116.2: Electronic hospital donor referrals have arrived.

Abstract

Background: The Centers for Medicare and Medicaid Services in the United States and additional regulatory organizations require that hospitals refer all potential organ, tissue and/or eye donors to their designated Organ Procurement Organization (OPO). To replace the current time-consuming and error-prone telephonic referral process, one OPO, its software system partner, a Hospital clinical team and their Electronic Medical Record (EMR) team successfully collaborated to implement the first-ever secure direct and automatic electronic donor referral interface between a Hospital EMR system and an OPO donor management system. The goals of the interface include: (1) increase the number and timeliness of referrals (and thus transplantable organs); (2) reduce Hospital and OPO resource costs; and (3) reduce risk of error due to human verbal communication and transcription risk. Methods: The multi-disciplinary team collaboratively created a secure technical interface directly connecting the OPO and Hospital systems. The team designed seamless donor referral triggers within the Hospital EMR which expanded upon existing Best Practice Advisory (BPA) notifications that previously instructed the EMR user to call in the referral, and now automatically deliver electronic donor referrals from the Hospital to the OPO. Immediately upon receipt, the OPO’s electronic donor management system creates a new referral that is auto-populated with actionable patient information and delivers real-time notifications alerting OPO staff of the new referral. The interface automatically returns the associated OPO referral ID number to the patient’s EMR. This interface was successfully launched in the Hospital ICU in October 2018. In April 2019 (six months later), the Hospital successfully rolled out the interface to additional units and facility locations, and numerous additional interface discussions and implementations are currently underway. Results: Immediately, the monthly referral count from the Hospital ICU to the OPO quadrupled (October 2017 = 18; October 2018 = 72). Since the launch, the OPO has been able to convert on a total of 36 organ, tissue, and eye donors across the facility. The use of an existing BPA resulted in minimal change to Standard Operating Procedures and reduced the need for clinical team training. Successfully transmitted referrals contained zero (0) errors in data transmission. Higher levels of awareness of organ donation potential in the units was observed. Conclusions: The current results were successful in the following measures: 1) increased number of referrals; 2) reduction in resource cost; and 3) decreased errors. The interface was established using standard interoperability technology connecting widely-adopted OPO donation software and Hospital EMR Systems to allow for scalable expansion. There is unlimited potential for streamlining the referral process through this electronic interface, ultimately leading to more donors and transplantations.