27 Months Follow Up of a Cohort in the Transplant Continuum After Using a New Electronic Medical Record Tool to Document Transplant Option Discussions Among Patients with EGFR <20 Ml/min/1.73m2
1MAPMG, McLean, VA, 2Kaiser Permanente |, Oakland, CA, 3Kaiser Permanente, Oakland, CA, 4Kaiser Permanente, Oakland,, CA, 5Kaiser Permanente, Hyattsville, MD, 6MAPRI, Rockville, MD
Meeting: 2021 American Transplant Congress
Abstract number: 498
Keywords: Kidney transplantation, Outpatients, Renal failure, Waiting lists
Topic: Administrative » Quality Assurance Process Improvement & Regulatory Issues
Session Information
Session Name: Quality Assurance Process Improvement & Regulatory Issues
Session Type: Poster Abstract
Session Date & Time: None. Available on demand.
Location: Virtual
*Purpose: The purpose of this study was to assess: 1) the documentation of transplant option discussions; 2) the number of members listed & transplanted preemptively; and 3) transplant opportunity.
*Methods: A new tool for documenting Transplant discussion options was implemented in the electronic medical record (EMR) and a cohort from June 13, 2018 was followed over the next 27 months. Our intervention consisted of training providers and case managers how to document transplant option discussions.
*Results: A total of 1857 patients with eGFR ≤ 20 mL/min/1.73m2 were identified and of those, 604 (32.5%) ) were in transplant continuum (referred, evaluated & waitlisted). Of those in the transplant continuum, 241 members were waitlisted of which 86 (36%) were preemptively listed. Of those 1253 not in the transplant continuum, 1070 did not have documentation of transplant option discussion. See attached cohort diagrams. In 27 months after the EMR tool was implemented, the undocumented transplant discussion improved from 1070 to 1. A total of 642 members were deemed not transplant candidates, of which 400 were above 75 years old & 81 were obese with BMI >40. As of 10/4/20, members in the transplant continuum increased from 604 to 1039, waitlisted from 241 to 447 of which 34.7% are preemptively listed. 151 were transplanted of which 9 were preemptively (out of 56 preemptively listed). Of the 9 preemptive transplants, 3 were from living and 6 were from deceased donor. The number of our waitlisted members per year increased from 70 in 2017 to 90 in 2018 and 120 in 2019. The total number of renal transplants per year increased from 46 in 2017 to 65 in 2018 and 77 in 2019.
*Conclusions: We demonstrated a simple, easy EMR tool can help increase documentation of transplant option discussion, waitlisted members and transplant opportunity. This study suggests that patient management for transplant services could be significantly improved and clinical outcomes could potentially be impacted.
To cite this abstract in AMA style:
Yishak AA, Bhatnagar MS, Tomimatsu AV, Londe RLa, Clark E, Rubenstein KB, Vupputuri S. 27 Months Follow Up of a Cohort in the Transplant Continuum After Using a New Electronic Medical Record Tool to Document Transplant Option Discussions Among Patients with EGFR <20 Ml/min/1.73m2 [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/27-months-follow-up-of-a-cohort-in-the-transplant-continuum-after-using-a-new-electronic-medical-record-tool-to-document-transplant-option-discussions-among-patients-with-egfr/. Accessed May 23, 2025.« Back to 2021 American Transplant Congress