Background: Communication between dialysis and transplant centers with regard to end-stage renal disease patient information throughout the transplant process is administratively intensive. We collaborated with the Southeastern Kidney Transplant Coalition and developers at Apex Health Innovations to create a multi-module, secure, web-enabled software application called Transplant Referral EXchange (T-REX) to enhance coordination between dialysis and transplant staff.

Methods: In 2017, we piloted T-REX at 1 transplant center and 4 dialysis facilities in Georgia. Dialysis staff (n=8) used T-REX to document use of transplant education materials and send electronic (vs. fax) referrals for transplant, specific to the center's requirements, to transplant staff (n=3). All staff utilized real-time communication via a messaging feature in T-REX. Preliminary analysis of T-REX implementation was examined 7 months after pilot start. Referral documentation was examined within T-REX and referral reports pulled from transplant center electronic medical records to determine usability.

Results: From April 1 to November 1, 2017, 68 referrals were electronically sent and received via T-REX. The mean time between a referral sent by dialysis staff to time of referral receipt (including all required patient information to schedule an evaluation) by transplant staff was 33.8 hours. The mean time to process a referral decreased from 50.1 hours (April 1-July 15) in the first half to 24.1 hours (July 16-November 1) in the second half of the pilot. All but 8 referrals from these dialysis facilities were sent via T-REX (vs. fax).

Conclusion: The pilot phase of T-REX showed high usability among dialysis staff. A randomized controlled trial among dialysis and transplant centers in the Southeast will be conducted in 2018 to examine the effect of T-REX vs. standard of care on transplant access. T-REX could help improve communication between healthcare providers, streamline efficiency of the transplant process, and ultimately help improve dialysis patient access to kidney transplant.

CITATION INFORMATION: McPherson L., Mutell R., Broughton P., Basu M., Gander J., Pastan S., Patzer R. Enhancing Coordination across Healthcare Settings through a Web-Based Transplant Referral Exchange (T-REX) Platform Am J Transplant. 2017;17 (suppl 3).

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