Application for 2015 University of California Larry L. Sautter Award for
Innovation in Information Technology
Date:
May 16, 2015
Project Title:
Living Donor Application
University of California Davis Health System
Submitted:
Dan Cotton, Educational Technology & Application Development Manager
UC Davis Health System IT
daniel.cotton@ucdmc.ucdavis.edu (916) 734-2019
Michael Minear
Chief Information Officer, UC Davis Health System
mnminear@ucdavis.edu (916) 734-7131
I. Project Leaders and Team Members
UC Davis strongly promotes a team science approach as a methodology for translational research. One of the
key elements leading to the success of this project was the consistent partnering of individual experts
throughout UC Davis Health System IT and the Living Donor Transplant Team to achieve team goals.
Project Leadership
 Daniel Cotton, Educational Technology & Application Development Manager
Information Technology
 Alesia Minyard, Analyst
 Peter Ruan, Development Supervisor
 David Haake, Senior Web Developer
 Vladimir Levin, Senior Web Developer
 Yujie Liu, Senior Web Developer
Living Donor Transplant Team
 Luke Preczewski, Transplant Executive Director
 Michelle Sturges, RN BSN, CCTC, Transplant Coordinator
 Sharon Stencel, RN MSN, CCTC, Transplant Coordinator
 Rosemary Benefeito, Analyst
Executive Sponsors
 Michael Minear, Chief Information Officer, UC Davis Health System
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II. Summary
The UC Davis Health System Information Technology department partnered with the Living Donor Transplant
Team to create the Living Donor (LIDO) application. LIDO allows the Living Donor Transplant Team to manage
individuals interested in donating a kidney from the time they first express interest in the program until the
donation has taken place and beyond.
III. Project Description
Background
The UC Davis Transplant center is a national leader in Kidney and other types of transplants. Sadly many
patients across the world are on long waiting lists to receive this life saving surgery waiting for donated organs.
In recent years, the living donor transplant program has advanced therapies in desensitization and paired-donor
exchange to make it possible to transplant kidneys from living donors who previously would have been
incompatible. By making living donor transplants possible, UC Davis clinicians helps the recipients of those
organs, and also the patients behind them on the waiting list.
UC Davis Medical Center - Waiting list and Kidney Transplant Activity 1
All donors must submit a “Living Kidney Donation Interest” questionnaire to initiate the donation process. In the
past, potential donors submitted the questionnaire for consideration via a paper form; they would have to email,
fax, mail or deliver form in person. Donors could also call the Living Donor Transplant Team directly and have a
staff member fill out a questionnaire on their behalf. These methods of submitting donor information lacked the
security this sensitive data required and were extremely inefficient. Basic donor information was entered into
Transys, a home grown application primarily used to manage transplant recipients, all other information
collected about donors was tracked on excel spreadsheets.
Many steps are required to screen and qualify a donor for kidney donation. Each phase of the Living Donor
Transplant Team’s business process was thoroughly analyzed and is accounted for in LIDO. The analysis and
software development process took approximately two years resulting in an application customized for the Living
Donor Transplant Team’s operational needs.
1
Scientific Registry of Transplant Recipients (SRTR). (2014). Waiting list and Kidney Transplant Activity, University of
California David Medical Center. Transplant Program (Organ): Kidney. Accessed from
http://www.srtr.org/csr/current/Centers/centerdetail.aspx?facility=CASMTX1KI
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Living Donor Application Overview
LIDO was built with the intent of managing the donor data and processes from the time the initial questionnaire
is submitted until the process was completed. All project participants collaborated weekly about the living
donation business processes and developed a process map for current and desired workflows. Together, the
team determined the high-level functionality the system should accomplish and designed a system that allowed
a high degree of flexibility. Rather than staff adapting practices to software, the software was tailored to serve
the Living Donor Transplant Team’s newly defined workflows. LIDO has radically changed, and improved the
way the team processes and tracks donors.
Implementation Timeframe
07/2011 – Business analysis began
09/2013 – Deployment to production environment
Project Benefits
1. Electronic Questionnaire Submission – LIDO allows potential donors to submit an initial
questionnaire electronically. This provides both convenience and security to the questionnaire
submission process.
Benefit: In the early months, after LIDO “went live” a total of 452 donors had been processed, and only
approximately 34 donor questionnaires were entered manually by the Living Donor Transplant Team.
This means that 92.48% of all questionnaires were entered electronically. Previously, 100% of the
questionnaires were entered to the Excel spreadsheet and processed manually.
2. Customizable Questionnaire – LIDO provides the ability to change the questions appearing on the
primary questionnaire, as well the sequence in which they appear. The feature allows the team to
specify how each question on the questionnaire will be effected by the screening algorithm. Additionally,
the instructions, privacy statement, and some of the text appearing on after a donor submits a
questionnaire are all customizable.
Benefit: Customization provides the Living Donor Transplant Team with the flexibility to change as
much of the questionnaire as they require. The team can add, remove or change existing questions as
the need arises. This ensures they capture the most critical information when the donor submits the
questionnaire.
3. Automatic Screening – LIDO automatically screens donor questionnaires into various online work
queues when the donor submits a questionnaire. The donor gets immediate feedback if they are a
possible candidate or not; this feedback helps to set the donors expectation as to what to expect next in
the process. If they are not a possible candidate they are provided information on how to contact the
Living Donor Transplant Team should they feel it is necessary.
