Thousands of lives depend on a transplant network in need of ‘vast restructuring’

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White House Digital Service found that the technology that matches donated organs to patients has failed repeatedly.

The mechanics of the entire transplant system must be overhauled, the review concluded, citing aged software, periodic system failures, mistakes in programming and over-reliance on manual input of data.

“When nearly 100 percent of hospitals use electronic records, the notion that we rely on human beings to enter data into databases is crazy. It should be 85 to 95 percent automatic," said University of California at San Francisco surgery vice chair Ryutaro Hirose, a former chair of the UNOS liver transplant policy committee. “We could concentrate more on improving patient care.”for transporting organs. “With DoorDash, I know where my food is.

that they had “no confidence” in the security of the transplant network. They asked the White House to intervene to protect it from hackers. Shepard, who is stepping down in September, said his organization is audited yearly by HHS. He said that“The code is extremely large,” Shepard said. “They can come in and ask for specific pieces.”

UNOS oversees what is formally known as the Organ Procurement and Transplant Network, a complex collection of about 250 transplant-performing hospitals; 57 government-chartered non-profits that collect organs in their regions; labs that test organs for compatibility and disease; and other auxiliary services.

Only the government, however, can revoke an OPO’s license to operate. That has never happened in the history of the transplant system. “HHS should ensure that the OPTN uses a state-of-the-art information technology infrastructure that optimizes the use of new and evolving technologies to support the needs and future directions of the organ transplantation system,” the Academies, adding that the system “could save additional lives” if it acted more cohesively with better oversight.

The 1984 National Organ Transplant Act established the transplant network as a “quasi-governmental agency” — with UNOS in mind — run by a non-profit under a single contract, the Digital Service report said. UNOS’s shortcomings are compounded by HRSA’s own failings. The agency lacks technical expertise, can’t force the network to turn over data, and is so concerned about upsetting the nonprofit that it has been reluctant to push for more intensive demonstrations of the system, according to the report and interviews.

 

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