Orthopaedic registry history and future in South Africa

Data is power. In 2017, the South African Orthopaedic Association (SAOA) presidential line identified a political and market-influenced initiative to collect and use data in the health care space. The South African government had funded a "Health Market Inquiry" (HMI), which determined that medical professionals were poorly monitored and lacked peer review. Clinicians were not involved in this effort and were not well positioned to represent the interests of patients. The report noted that funders and hospital groups favored patient-reported outcome measurements (PROs) but proposed to collect and interpret the data themselves. Clinical data was, therefore, being collected and interpreted by nonclinicians. It became evident that it was in the interest of the SAOA to control this data securely with orthopaedic peer interpretation of the data. At the time of the HMI report, 2 databases were in use in South Africa: a National Joint Registry had been created in 2012 (limited to arthroplasty) and the REDCap database had been adopted by many academic units and was used mainly for research. Other than these registries, medical data was individually stored and opaque. This report summarizes the efforts of the SAOA to collect meaningful PROs and provide clinically relevant data analysis to inform health care policy and clinical quality improvement.