Benefit: This feature saved the team approximately 53 hours in the first couple of months of use. The
Living Donor Transplant team estimates the initial contact with each donor takes 1 hour. Previously, ALL
donors who submitted a questionnaire had to be contacted. With LIDO, Only donors who are screened
and determined as suitable candidates are contacted by the Living Donor Transplant team. Additionally,
the automatic screening algorithm determined that 53 potential donors were not suitable candidates.
This allowed the teams to more quickly turn their attention to contacting donors who were more likely to
be viable candidates.
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4. Customizable Queues – In addition to the automatic screening
process which places the donor into predefined queues’ after they
submit their questionnaire, the Living Donor Transplant Team is able
to make additional custom queues to indicate where the donor is in
the donation process. The queues and corresponding dashboards
allow real time views into the entire donation process. (Figure 1)
Benefit: This enables the Living Donor Transplant Team to
manually assign a donor to a custom queue as they deem
necessary allowing them to more strategically organize their work.
Previously the team was extremely challenged to locate donor’s
case file and provide an accurate real-time status.
Figure 1 - Active Donor Dashboard
5. Single Source of Donor Data – LIDO contains all the donor data collected by the Living Donor
Transplant Team; it provides the ability to track all evaluation items, dates the evaluation was
scheduled, date the evaluation was completed and provides the ability to upload documents specific to
the evaluation. In addition to this critical donor data LIDO tracks the following data: (Figure 2 & 3)
a. Donor Demographics
b. Case Comments
c. Other case documents
d. Questionnaire data
e. Administrative tasks
f. Donor Status History
Benefit: One of the single biggest advantages to the team is having all of the donor data in one, secure
location. All data that pertains to a donor’s case in contained within a donor’s record in LIDO, and all
members of the team with appropriate permissions may access the data by simply logging into LIDO
and accessing the donor’s record. Previously, if a donors case file was not within the immediate grasp of
the team member who needed to review the file, finding the case file was often very difficult and time
consuming; due to many factors, it was not possible to have a central repository for donor case files.
Figure 2 - Donor Details (Demographics)
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Figure 3 - Donor Details (Evaluation Items)
6. Recipient Pairing – LIDO allows the Living Donor Transplant Team to pair a donor with a recipient, and
allows the Living Donor Transplant Team to “push” that pairing to Transys; Transys is the recipient
tracking system.
Benefit: Pushing the Donor/Recipient paring removes the need for double entry into the Transys
system.
7. Message Center – The message center feature within LIDO is role based. When a user sends a
message, it is sent to a role not a specific person. Messages may only be sent to users within the LIDO
system, and may NOT be sent to individuals outside the LIDO system.
Benefit: Since messages are sent to a role, any user with the corresponding role may read and respond
messages sent to that role. This prevents messages from sitting in individual team members “in boxes”
potentially causing delays, if the intended team member was unavailable and/or out of the office.
Additionally, it keeps the communication within the application eliminating the risk of sending electronic
protected heath information (ePHI) accidently.
8. Paperless Case File – Since the system previously used was paper based, one of the significant
problems was routing and tracking the paper “case file.” The team was challenged to keep all test
results and other pertinent case information together and accessible to all staff when they needed it.
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Benefit: LIDO is a role based system, which means that each user of the application with the
appropriate role and permissions may access the donor record at any time from any location via the
web eliminating the need to track down the packet.
9. Security – LIDO leverages the following authentication and authorization applications:
a. Central Authentication Service (CAS) – CAS is an authentication service that utilizes the
campus Lightweight Directory Service (LDAP)
b. Central Role Management (CRM) – CRM is an application that was developed by UCDHS IT
and provides authorization to an application via the use of “roles”
Benefit: The application is compliant with existing security requirements for applications developed by
Health System IT and relevant governmental regulations. With the use of CRM, the end user is able to
grant permission to users of LIDO and assign them certain roles which grants them access to certain
features.
Technology Utilized in the Project
The Living Donor application is completely built with Java Enterprise technologies. Java EE provides seamless
integration of persistence, controller/service, presentation layers, security (authentication and authorization) and
a Java EE certified application server.
Java Persistence API (JPA) provides an object mapping facility that can correlate conceptualized object models
in an enterprise environment and manage relational data in persistence layer.
Enterprise Java Beans (EJB) provides services such as transactions, security, messaging and web services that
encapsulates the business logic of an application.
JavaServer Faces (JSF) is a server-side user interface component framework that provides the wiring of
component-generated events to server-side application code.
Java EE security services provide a robust security mechanism for authentication users and authorizing access
to application functions and associated data.
Glassfish is a Java EE certified application server that “ties” the above technologies together, so that developers
can concentrate on building functions or features that satisfy business requirements.
Eclipse is the primary development tool used to build the application. Eclipse is a one-stop shop that provides
fluid development experience to implementing enterprise applications.
The database backend is using MySQL.
Conclusion
The Living Donor Application is testament to the determination and collaboration between UCDSH IT and the
Living Donor Transplant Team, which resulted in a highly functional application that meets all clinical needs of
the Living Donor Transplant Team. LIDO provides an innovate approach to managing donor data and provides
the Living Donor Transplant team a tool that allows them to continue to deliver excellent care to donors without
excessive effort in managing donor data.
The Living Donor Transplant team submitted an abstract – in the category of efficiency – to United Network of
Organ Share (UNOS) for consideration for presentation at the ‘2015 UNOS Transplant Management
Conference.’ The abstract detailed many of the benefits of LIDO that this application highlights. UNOS accepted
the abstract and a member of the Living Donor Transplant team presented the abstract along with a
corresponding poster to the conference held in April 2015.
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