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Joint Replacement - Hip & Knee

Product Overview

The Joint Replacement – Hip & Knee application helps teams reduce surgical complications, decrease length of stay (LOS), reduce care practice variability, improve outcomes, and improve patient satisfaction for patients undergoing hip or knee replacement. In-Development

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Benefits Include:

Reduced variation in hospital care (blood utilization, glycemic control, early mobility, etc.).

Increased patient satisfaction and quality of life.

Decreased reimbursement losses that result from failure to meet appropriate use criteria and/or from preventable surgical complications.



  • Patients with medical necessity documented in EMR
  • PQRS measures, such as pre-op evaluation for VTE and CV risk factors, documentation of current medications, prophylactic antibiotics, and VTE prophylaxis
  • Complication rates (e.g., hospital-acquired conditions and periprosthetic joint infection)
  • Transfusion rates
  • Readmission and reoperation rates
  • LOS

Data Sources

  • EMR
  • Billing System
  • Patient Satisfaction

Joint Replacement - Hip & Knee: A Deeper View


Total hip and total knee replacements are common and growing rapidly in the U.S., with wide cost variation largely based on post-surgical complications, and post-discharge care. CMS has launched a bundled payment model that requires eligible hospitals to be accountable for costs and quality of care of Medicare total joint replacement patients from day of surgery to 90 days after surgery. The Hip and Knee Replacement Application helps organizations track variability in key treatment processes for these procedures, connect those processes to outcomes and cost, and track compliance to improvement measures.


The Hip and Knee Replacement Application is aimed at clinical and medical directors, operational directors, and clinical program guidance teams focused on total hip and knee replacement.

Problem Summary

Candidate selection and varying treatment processes for hip and knee arthroplasty can often lead to variations in outcomes and bundled payments. Without data that links practice variations to outcomes, it can be challenging to address the drivers of variation or track the results of process improvements.

Success Measures

Opportunity Identification:

  • Identify potential reimbursement losses due to failure to meet appropriate use criteria and/or surgical complications.
  • Identify variability in blood utilization, glycemic control, and early mobility.

Process Improvements:

  • Increase the percentage of patients undergoing TJR that meet all appropriate use criteria measures.
  • Decrease the time from surgical end to first time out of bed.
  • Decrease the percentage of TJR patients who have post-operative blood transfusions.

Outcomes Improvement:

  • Decrease reimbursement losses.
  • Decrease LOS.
  • Decrease incidence of post-operative DVT/PE.
  • Improve patient satisfaction.