Introduction: In the United States, national regulatory organizations require that hospitals refer all potential organ and tissue donors to an Organ Procurement Organization (OPO). Secure, direct, electronic donor referral interfaces are being launched across the country to replace the current time-consuming and error-prone telephonic referral process.
Method: The secure technical interface (“iReferral”) directly connects the OPO 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 OPO, greatly reducing the burden of decision-making and donation knowledge by the hospital staff. An additional trigger option allows staff to “one click” electronically refer for cases such as end-of-life discussions. Immediately the OPO receives a new referral auto populated with actionable patient information and real-time notifications alert OPO staff. The interface automatically returns the associated OPO referral ID number to the patient’s EMR to provide confirmation to the referring clinician.
Results: This interface is currently implemented at 67 hospitals across the United States. At a pilot hospital, annualized data after the first year of implementation demonstrated a 49% increase in vented referrals and 78% increase in organs transplanted. At a large hospital network, over 10,000 referrals have been sent electronically since launch in February 2021 which has led to: 1) saving an estimated 3,000 nursing hours; 2) increasing vented referrals by 42%; and 3) a 31% increase in compliance rates (reduced missed referrals).
Conclusions: This interface has increased the number and timeliness of referrals (and thus transplantable organs) and reduced Hospital and OPO resource costs. As the interface was developed utilizing common healthcare interoperability standards there is unlimited potential for expansion and streamlining the referral process, ultimately leading to more donors and transplantations.