Through advances in science and medicine, organ transplanting has increased in frequency—and developed into an ever-growing business. At
In 1996,
A dozen years later, the hospital is still working toward that goal. “There’s nothing magical about information systems,” says Bryan Barshick, the center’s decision support/transplant manager, who is in charge of the project. “It will give you the bedsheets but it won’t make the bed for you.”
As a May 2007 Baseline cover story on the transplant program at the
While John Hopkins does not yet provide a text-book example of how to implement systems to manage a complex transplant center, it does offer other hospitals a guide to get closer to that goal.
No Room for Error
At John Hopkins, a big challenge has been getting staff and clinicians to abandon their comfort zone with paper-based processes in favor of automated transplant management systems. It’s not an uncommon problem for organizations adopting new technology. The transition is doubly challenging for John Hopkins and other top hospitals with zero tolerance for error in patient care and transplant compatibility. Mistakes can cost patients their lives.
All patients are listed in a national database administered by the United Network for Organ Sharing (UNOS), which matches organs with recipients based, in part, on how long they have been waiting for a transplant. UNOS uses complex algorithms to calculate that waiting time. It collects about 120 types of data and treats each type of organ tissue differently. Its database doesn’t automatically connect with the transplant databases at all hospitals, requiring some transplant centers to fax or e-mail patient data to UNOS.
The systems used to track patients and transplants tripped up Kaiser Permanente and, according to California regulators, placed patients “at risk for…potentially life-threatening delays in care.” Kaiser lost track of patients’ paper records, patients’ complaints and the time they spent on UNOS’ waiting list.
Two years ago, Johns Hopkins replaced the transplant database it had been using, which it declines to name, with a more modern one from TeleResults, a database vendor based in
The hospital is building interfaces between the database and various in-house and third-party laboratories. Radiology will soon get an interface, and Barshick also will try exporting data electronically from TeleResults to UNOS.