415.2: Increasing organ donors and transplants via interoperability.

Introduction: National regulatory agencies in the United States of America (USA) require that hospitals refer all potential organ and tissue donors to their designated Organ Donation Organization (ODO). To replace the current time-consuming and error-prone telephonic referral process, secure and direct electronic donor referral interfaces are pursued and launched across the country. Implementation of the interface has led directly to increased referrals, donors, and organs recovered for transplant as well as hospital and ODO resources saved. Method: The secure technical interface directly connects the ODO and hospital systems and is accompanied by seamless donor referral triggers within the hospital Electronic Medical Record (EMR). These carefully tuned triggers automatically prompt delivery of electronic donor referrals from the hospital to the ODO, ensuring timely and compliant referrals. An additional trigger option allows staff to “one click” electronically refer for cases such as end-of-life discussions. Immediately the ODO receives a new referral auto-populated with actionable patient information and real-time notifications alert ODO staff. The interface automatically returns the associated ODO referral ID number to the patient’s EMR chart to provide confirmation to the referring clinician. Results: This interface has been successfully launched at over 140 hospital facilities in the USA with many more in the process of implementation. Over 30,000 referrals have been sent using this interoperability technology, saving an estimated 10,000 nursing hours that otherwise would have been spent on the phone (based on an average of 20 minutes per phone referral). Upon launch, hospitals have consistently demonstrated increases in vented referrals, donors, and organs recovered for transplant. Hospital A experienced 114% increase in vented referrals, 100% increase in organ donors, and 333% increase in organs recovered for transplant. Hospital B experienced a 139% increase in vented referrals, 133% increase in organ donors, and 65% increase in organs recovered for transplant. Hospital Network C experienced 93% increase in vented referrals, 53% increase in organ donors, and 56% increase in organs recovered for transplant. Hospital Network D experienced 148% increase in vented referrals, 48% increase in organ donors, and 56% increase in organs recovered for transplant. Hospital Network E experienced a 47% increase in vented referrals, 77% increase in organ donors, and 81% increase in organs recovered for transplant. Conclusion: This interface has demonstrably increased the number of referrals, donors, and organs recovered for transplant as well as greatly reduced hospital and ODO resource costs. As the interface was developed utilizing common healthcare interoperability standards, this enables rapid launch and expansion across the USA and the world to streamline the referral process and ultimately lead to more donors and transplantations.