IT UpdateNovember 12, 2015

Agenda

Opening Remarks James Gleason

IT Update Alex Tulchinsky

IT Advisory Committee (ITAC) Background Formed in 2012 under Bob Merion’s leadership

Committee charter “Assist the UNOS CAC in fulfilling its oversight duties for UNOS operations

by providing external expertise regarding information technology efforts…”specifically . . .

Assists the CAC to develop a strategic plan for Information Technology (IT) needs of the corporation and oversees the execution of the IT plan

Identifies strategic priorities in IT, and assists the CAC in setting standards for organizational IT performance

Oversees the work of the corporation in fulfilling the IT-related requirements of the OPTN contract.

ITAC 2014/15 Composition

ITAC Chair:

ITAC members from UNOS board (3 voting members, serving 2 years):

ITAC 2014/15 Composition (cont’d)

ITAC advisors from the IT community (3 non-voting members, serving 2 years):

• Haris F. Basit• Arthur (Art) L. Glasgow• Rick Hasz

ITAC UNOS staff and board leadership :

ITAC Past Accomplishments Performed an assessment of UNOS IT organization & leadership

Performed an assessment of current and future IT workload

Reviewed past and planned IT delivery performance

Recommended leadership and organizational improvements

Recommended significant UNOS IT staff increase/development

Recommended IT process improvements

Oversee the implementation of board approved IT actions supporting those recommendations

Provided direct access and consultation with user community

ITAC 2014/15 Goals

Oversee the implementation of board approved IT actions and supporting recommendations to include . . . Continued recruitment to full staff Oversee continued IT organizational and process improvements Monitor system development and service delivery per schedules Insure continued leadership and financial support for IT effort across fiscal

calendars Provide client and expert guidance for IT futures Insure service is anchored in client need and satisfaction Continued IT translation services to the CAC and UNOS board (i.e. make IT

communications user understandable)

Projects

Customers

Technology

Data

Culture

IT Update

June 2014 – November 2014

Jun-13 & Prior Non-BoD

Nov-13

2014 2015Q2 Q3 Q4 Q1 Q2

April May June July Aug Sept Oct Nov Dec Jan Feb March April May June

Uniform National Pancreas Allocation HLA Equiv.

Donor Screening w/ Qualified Specimens Improve Vessel

TIEDI C# Conversion TIEDI and OMB Changes Patient Safety – Living Donor Events

KAS - Phase I Revised Kidney Allocation System (KAS) - Phase II HLA C & HLA DBQ Clarify A2-A2B

KPD - Phase 4 (EW/WF) Ped Liver Remove ICU Req & Modify Liver Hepatoblastoma

LAS & Diagnosis Data Element <12 Update DCD

Integrate DonorNet Import/Export into ETT Update PDDTE

Membership Inactive Screening

TIEDI and OMB Changes

Re-Instate No Appeal

2014 2015 2016

Q4 Q1 Q2 Q3 Q4 Q1

Oct Nov Dec Jan Feb March April May June July Aug Sept Oct Nov Dec Jan Feb March

(#4) Improve Vessel Disposition Reporting

Add Serum Sodium to MELD Score Deceased Donor HLA Typing

TIEDI and OMB Changes

Living Liver Donor Follow-up (#1) Require Reporting Whether Donor Screening Tests are Completed Using Qualified Specimens

Pancreas Serum Lipase

KAS Phase II HLA C & HLA DBQ

Patient Safety - Living Donor Events

Imminent & Eligible Death

Aborted Living Donor Recovery

(#2) HLA Equivalency Tables

Histo Policy

KPD Histo Testing Policies

LAS & Diagnosis Data Element <12 Ped Liver ICU Req & Liver Hepatoblastoma

(#3) Potential Donor-Derived Disease Transmission Reporting

Review Min Screening Req for Deceased Donor Clarify A2-A2B

Membership Inactive Screening

2015 Projects Timeline

ABO Blood Type Policy Mods

Donation after Circulatory Death

Reinstate "No Appeal / No Withdrawal

Proposal to Align OPTN Policies with 2013 PHS Guidelines

Modify Pediatric Heart Allocation HCC Exception Score Cap

Delay HCC Exception Score

Consent to Authorize

HOPE Act Living

HOPE Act Deceased

Jun-13 & Prior Nov-14

Nov-13 Non-BoD

Jun-14 HOPE Act

HOPE Act Prep Work

HOPE Act Impacts

Screening Requirements for Deceased Donor2013 PHS Guidelines

HOPE Act

Serologies Affecting Match Run AppearanceInfectious Disease Verification Process

Wai

tlist

Don

orN

etM

atch

Patie

nt S

afet

yM

embe

rshi

pTr

ansN

etTI

EDI

KPD

Historical Perspective

2013 – End of Year

1Y [2012]

