Prep@Gref: Software Streamlining for the Search for Donors for Hematopoietic Stem Cell Transplantation

Introduction: Donor recruitment in allogeneic hematopoietic stem cell transplantation (HSCT) is a multi-step process involving several stakeholders: patients, donors, coordinators, clinicians, HLA typing lab and blood collection center. With few, if any software existing on the market to perform these steps securely and efficiently, we aimed at developing an in-house academic software to streamline this process. Our objectives were: to reduce delays, facilitate interactions between stakeholders through secure real-time sharing of information and documents and limit the workload at each step.

Methods: We set off by listing the steps involved in donor recruitment, analyzing their outputs and time required to accomplish them, documenting the delays between them and establishing key performance indicators. We then created the Prep@gref software that includes an interactive list of patients awaiting an allogenic HSCT, with work lists specific to each of the previously-listed steps (updated in real time), documents and information necessary for proceeding (or not) with donor recruitment and automated alerts for deadlines to accomplishing the individual tasks by each stakeholder. Training stakeholders and optimizing the software preceded its introduction into routine practices. Measurable outcomes were: median time to donor identification (related and unrelated donors), non-quantifiable variables include: stakeholder feedback and ease-of-use of the software.

Results:

Tracking key performance indicators shows that the time for matched related donor (MRD) identification has reduced by a median of 29% over the past 5 years: 34 days pre-Prep@gref to 24 days since the introduction of Prep@gref into routine use. Time for mismatch related donor (MMRD) has reduced by a median of 32% (36 days pre-Prep@gref versus 25 days post). Unrelated donor search reduced by 21% (67 days versus 53 days, respectively). Time for adoption of the software by stakeholders could explain the slow amelioration of indicators over time. Increase in activity of the transplant program (21% since the introduction of Prep@gref into routine use) and the COVID-19 pandemic did not significantly affect the time for donor identification. Positive feedback from clinicians and coordinators favor its positive impact on practices.

Conclusion: Prep@gref software represents a prototype of complex care process modeling, evolving from the traditional organizational set up in many hospitals for donor recruitment. Saving times and being able to delegate tasks is key in addressing shortage of human resource that periodically happen in our activities, while absorbing the growing workload and increasing complexities of these tasks.

Chabannon:BELLICUM PHARMACEUTICALS: Membership on an entity's Board of Directors or advisory committees; GILEAD: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; NOVARTIS: Speakers Bureau; BMS/CELGENE: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; FRESENIUS KABI: Research Funding; JANSSEN PHARMACEUTICALS: Membership on an entity's Board of Directors or advisory committees; TERUMO BCT: Speakers Bureau; MILTENYI BIOTECH: Research Funding; EBMT: Membership on an entity's Board of Directors or advisory committees; SANOFI SA: Honoraria, Research Funding, Speakers Bureau.