*Purpose: Use real time group messaging data among procurement and transplant professionals to supplement the review of UNOS Report of Organ Offers (ROO) for declined primary offers when the organ was later transplanted elsewhere at a later sequence.

*Methods: UNOS ROO data for offers facilitated by an organ procurement organization (OPO) from July 2017 – December 2020 were connected to group messaging data from a dedicated secure communication mobile app used by participants from the OPO, recovery, and transplant clinical and coordination teams. Critical decision time points in the organ offer, procurement, and transplant processes were reviewed on a monthly basis during a routine monthly meeting among the teams.

*Results: Teams reported enhanced quality of their monthly retrospective review of the ROO when supplemented with real time documentation. Administrators reported that they received a detailed, factual account of what transpired during each offer. Teams highlighted that having real time documentation was particularly useful for organ offers that were later transplanted elsewhere at a later sequence. Administrators substantiated the need for centerwide organ acceptance standards and processes. The delineation resulted in increased buyin from clinical teams.

*Conclusions: UNOS ROO and other organ utilization tools and data are used to effectively improve offer evaluation processes in organ procurement and transplantation. Mobile apps capture additional contextual data that is helpful when analyzing offer data and mitigate reimbursement and liability issues. Reviewing insights provides an opportunity for feedback and testing of decision-making strategies and organ offer filters.

Table. Report of Organ Offers with color code Green: transplanted, Gray: never primary, Orange: transplanted someone else same center, and Red: transplanted elsewhere after the decline. Particularly for Red offers, programs look at data captured in the real-time messaging app to reconstruct the case events and timeline.

Figure. An organ case using the mobile application, which automatically records and documents context, coordination, and communication events and is linked to supplement any organ offer from the UNOS report of organ offers.

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