< 1Y [2013]

3Y [2010]

2Y[2011]

5Y[2008]

4Y[2009]

21 – Pipeline 39,010 hours

2 – In Progress7650 hours

2000

4000

6000

8000

10,000

12,000

14,000

16,000

18,000

20,000

0

IT E

ffort

Est

imat

e in

Hou

rs

Age [year of BOD approval]

10,530 (5)

10,940 (4)

7650 (2)

2240 (3)

9090(4) 6210

(5)

2013 – In Progress1)Kidney Waiting Time Modifications2)Update the Calculated PRA (CPRA)

2014 – End of Year Projection

1Y [2013]

< 1Y [2014]

3Y [2011]

2Y[2012]

5Y[2009]

4Y[2010]

24 – Pipeline 24,620 hours

5 – In Progress16,560 hours

2000

4000

6000

8000

10,000

12,000

14,000

16,000

18,000

20,000

0

IT E

ffort

Est

imat

e in

Hou

rs

Age [year of BOD approval]

16,690 (12)

800 (3)1430 (1)

1180 (2)3150

(3)

7Delivered

22,740hours300 (1)300 (1)

7350 (1)

2240 (3)

5940 (1)

1540 (1)

290 (1)290 (1)

2014 – Completed1)Kidney Waiting Time2)Update CPRA3)Reorganize hemodynamic data on Heart Justification form4)Modify Requirements for Mandatory HTLV-I/II5)Patient Safety Reporting6)PA/KP Allocation7)KAS – coming December 4th

2014 – In Progress1)Ped Lung Diagnosis – Other Specify 2)TIEDI OMB 3)Revise LAS4)Potential Donor Derived Disease Transmission reporting5)Living Liver Donor Follow-up

2015 – End of Year Projection

1Y [2014]

< 1Y [2015]

3Y [2012]

2Y[2013]

5Y[2010]

4Y[2011]

6 + ? – Pipeline 7560 hours + ?

3 – In Progress1740 hours

2000

4000

6000

8000

10,000

12,000

14,000

16,000

18,000

20,000

0

IT E

ffort

Est

imat

e in

Hou

rs

Age [year of BOD approval]

21Delivered

35,880hours

1620 (2)

7560 (6) 120 (1)120 (1)

2015 – Completed1.Ped Lung Diagnosis Other Specify 2.Reinstate No Appeal/No Withdraw3.Donor Screening using Qualified Specimens (#1)4.TIEDI OMB 5.Require HLA C and HLA DQB6.Patient Safety System - Living Donor7.Clarify A2/A2B 8.Ped Liver Remove ICU9.Ped Liver Hepatablastoma10.Revise LAS 11.Consent to Authorization

12. Vessel Disposition Reporting (#4)13. Potential Donor-Derived Disease

Transmission Reporting (#3)14. Imminent and Eligible Death 15. HLA Equivalency Tables (#2)16. Minimum Screening for Deceased

Donors17. Add Serum Sodium to MELD 18. Comprehensive Histo Compatibility

Rewrite19. Living Liver Donor Follow-up 20. 2013 PHS Guideline Review 21. HOPE Act - June 2015?

2015 – In Progress1)Donation after Circulatory Death2)Cap HCC @ 343)Delay HCC

2015 – End of Year Projection

1Y [2014]

< 1Y [2015]

3Y [2012]

2Y[2013]

5Y[2010]

4Y[2011]

6 + ? – Pipeline 7560 hours + ?

3 – In Progress1740 hours

2000

4000

6000

8000

10,000

12,000

14,000

16,000

18,000

20,000

0

IT E

ffort

Est

imat

e in

Hou

rs

Age [year of BOD approval]

2 year totalprojects delivered

28 58,620 hours

(including HOPE Act)

1620 (2)

7560 (6) 120 (1)120 (1)

Customers

Technology

Current State

Small Changes …

Become Big Efforts…

User Interface &Application Layer

Business Logic & Data Layer

Request

Database

Business Logic

Front End

User Interface

Target State

Business Logic

Business Logic

Business Logic

Front End

Front End

Database Database

Modular Services operating independently of one another

Small changes have limited impact

Algorithm layer

Datalayer

Request

Information Security Update

Disaster Recovery & Business Continuity

Data

Information Architecture

Automate Collect

Exchange

Organize Analyze

Format

Store

Culture

Thank You!

Questions?