Hospitals provide data on specific AOANJRR forms. The forms are completed in theatre at the time of surgery and are returned to the AOANJRR each month. While initial discussions indicated that most hospitals would prefer to send the information electronically a review of the information collected and the systems used showed that a paper-based system would be more appropriate. The AOANJRR continues to use a paper-based system but has established the mechanisms to collect data electronically when this is feasible for contributing hospitals.
The AOANJRR validates data collected from individual hospitals by comparing it with data provided by State and Territory Health Departments. Validation of AOANJRR data against health department unit record data uses a sequential multi-level matching process. Individual level patient/procedure validation data is provided by all State and Territory Health Departments. The initial matching is performed using hospital and patient identity number with subsequent matching undertaken on relevant procedure codes and appropriate admission time period. 'Errors' in data can occur within Government and AOANJRR data at any of these levels, that is, errors in patient identification, coding or admission period attribution by either the hospital or State/Territory Health Department.
Currently the AOANJRR receives information from hospitals on more procedures than are provided by the State and Territory Health Departments.
On the initial pass of this validation process almost 94% of records were validated. Note that these percentages do not reflect the capture rate of procedures, but rather the provision of data to the AOANJRR and the adequacy of matching data from several sources in the absence of an industry standard. Subsequent errors in 'matching' are managed depending on the nature of the error. Errors within the health department files may have been identified on procedure code, for example a procedure within a specific hospital may be identified as ICD-10-AM code 49318-00 (a Primary Hip code), and the AOANJRR has received a form for a Primary Knee procedure performed in that hospital on a patient with that unit record number within the specified admission time. Other errors may only be resolved by contacting the original treating hospital, for example, clarification of primary or revision codes or admission times. The validation process also identifies procedures that have not been notified to the AOANJRR. Sufficient information is supplied in the state unit record data (patient unit record number and admission period) to enable the AOANJRR to request procedure details from individual hospitals for these unreported records.
Following the validation process and the retrieval of unreported records, the AOANJRR contains the most complete set of data relating to hip and knee replacement in Australia.