monitor patients, implants, clinical practices, and surgical outcomes for KP's 9 million members. Critical to registry success is surgeon leadership and engagement; each geographical region has a surgeon champion who provides feedback on registry initiatives and disseminates registry findings.
  
  
  RESULTS
  The registries enhance patient safety by providing a variety of clinical decision tools such as risk calculators, quality reports, risk-adjusted medical center reports, summaries of surgeon data, and infection control reports to registry stakeholders. The registries are used to immediately identify patients with recalled devices, evaluate new and established device technology, and identify outlier implants. The registries contribute to cost-effectiveness initiatives through collaboration with sourcing and contracting groups and confirming adherence to device formulary guidelines. Research studies based on registry data have directly influenced clinical best practices.
  
  
  CONCLUSIONS
  Registries are important tools to evaluate longitudinal device performance and safety, study the clinical indications for and outcomes of device implantation, respond promptly to recalls and advisories, and contribute to the overall high quality of care of our patients.
authors.affiliation: Surgical Outcomes and Analysis Department, Kaiser Permanente, San Diego, USA.
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Paxton
authors.forename: Mary-Lou
authors.initials: ML
authors.lastname: Kiley
authors.forename: Rebecca
authors.initials: R
authors.lastname: Love
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Barber
authors.forename: Tadashi T
authors.initials: TT
authors.lastname: Funahashi
authors.forename: Maria C S
authors.initials: MC
authors.lastname: Inacio
mesh_terms: D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D057286:Electronic Health Records / Q000458:organization & administration; D006279:Health Maintenance Organizations / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D011358:Product Surveillance, Postmarketing / Q000379:methods; D019736:Prostheses and Implants; D058996:Quality Improvement / Q000191:economics / Q000458:organization & administration*; D012042:Registries; D014481:United States