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TownHall: A Look Inside the Incredible World of Organ Donation with Mathew Moss

Sarah Richardson: [00:00:00] Today on Town Hall,

Matt Moss: that's how critical this is, and I didn't know that before I started.

There are a number of people literally like they're an inpatient, and if they don't receive that organ within hours or days, they'll die.

Sarah Richardson: i'm Sarah Richardson, a former CIO and President of this Week Health's 2 2 9 community development where -we are dedicated to transforming healthcare one connection at a time. Our Town Hall show is designed to bring insights from practitioners and leaders on the front lines of healthcare. All right, let's jump right into today's episode.

Today I'm joined by Matt Moss, SVP and CIO of New England Donor Services, a passionate leader in the world of organ and tissue donation, with a background that spans operations, logistics, and innovative donor service programs. Matt plays a key role in enhancing how technology registries and response teams.

Work together to fulfill the mission of saving lives. His expertise sits at the powerful intersection of compassion and precision, [00:01:00] helping shape the systems that make donor matches possible across New England and beyond. Welcome to the show, Matt.

Matt Moss: Thank you. Thank you for having me.

Sarah Richardson: I'm so glad you're here because we still haven't met in person, but we got to meet through Mutual Connection.

I think it was Renee that actually introduced us, or Rebecca and such an awesome network up in the New England area, and I'll get to see you in a couple weeks. At another event, but when we connected and chatted about what you do, I was like, this is a fascinating space that most people don't know much about.

Huge education. The day we chatted and I'm like, Hey, wanna be on the show? And you're like, absolutely. So here we are. So thanks again.

Matt Moss: Yeah. Thank you again for having me.

Sarah Richardson: Of course. And you've spent years working in the donor services space. Yeah. What first drew you to this type of mission driven work and what keeps you going every I mean, so I spent 20 years working for large health systems in New England. I spent a lot of time at Caritas State and then student. Then I was at Southshore Hospital for a couple of years, and while I was there, my primary role was [00:02:00] developing private health information exchanges. So I got to meet a lot of CIOs throughout New England.

Matt Moss: Southshore in particular was really integrated with several large health systems. So when the position was open at New England Donor Services, one of their biggest business issues at the time was. They simply didn't have access to all of the hospital EMRs that they do business with. So it was like something like 17%.

So when our clinicians would ask the IT department, they didn't know how to frame the question the right way. Covered entities like hospitals have a HIPAA exemption to share information with organ procurement organizations as created by CMS. So it was like Groundhog Day with Bill Murray a little bit because I had the same conversations with the same CIOs that I know that they have their information security policies, but literally the federal government allows us from a HIPAA privacy standpoint to access their EMRs.

Sarah Richardson: When you consider the response teams [00:03:00] and real time coordination to operate and ensure like viable matches across state lines and hospitals, what does that look like in your organization?

Matt Moss: Again, with my background in integration, when I started at New England Donor Services, there was no technology. There was no integration between our electronic donor record and the hospitals.

EMRs. So this is something that I co-authored, an article that was published in Harvard Business Review. I work closely with Yale New Haven, and we developed integration at first with HL seven between their Epic implementation and our electronic donor record. And now we have an app on Epic Marketplace.

So about. We're probably live with, actually, I just looked at it today, it was like 67% of our hospitals. We have received referrals from about 250 hospitals in New England. So we have that e-referral technology live with those hospitals. So it starts with the referral really. So CMS, again mandates that the hospitals [00:04:00] send that information.

And then from there we do screening. That's all done within our electronic donor record, but the first thing is really receiving a referral. We receive about, I think it's about a hundred thousand referrals. So basically all deaths we receive. The hospitals never determine if somebody can be an organ donor or not, or irritation donor.

We're the ones that always make those decisions. And again, any Ds. We're certified by CMS. We're the only organ procurement organization. We support the vast majority of New England and we recover in addition to organs, hearts, kidneys. We also recover tissue. So the tissues from cadavers, so that's things like skin and bone, heart valves, and corneas.

We also, and this is covered in the news a lot, we do bases and we do arms, and we call those VCAs.

