UC57: Organ Transplant Waitlist Monitor

The Problem

Organ transplant candidates on the waiting list must maintain monthly lab work (liver function, renal function, coagulation studies) to remain "active" and eligible for organ offers. Patients who miss labs become "inactive" and drop down the waitlist; lapse times can stretch 6+ months. Systematic monitoring and patient reminders keep candidates active and ready for organ offers.

What the Agent Does

Batch runs weekly: queries UNOS waitlist (via DonorNet access) and transplant center EHR
Identifies all waitlisted patients and their lab compliance status
Checks: are required labs (CBC, CMP, PT/INR, tissue typing) current (within last 30 days)?
If labs are due or overdue (within 5 days): sends patient reminder (SMS or patient portal message): "Your transplant labs are due next week; please schedule with phlebotomy"
Monitors lab results as they come in; updates UNOS DonorNet status automatically
If labs overdue >7 days: alerts transplant coordinator; coordinator reaches out to patient directly
If patient remains inactive >90 days: may require re-evaluation or removal from list
Generates compliance dashboard for transplant center: % of waitlisted patients with current labs; time-to-inactivity for overdue patients

Data Requirements

Primary Data Sources: UNOS/DonorNet waitlist status, lab results (CBC, CMP, PT/INR, tissue typing), patient demographics, transplant center EHR, patient contact info
Classification: PHI/PII (waitlist status, lab results, patient identifiers)
Quality Metrics: Lab compliance tracking accuracy >99%; reminder delivery >95%; time-to-inactivity reduction >50%
Complexity: Medium (UNOS/DonorNet integration, lab tracking, notification logic)
Systems: UNOS/DonorNet, Epic (transplant center EHR)

Score Breakdown

Criterion	Weight	Score (1-5)	Weighted
Time Recaptured	15%	4	0.60
Error Reduction	10%	4	0.40
Cost Avoidance	10%	3	0.30
Strategic Leverage	5%	3	0.15
Data Availability	15%	3	0.45
Process Clarity	15%	3	0.45
Ease of Implementation	10%	3	0.30
Fallback Available	10%	3	0.30
Audience (Int/Ext)	10%	4	0.40
Composite	100%		3.35

Why It Scores Well

Patient Outcome: Keeps transplant candidates active and ready; improves access to organs
Operational Efficiency: Transplant coordinators freed to focus on organ offers vs. administrative reminders
Regulatory Fit: UNOS requires active status for organ offers; agent supports UNOS compliance
Scalability: Applies to all waitlisted patients
Data Availability: UNOS and EHR systems have mature integration

Regulatory Alignment

UNOS Transplant Rules: Mandatory lab frequency for active status; organ allocation depends on active status
CMS Transplant Program Standards: Transplant centers must maintain waitlist compliance
HIPAA: Waitlist status is highly sensitive PHI; UNOS systems have HIPAA-compliant data handling
FDA: No additional requirements (lab coordination, not clinical decision-making)

Sprint Factory Fit

2 sprints (UNOS/DonorNet integration, lab tracking, notification logic, transplant coordinator interface)

Sprints Required: 2 sprints (UNOS/DonorNet integration, lab tracking, notification logic, transplant coordinator interface)
Timeline: 3 to 4 weeks from requirements to pilot
Governance: Transplant center director approval; monitor lab compliance rates and time-to-inactivity weekly
Success Metrics: Lab compliance >90%; patient reminder response >80%; time-to-inactivity reduction >50%; patient satisfaction >4.0/5

Comparable Implementations

UNOS/DonorNet: Waitlist Management
Transplant center EHR modules
Epic transplant management features

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