Organ Transplant EHR/EMRs are repositories of patient demographic, clinical and financial information and are continually accessed/updated by nurses (transplant coordinators), physicians, surgeons, social workers, pharmacists, tissue typing labs, etc. Progress notes are continually passed back and forth between all of the participants involved in delivering care.
Since organs are in short supply, the federal government gets involved in their allocation and distribution. The U.S. Organ Procurement and Transplantation Network (OPTN, optn.transplant.hrsa.gov) is responsible for organ matching and placement process, collecting and managing scientific data about organ donation and transplantation, maintaining the nation's organ transplant waiting list and recipient/donor organ characteristics. All U.S. transplant centers and organ procurement organizations must be members of OPTN to receive any funds through Medicare. The U.S. Department of Health and Human Services (HHS) contracts with The United Network for Organ Sharing (UNOS, unos.org) to administer the OPTN.
SRTR (ustransplant.org) reports include statistics about organ donation and recovery, waitlist activity such as transplant rate, and post-transplant outcomes such as graft and patient survival. These reports are published every six months with revised data about each Organ Procurement Organization and Transplant Program operating in the United States. Most transplant centers manually pore over SRTR data to ensure that they had accurately computed their outcomes from what had been reported to UNOS and whether the results matched their own computations. Much of this potential for errors goes away with this EMR application's safeguards to ensure that the reporting to UNOS was automated. UNOS forms have a lot of fields and not filling out a certain field, e.g. severity of a tumor, could lead to expected survival rates being better than actual outcomes.
Prospective transplant patients may be referred to a transplant center (there are 261 transplant centers in the US). Upon medical and psychiatric evaluation, a patient may be deemed suitable for a transplant. For kidneys, one waits for years for an organ to become available. For liver and intestine, a sicker patient gets precedence over a less sick patient.
Organ recipients do not all manage to live their remaining lives with one transplanted organ. A deceased-donor kidney may last 8-10 years while one donated by a living donor may last a few years longer. Transplanted organs fail and recipients become candidates again and need to be followed as candidates at a transplant center. At any given time, a center is managing first time transplant candidates, post-transplant patients and previously transplanted patients who need a new organ. Immunosuppressive drugs have to be managed for post-transplant patients and their progress updated in UNOS databases. A recipient may change his transplant center. Some of your patients may have a second kidney transplanted at your center while a previous transplant might have taken place elsewhere. These patients' graft and patient survival statistics are computed differently.
Organ transplantation is quite different from other areas of health care because of organ shortage and the resulting regulatory environment. Patient data is entered into UNOS databases when they are put on waiting lists, when they undergo transplantation and periodic reports have to filed by the transplant centers for the rest of the lives of the recipients. Similarly, organ donors are managed through this system. Insurance companies and the government expect regular updates to organ and patient survival data computed using Kaplan Meier survival analysis.
Organ transplantation is quite different from other areas of health care because of organ shortage and the resulting regulatory environment. Patient data is entered into UNOS databases when they are put on waiting lists, when they undergo transplantation and periodic reports have to filed by the transplant centers for the rest of the lives of the recipients. Similarly, organ donors are managed through this system. Insurance companies and the government expect regular updates to organ and patient survival data computed using Kaplan Meier survival analysis.
Most providers of transplant EMRs offer expensive systems (> $1 MM) with correspondingly high ongoing maintenance fees. Organtx is about to offer an affordable SaaS offering.