Sarah Richardson: People don't necessarily have donor conversations. You might have it on your driver's license, but you don't really know what the process looks like or entails and you cover Northeast. But what is the total geography [00:05:00] of the populations you serve and let's just say someone is a match and available, and what does some of that like logistics look like?

Like Yeah, we got kidneys over here, like how far can you take them?

Matt Moss: The laws have changed. A lot of the organs are allocated within 500 nautical miles, so it used to be just within our region, which. The federal government called Region one, so that's most of New England without a small slice of Western Vermont.

So we used to recover and allocate all within our region. Now it's within 500 nautical miles. The federal government changed those rules recently within the past few years, but we at New England Donor Services, we have nothing to do with allocation. So we assess and we recover. We compile all sorts of information, and then we send a large XML file to a contractor of the federal government called Genos.

And Unos does the allocation and offers those organs out. We could recover in organ at Mass General, and it could stay right at Mass General, or [00:06:00] it could go to North Carolina, it could go to York. We don't make any of those decisions.

Sarah Richardson: Wow. And technology plays such a huge role. Managing all of these registries and logistics.

How does your team use the data, the tools, any, any of these, like even realtime systems to optimize both matching and response? You mentioned the feeds going into government, otherwise. Yeah. What does that framework look like that you have created?

Matt Moss: We have realtime replication with our electronic donor record.

So the vendor is life logic and the product is called True North. So that would be analogous to Epic. And just to disclose, I'm on the board of that company. We do real time replication with our electronic donor record. So as information's keyed in. We then stream that information to our electronic data warehouse.

We also get feeds from like six or seven different systems. So things like our inventory control system. We actually get a feed from the system that does allocation, so we can do analysis on some of that data. But over the years, I mean, I always make a distinction between machine learning. Generative [00:07:00] ai.

'cause I feel like that just becomes this hype monster. So I always try to make a distinction, but we've been alive with machine learning tools for over five years now. Um, so we use machine learning in part to decide how we assign our teams, right? So we have finite resources in organ donation. It's not, we get seven donors a day or three.

Like we don't know. We don't, we get zero. We could have 12. We don't know. And our resources are finite, right? So we've developed. A machine learning tool that helps us assign resources based on the donor type. From a technology standpoint, it's like a dream, right? I mean, I tell my team, I mean, we could be doing the same exact work for a kitty litter factory, but instead we get to do it in the organ donation industry.

But our typical user is really technology oriented. In addition to what I talked about, machine learning and some of our cool integration and enterprise data warehouse, we've also developed a system we called Ears Event Alert [00:08:00] Response System. That has all sorts of clinical decision support based in, so for example, if we get a serology result, the federal government tells us how long we have to report that to the transplant programs.

So we have alerts built in and escalation matrix that if that information's not given to the transplant program, we go through a whole escalation matrix and start paging people. So, and it stops once it's entered.

Sarah Richardson: And there's gotta be an emotional component to what y'all do. I mean, you said, yeah, we could be doing like kitty litter or we, we get to do what we're doing.

What, yeah. Does the support structure with one another look like, I mean, you've got some high stakes things that are happening, could be emotionally intense. How does your team work together with the weight of some of the responsibility they have and understanding the impact they're having?

Matt Moss: Yeah, and that's what's different from working at NEDS from working at a large health system is that it's so much smaller and you're so much closer to the work.

So it's not like I'm dealing with like business analysts or data analysts. [00:09:00] I'm dealing oftentimes with the people doing the direct work. We have about 400 people in the company and lots of different types of roles. One role in particular that always sticks in my mind are our, our family services coordinators.

So they're the group that if somebody's not a registered organ donor, they ask the next of kin or the family members if they would consider allowing their loved one to be an organ donor. You You know, we say we go to them like on the worst day of their life and it's a terribly difficult job. And as like an IT professional, right?

I've clearly chosen a different path, right? So that group always sticks in my head and we're always really proud when we can deliver something to them. So the one thing we just did recently, because we really sat down and as CIO I'm hyper aware of like this people process technology, right? You know, if I had to pick one thing in grad school that was ingrained on me, it's not the technology itself, the people in the process are just as important.

