HL7 EHR Integration for Organ Donation Eases Clinician Burden

An EHR integration that automates organ donor referral calls through HL7 data exchange has helped streamline the time-sensitive organ donation process and alleviate clinician burden, according to an article published in the Harvard Business Review.

The nation’s organ donation process has traditionally relied on providers calling their designated organ procurement organization (OPO) when a patient dies or is near death for an initial medical screen to determine if the patient can be an organ donor. Typically, this call takes about 15 minutes.

While 15 minutes may not seem very long, the calls can consume a sizable amount of staff time at hospitals and OPOs in the aggregate and contribute to clinician burden.  

New England Donor Services (NEDS) recognized the opportunity for innovation and developed non-proprietary health IT to replace this phone call with an automated message.

Yale New Haven Health tested this technology for eight weeks in 2020 at its flagship academic medical center, Yale New Haven Hospital.

An initial pilot, which involved three critical care floors at the Yale New Haven Hospital York Street Campus, began in March 2020, just before the first wave of COVID-19 reached its peak in the Northeast.

The organizations originally planned to deploy the health IT over six to 12 months at the hospital’s York Street Campus before gradually rolling it out across the rest of that academic medical center and the other four hospitals in the health system in the following years.

However, time savings in the first three months of the test were so crucial given the clinical demands of the COVID-19 surge that the organization immediately deployed the EHR integration systemwide.

In 2020, the tool saved the health system 470 hours of nurses’ time.

The EHR integration automates organ donor referrals via electronic messages through the HL7 data exchange protocol. An additional message is sent back to the hospital notifying it whether the referred patient has the potential to donate organs.

NEDS officials noted that four critical factors helped ensure the success of the initiative that could be applied to other joint health IT efforts.

First, they emphasized the importance of partnering with the right organization.

“Recognizing the need for operational innovation and systemwide improvement in organ donor referrals, NEDS consciously picked a partner — Yale New Haven Health — with a similar reputation,” NEDS officials wrote. “Significantly, the two had collaborated for decades, which produced the trust needed to test an unproven idea.”

Next, they stressed the importance of articulating the value proposition in a meaningful way. Provider institutions constantly receive proposals for new health IT initiatives, so organizations need to provide a clear, compelling value proposition upfront, according to NEDS.

Additionally, NEDS officials noted that developers should avoid proprietary technology. Given the variety of EHRs being used by health systems, configurable health IT is crucial to persuade as many systems as possible to adopt the solution.

Lastly, NEDS officials said that the health IT must be easy to use and part of the workflow.

“Every hospital — and sometimes each unit in a hospital — has its own rhythm and flow; who contacts the OPO, where notes are kept in the EHR, the sequence of screens on an EHR, and even roles on a care team in an ICU can differ,” they explained.

To tailor the health IT to end-user needs, NEDS placed the clinical trigger to send the referral message in a location within the EHR that created a generic operational process that could be tailored to a given hospital or health system’s existing workflow.

Yale New Haven Hospital’s IT staff observed how the clinical staff worked and placed the clinical referral triggers in a location in the EHR that worked best for the care team.

“The potential of EHR systems is enormous, but tapping it depends on making new functions easy to adopt,” NEDS officials wrote. “Designing non-propriety technology, giving it to trusted partners to test, and planning the deployment collaboratively with those at the frontline of care can achieve that goal.”