General Hospital Papageorgiou Success Story: smartHEALTH supports C’ Orthopaedic Clinic of Papageorgiou General Hospital to develop the first national arthroplasty registry in Greece

This report presents a successful collaboration story between the C’ Orthopaedic Clinic of the Papageorgiou General Hospital and the European Digital Innovation Hub “smartHEALTH”.

Key Information

The Centre of Arthroplasty Registries (Arthroplasty Registry) of the C’ Orthopaedic Clinic of General Hospital Papageorgiou, is unique in Greece, as the only hip and knee arthroplasty registration centre with long-term monitoring. The recording is done according to the rules of GDPR and is a research project of the Aristotle University of Thessaloniki funded from the research program of Professor Tsiridis. The centre is a guarantee of quality of services in Greece and Internationally and its results are recognized by all reputable International journals and organizations.

• Technologies Used: Internet Services & Applications; Software Architectures
• Collaboration Period: May 2024 – March 2025
• Services Provided: Flagship national registry development service

The Challenge

Arthroplasty registries are widely used to monitor the survival of orthopaedic implants, at a national level. Greece is lacking such a national registry. The study of national arthroplasty registries provides information on complications and catastrophic implant failures, prosthesis survival, drug and surgical efficacy, with the aim of continuously improving the provision of medical care to patients. These data are unique at the national level and used to optimize health economics.

Doctors from the C’ Orthopaedic Clinic of General Hospital Papageorgiou contacted smartHEALTH EDIH to help creating the first national registry of arthroplasties, which aims to record and monitor the progress of hip, knee and shoulder arthroplasties. The national registry would optimize the medical care provided and the economics of health, through the digitalization of the national health system.

The Analysis

The experts from FORTH/CeHA have long standing experience in developing Health-related software, including registries. The experts were in position to provide all the knowledge & skills needed for developing such a system, in prototype level, taking into account various requirements. The project had several challenges, both technological and managerial. In terms of technological challenges, specifications have been studied and defined for issues of structure, installation, maintenance, interoperability, security and regulations. Management challenges included studying regulatory rules, accessing data, exploiting results, involving other clinics, connecting with other national registries, etc.

The Solutions

The experts provided services concerning three major dimensions:

• The non-functional characteristics of the registry, including compliance to regulatory requirements
• Software architecture to host the required data and functionalities
• An operational prototype for testing the functionalities and data

More detailed, experts evaluated the non-functional features of the registry and made suggestions regarding its architecture, interfaces, information security and personal data protection. The clinic’s doctors made suggestions for the registry’s content, drawing on their many years of experience in using a local registry. Following the ISO 25010 standard, the experts assessed and developed the system using 3 criteria:

• Scalability and system performance efficiency
• Compatibility – Interoperability and adaptation to the local environment
• Security – Privacy

Experts developed also a functional prototype that meets the above specifications, which is available for trial use. The trial so far is successful and the prototype is working smooth. The Orthopaedic Clinic has received also guidance for taking the proper initiatives for the institutionalization and operation of the registry.

smartHEALTH will support the promotion of the registry to the national authorities for adopting it, on national level. smartHEALTH will also provide training to the clinic, which will be open for all clinics of Greece to use the registry.

The cost of the service covered completely from the EC and the Greek state, without any contribution from the clinic, thanks to the funding scheme of EDIH.

The Implementation

Τhe hospital received a functional prototype of the registry. All the procedures needed for becoming operational were also delivered by the experts. The plan is that the registry will be managed by the 3rd Orthopaedic Clinic and will be open to host data from other clinics. Incentives and instructions have been given to allow other corresponding clinics, at national level, to use and update it. The registry will also allow connection with other similar ones abroad.

The registry is designed to facilitate easy data entry. In most cases, data is selected from lists of values and a correctness check is performed. An administrative interface is provided for updating the selection lists. For example, it is possible to add diagnoses or modify the name of a diagnosis. In this way, the registry covers all current and future needs from doctors. By design, the registry also allows convenient search of data and export them for easy compilation of reports.

The Benefits

The operation of the registry, in national level and connected with other similar systems abroad, will have serious positive impact, both in society and economy. In short, the registry will bring better patient outcomes, fewer complications and major cost savings for healthcare systems.

More specifically, it is expected that citizens will have:

Social Impact

• Improved Patient Outcomes
• Enhanced Surgical Standards
• Patient Empowerment
• Reduced Health Disparities

Economic Impact

• Cost Savings from Fewer Revisions
• Efficient Resource Allocation
• Reduced Burden on Healthcare Systems
• Support for Value-Based Healthcare

Lessons Learned

This case was delivered in a very smooth and efficient way. The EDIH worked successfully for the challenges posed by the hospital. The Key Account Manager who dealt with this case assigned proper experts for working together with the people of the hospital and coordinated the process.

A key for the success of this case was the ability of the involved doctors to describe their needs effectively. Thanks to their previous work with a local registry funded by a previous project, they were able to correspond effectively.

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