So I had some of my applications analysts spend [00:10:00] time with their leadership as we're looking. We really had to like look and see how they're doing their work, right? Like in lean they call it like going to the right. So we developed this really cool dashboard that saves them an immense amount of time.

Instead of like going in this pathway, going down this pathway, remembering what data they saw. Now we have it all in a single view and it saves them hours and hours every day. Again, because they're meeting with a lot of the donor families. We're looking at a telecom system now that has an API that we can stream texts from conversations.

We can essentially look at the quality of those conversations. We have to develop criteria, but this would be another example of ai.

Sarah Richardson: It's amazing too when you consider just the workflow component of the uniqueness and the fact that when there's 400 of you in one company, you get a chance to really dig into the people in the process.

'cause you know the tech is there and so it's like how you're applying it in the most efficient ways. That really, [00:11:00] gosh. I mean, I can't think about having that conversation. Like your job is to go in and talk to families who. Losing a loved one and didn't register for donor services and yet, is what you share with me is that up to seven lives can be saved?

Yeah.

Matt Moss: Seven. Yeah, depending on how you count, seven or eight. That does include, and I know a lot of people that have had me work and. They oftentimes have a cadaver tendon, right? Yeah. So those are the type of tissues that we recover. Yeah. So with our mission statement, it's saving and enhancing lives. So the tissue is the enhancing part.

I just have so much respect for those people. Um, yeah. And our donation coordinators too, I mean, they work around the clock. Their schedules are like firemen a little bit. It's like 10 days a month. They do 24 hour shifts. They never know when they're gonna get called. What situation they're gonna be called into.

Because it's a smaller company, you really work with lots of different types of people in a kind of a small environment. We have six or seven recovery surgeons on our payroll. Yeah, it's great. [00:12:00]

Sarah Richardson: Wow. So when it comes to community education and registration, to your point where we're just talking about what outreach strategies work in the New England region, or how do you get the word out to people besides DMV kind of spaces about the importance of organ ownership?

Matt Moss: We have a whole group that just solely focuses on this because that's actually one of our biggest business challenges is that the percentage of our donors that are registered is actually going down, even though. For hosting events throughout New England. That's for a myriad of reasons. One is like kind of this skepticism of the healthcare system.

I think our world, since COVID has kind of been blown up a little bit. Those are data-driven decisions about where we host events. The New England states provide us with data about who's registering the percent of where they're registering. So we use that data to where we host events in addition to the community group that we have a role [00:13:00] called hospital donation strategist, and they're working in the hospitals.

So at a big hospital like Mass General. We'll have a dedicated person that literally has like a desk within the transplant program. And then smaller hospitals, we might have one person that might, if the donation potential is low, they might work at 20 or 30 different hospitals. But there, they disseminate information about organ donation.

They dispel false narratives about our industry. Yeah, so I mean, we have a lot more work to do there. And again, I think that the environment, whether it's been. COVID. I think some of the things going on politically, I think generally speaking, that people have negative perceptions about healthcare, and I think that impacts the donation rate.

Sarah Richardson: When we were prepping for our conversation, we covered a bunch of the misconceptions about organ and tissue donation. I would love for you to share things that are important for people to know that can reframe. Yeah. Maybe some other, and I'll start with the one where, you know, just because it says organ donor on your driver's license, the [00:14:00] EMT is not gonna decide whether or not to save you because of that.

Right. They're gonna save your life. Right. Someone makes the decision in that case. That's right. And that was a really good question so like what are some of misconceptions that people need to know

Matt Moss: Yeah, this like notion that like somebody's in a car crash and this person's an organ donor, we need to get to them top.

That's completely false, right? So all of our organ donors have been intubated and they're all brain dead. They're all on a ventilator and they're all brain dead. A hundred percent. I think when I talk to people, 'cause I'm acutely aware about less than 50% of our organ donors are actually registered. So if that number was 80%, like we would save hundreds of more lives.

