Using a rule-based platform for organ allocation and process automation
This ability to develop and implement rules and to make changes to them quickly forms the foundation of the allocation scheme. “Being able to make use of these rules effectively is where IBM Business Process Manager on Cloud comes into play,” says Mr. Powell. “We’ve found the tool not only integrates well with Operational Decision Manager on Cloud, it also integrates well into our existing systems, which is really important to capturing workflow and implementing changes quickly. We recapture both the workflow and the decision-making capability in Operational Decision Manager to actually enable the allocation to happen.”
NHSBT recently reached a critical milestone: the first transplant of an organ—a heart—allocated according to a new scheme developed using IBM Business Process Manager on Cloud (BPMoC) for process optimization and IBM Operational Decision Manager on Cloud (ODMoC) as the rules engine for the allocation scheme itself.
Mr. Powell and his team built the heart/lung allocation scheme workflow in BPMoC, which enables NHSBT’s 24-hour operational center to monitor the status of an organ offer—whether it’s been accepted or rejected—and manage the subsequent workflow. In the case of a rejection, that means moving rapidly from one potential recipient to the next until a suitable recipient is identified.
And where BPMoC and ODMoC operationalize rules and processes, the IBM Blueworks Live (BWL) software, a SaaS offering, allows NHSBT to constantly evaluate new processes and models. “Blueworks Live has enabled us to capture workflow information in an accessible and understandable format so that we can both improve implementation planning and articulate to a wider audience how the actual allocation scheme works in practice.” That wider audience includes statisticians, analysts, those with regulatory responsibilities and the NHSBT operational center, as well as stakeholders in IT.
BWL, BPMoC and ODMoC are the first business-critical applications NHSBT has moved to the cloud, a move Mr. Powell attributes to his organization’s need to focus on its mission—making sure that as many people as possible receive needed organ transplants—rather than technology. “For us, the cloud is about letting other people worry about things like how many virtual machines we need to run in which data center.”
Optimizing transplant outcomes
On average, four to five donors become available each day in the UK, and each of those donors will donate between 2.5 to 4 organs, so NHSBT is looking to utilize its cloud-based platform for more than just heart and lung allocation schemes. Next is a national transplant waiting list that can be accessed by clinicians from their mobile devices, enabling them to register a new patient or change a patient’s status in near real-time.
Also in development is a liver allocation scheme, which is expected to increase the number of liver transplants by approximately fifty annually. “That’s fifty lives saved or significantly transformed,” says Ms. Johnson, who interacts with surgeons in the development of allocation schemes. She credits newfound agile development capabilities facilitated by BPMoC and ODMoC platforms with improving responsiveness to surgeons’ input.
“It’s the clinicians who design the schemes, and then we work with them to turn that into something that’s implementable,” she says. “If I talk to them about cloud platforms they have no clue what I’m talking about. But surgeons certainly understand it when I tell them we can adapt allocation schemes incrementally and routinely based on new data or research; we don’t need years anymore. That’s enormously valuable to them.”
On the IT side, Mr. Powell envisions an expanding role for data in the development of allocation schemes and, in the long term, the emergence of a self-learning IT environment. “Will the nature of the data going into the system inform the way we design allocation schemes in the future? Could we get to a point where the system is almost learning for itself and helping us achieve the competing demands of equity of access and organ utility over time? I think yes. We absolutely see this as being a step towards more intelligent allocation schemes over time.”
“We seek balance,” says Ms. Johnson. “We seek to ensure that everyone has equal access or equal opportunity for a transplant should they need one. Every improvement we make to our allocation schemes ensures that we make best use of all the organs that are available and maximize the number of years people will live with a transplant. That matters profoundly.”
The recent heart transplant represents the start of a technology-driven business process management journey at NHSBT. It just so happens that, in this case, the outcomes are literally life-and-death. But the challenge of doing more with less is universal, with organizations in both the public and private sectors grappling with how to allocate scarce resources to achieve their own set of critical outcomes. Regardless of whether an organization operates in the public or private sector, whether a life, an application delivery deadline or the on-time delivery of a customer’s order is at stake, business process management—leveraging technology to identify, understand and optimize both internal and outward-facing processes—is critical to setting any organization up for success.