Hundreds. I mean, every day people are dying, waiting for organs. So it's tragic. So I think to me, the biggest misconception is this notion that if somebody's a marginal case, if they've been in an accident, that the treating physician isn't going to do everything they can to save their lives. [00:15:00] And we might have shared this, I'm might have shared this when we talked the last time, is that the treating physician knows nothing about organ donation.

They don't know who's next on the waiting list. It has nothing to do with them. The treating physician does everything they possibly can to save you. The physician that declares death is a completely different physician, and the physician that recovers your organs is a completely different physician.

There's no connection between any of those things and New England donor services. We don't know who the ORs are going to, nevermind an ed doc or an intensivist. So I think that notion that, again, if you're some sort of marginal case that they're gonna say, oh, you can just donate your kidneys. We're not gonna really try to save you.

It could not be more false and I can't say enough about the integrity of doing with donor services. But also the transplant programs. We work with Mass General, Brigham Women's, Lahey we work with, and I think there's 13 now, transplant programs in New England, but then also just our community hospitals, [00:16:00] so there are others.

This notion that religion plays a part, there's no religion anywhere that says you can't donate your organs. So there is a false narrative out there, and I hope we can all collaborate to dispel those.

Sarah Richardson: Absolutely. And you mentioned your region one, there's how many regions are there in the US of donor services?

Matt Moss: there's a 54 55 Oregon procurement organizations. So I'm using that very specific term 'cause CMS essentially certifies us and there's a very distinct definition of what an Oregon procurement organization can do. So there'll never be more, there's been some consolidation in our field. I think there's eight or nine regions.

So they're about the same size of New England throughout the country. The regions mean less now that we're not allocating just within our region. And that is a podcast or an interview that could last for several hours by somebody much, much more confident about me to talk about allocation. But those [00:17:00] laws and rules have been changing 'cause there's this notion people were trying to game the system by moving to different states.

Again, enough higher area of expertise.

Sarah Richardson: I'm in Oregon, California. If I'm in Boston for an event, something happens to me. How does New England Donor Services tie that back to like a registry in California?

Matt Moss: I do know that, yeah, so there's several, 'cause California's such a big state. There are several OPOs in California and we do work with the other OPOs, and we would have them check to see if you were a registered organ donor in California.

Sarah Richardson: Cross collaboration, just to make sure you can maximize the saving of other lives is really key. And behind you says we never stop innovating. How do you think about innovation in your org and what technologies or partnerships are you excited about or looking forward to in the next few months?

Matt Moss: I'm so passionate about.

With donor services, and I feel so excited to go to work every day because it, from a technology standpoint, it's such an incredible place to work. Our users and our executive [00:18:00] team are very tech savvy. They have great ideas. I mean, I think I shared briefly, we developed an app on Epic App Marketplace is called Copernicus Donor Chart import.

It allows us to pull 200 clinical data elements from Epic in real time. And then we can pull on multiple instances too. 'cause some of the data changes, right, like a serology resolved or a vital sign stream could change on a minute by minute basis. So we're pulling that data and now for four or five health systems.

Over the next few years, that's gonna radically change. We'll be up to 60, 70%. Although Epic's data model is the same, that implementations across different health systems can vary. So there is like a few months worth of testing for each site. But yeah, I mean getting that data in real time, there's so much we can do with it.

I mean, one thing we're looking at is the screening process, right? A human's not great at [00:19:00] looking at 200 clinical data elements at one time. They're constantly changing. I. Computers are really good at that. So developing a machine learning tool that can look at those 200 clinical data elements, but first it'll be a decision support tool, right?

We can say, our screening tool says there's an 87% chance this patient can be an organ donor. And so we're looking at that. That's something I don't think is five years away. I think that's like a next year thing. So I mean it's, it's really endless. I think when I think about. Our electronic donor record, which is called True North, I think eventually it evolves where there's probably as much code written for fire as there is in integration, as there is for actually like keying data in, and I think there'll be a lot of opportunities from capturing text.

Putting that into structured data to help automate the data process. You know, I started doing this 30 years ago now. My first job was in the department of surgery at St. E's, and I could do a clip art and I could format a three and a half inch desk. And the nurses and [00:20:00] the leadership, they call me a computer genius.

Sarah Richardson: Because you can format your poppy disc. That wasn't even, was these the hard case ones? 'cause I mean, come on. We're not that, right? Yeah. But yes, there were.

Matt Moss: mean, so I, I think there's like, there's so much more, you know, like. The next 30 years. I'm just so excited for what we can do. It's an exciting time to work in this industry.

Sarah Richardson: How connected are you to the growing of organs? It's part of the things we're starting to see in some of these labs where you can grow a heart, you can grow a kidney. How plugged into those spaces are the donors? Yeah. Yeah. I

Matt Moss: mean, we definitely work with them. We have a clinical policy board and they come and they present.

Network primarily goes on at the academic medical centers. We do work with them. But yeah, I mean, again, anything that gets people off the waiting list in New England Donor services supports, whether it's US recovering organs and working with our transplant programs to transplant them. Or [00:21:00] xenografts, that's when they grow.

They genetically modify pig kidneys. We work with those programs. Yeah, whatever gets people off the waiting list, that's part of our mission

Sarah Richardson: for organizations, CIOs, others that may not be as aware of or plugged into your programs and services, how do they get more involved? Does an outreach to your org general as it meeting you at a conference, like how do you strengthen the awareness of what you do in communities and how do people get more involved?

Matt Moss: Yeah, I mean, I really work hard to. Participate in CIO dinners or conferences because I think it always makes a big difference. It removes a lot of the mystery of what we do. When you meet like me or somebody on my team, we host this fall, we did it two years ago and the pandemic interfered with this. But we host an annual event where we invite all of the IT folks that we work with.

So whether that's application people on the Epic side, CISOs. We invite them all to New England Donor services. I do a handful of presentations. My staff [00:22:00] do presentations. I mean, we really work hard. I mean, the, the fact of the matter is that we access all of the EMRs. So for the most part, they know that we're out there.

But I think about it as touch points. So we have, we access hospitals, EMRs, the hospitals all sent us their death file. So anybody that's died in the hospital within the past month. We get their desks, we reconcile those with the referrals. It's a mandated by CMS. So it's critical that we don't miss any desk that had organ potential because it could cost people their lives.

So we receive death files. We want to receive electronic referrals, we want to do the clinical integration. So I think about all of those different touch points. There's clinical decision support that you can build into Epic. So when a patient falls into a condition consistent with organ donation. We're alert that the clinicians at the hospital are alerted and then they can alert us.

So I just think about all those [00:23:00] touch points, but then what we can do with that data too. And I think that really resonates with New England donor services and organ procurement organizations in general. It's a smaller field. Which means we don't have as much money, but sometimes we can move because we're small, we can also move really fast.

So it really depends on what technology and what implementation. But yeah, from a technology standpoint, the next few years are gonna be really rewarding.

Sarah Richardson: We'll definitely stay plugged into it because I'm fascinated truly by what you and your team do. Before I jump into the speed round questions, I have to ask one last perspective, and how often do you get to hear about the lives you've saved, or you see stories in the news where the families connect because you know their daughter died, but now their daughter's alive and these families have these bonds.

How often do you get to. Hear about the impact you have on people's. lives Yeah.

Matt Moss: Pretty regularly. And the stories are compelling. We do on average about two [00:24:00] organ donors a day, right? But then those donors can donate six, seven organs, right? So I just think of everyone as just this incredible story and it, we use the term bittersweet, right?

Like you have somebody that has an untimely death in a car accident. Like an Overdose and then they can then save these other people's lives. I mean, oftentimes people that receive organs are inpatients in a hospital and they're waiting to die. Like that's how critical this is, and I didn't know that before I started.

There are a number of people literally like they're an inpatient, and if they don't receive that organ within hours or days, they'll die. It's terribly tragic. But to answer your question specifically, I would say my professional. Career highlights. We recovered arms from, from a donor, so we had a recipient that had a flesh eating bacteria and lost his arms and his legs, and we recovered the first arm above the elbow and [00:25:00] transplanted.

That arm and another arm on the same recipient. They made a documentary called Stumped about this, and it was fascinating because the director filmed the documentary from the perspective of the caregivers, which I really like. It added something hard to express. I guess you could identify more because it was coming from them, but we screened the documentary for like the 400.

We rented theater, we screened the documentary for our staff. Then at the end of the documentary, we introduced the recipient to the donor family for the first time. So the father shook the hand his son's arm on a recipient and it was so moving. And it's funny because the organs are just as impactful, but you can't see a heart, like you can't see a law.

But you can certainly see somebody shake somebody else's hand it, it's incredible.

Sarah Richardson: Yeah, it is so incredible what you do. Thank you [00:26:00] for what you've shared today too. Look at me, I'm like a little emotional. Just you tell a story about that kind of stuff. You guys must have a lot of Kleenex in your office because of all the good things that you do, and it makes you feel like, wow, it is bittersweet when you can tell those stories.

I have to ask you a couple of questions that aren't quite as heavy as donor services, but I always like to know what makes people tick. So if you weren't. Donor services, what would you be doing?

Matt Moss: Yeah, so that's a very easy question to answer, sir. Is, uh, a professional golfer, I always think about a quarterback, an NFL quarterback, but the nice single professional golfer is you don't have a 300 pound defensive end trying to knock your block.

Sarah Richardson: Does this mean you're a good golfer or you would just wanna be a good enough to be a professional?

Matt Moss: Oh, no, I'm terrible. Uh, I, I play all the time. But I think like more practical, like I love making videos at work, so I do an orientation video for my team. I do an end of the year video. I host a conference in the fall.

It's a OPO Information Technology Summit, and I [00:27:00] do hype video for that. So maybe something in film, but I also like the creative side. Marketing. If anybody at NEDS needs a name for something, it's often that they'll drop by and I'll come up with a name.

Sarah Richardson: So come up with a name. Well then my next question is, perfect.

One word you would use to describe the culture at New England Donor Services.

Matt Moss: We have three. So dynamic, dedicated, and driven, but I think the dynamic really resonates with me the most. I've never seen people so dedicated to a company or a mission. It's astounding and New England donor services.

Oftentimes the things, whether it's from an information technology standpoint, a clinical protocol, oftentimes the things that we do at any DS are adopted nationally and we're really proud of that. Some of our numbers like around even like, and not to get too specific though, we track, it's a ratio of how many.

Based on a pool of donors, how many lungs, for example, we should recover [00:28:00] versus how many we do. And our numbers are like off the charts good. And it speaks to our recovery. We pump organs now outside the body, I. So it's exactly what you think it is. It's like a plexiglass box and lots of beeping, and so we can do therapies now to those organs outside the body.

It's just incredible and we partner with lots of different companies to do that. I always say it's like kind of like working in a science fiction movie or something, just like, it's like we can do that.

Sarah Richardson: That's gotta be just such a phenomenal space to serve. And thank you for telling all those stories, but last question takes a lot of energy and to focus to do the things that you do.

What's your coffee order in the morning?

Matt Moss: I'm Americano. So it's just a couple of shots of espresso and hot water. I have a cafe ello here in my pantry. It's like a Cuban coffee and thankfully I live in an urban area, so I'm surrounded by lots of good coffee shops too.

Sarah Richardson: You're in Boston, you got a little bit of everything going [00:29:00] on up there, which is why it's always a fun place to visit.

And we just did a summit there and I'll actually been there a couple weeks for another partner event. So hope I get to see you in person. But thank you for sharing. Yeah, that'd be great. And the journey. New England Donor Services, all the things that you're doing, appreciate you being in our community and serving yours.

And we'll continue to tell this story as. There are major breakthroughs and really cool new technologies being delivered and developed in this space. You can come on our show anytime. I know our audience and us would love to hear it.

Matt Moss: Thanks, Sarah. Thank you for your time. I really enjoyed it.

Sarah Richardson: Thanks for listening to this week's Town Hall.

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