Beyond OrganJet: Nudge Videos to Increase Organ and Tissue Consent from Legal Next-of-Kin

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In 2010, after a dinner conversation with Baris Ata, I came up with an idea  to “democratize Steve Jobs” in terms of providing affordable, on-demand private jets for patients on transplant lists so that they could multiple list and vastly improve their chances of getting a transplant.

Instead of being dismissed as simply silly, this was considered as “imaginative”, “a genius idea” and “disruptive” by transplant surgeons, medical ethicists and other researchers who study organ transplantation.

So I founded OrganJet as a social enterprise in 2011 inspired by Harvard’s Social Enterprise Conference. Met Nitin Nohria.

MGH Transplant Group invited me to speak at their Grand Rounds. Met Transplant Chief Jim Markmann.

Al Roth blogged about OrganJet in 2012 in his Market Design blog, less than 10 days after he won his Nobel Prize.

Harvard Business School’s Julie Battilana wrote the case  OrganJet and GuardianWings in 2013.

Peter Ubel of Duke discussed OrganJet in The New England Journal of Medicine in 2014.

CBS News, Forbes and Atlantic have carried stories on OrganJet.

INFORMS community awarded us (Baris Ata, Anton Skaro and me) with the Pierskalla Award for Best Paper in Healthcare in 2015.

This paper that analyzes — a selfish routing game on a network of overcrowded queues with abandonment — the equilibrium impact of widespread multiple listing made possible by OrganJet was published in Management Science in 2016.

But I felt the bigger problem to solve was:

How to increase the overall supply of organs and tissues for transplantation in the US?

In 2015, I came up with another idea.

Rather than focus on increasing First Person Consent (FPC) — like signing up at DMV to be an organ donor — I looked at another place where increasing consent may be immediately helpful. It is when a person is not an organ donor, and the legal next-of-kin (LNOK) has to provide a second person consent when approached by a family services co-ordinator from the Organ Procurement Organization (OPO).

Jim Markmann loved it. Al Roth thought it could work well.

It was an original idea that had not been conceived of before!

What is the idea?

Show a video to those LNOKs who are undecided and see if we can nudge them towards a yes.

That simple.

New Jersey Sharing Network was the first OPO to pilot this to increase organ consent in early 2016, and helped co-create this video.

I was invited to the Obama White House in 2016.

I was invited to speak at AMAT Conference in New Jersey in October, where I connected with Nevada and Georgia OPOs who were eager to field test the idea.

Al Roth invited me to give a seminar at Stanford in 2017. This was my first seminar in an Econ department.

A few days later, I gave a seminar at Stanford Medical School (Lucile Packard). Pediatric Transplant Chief Carlos Esquivel was my host.

I connected with Donor West, the OPO in Northern California, during this visit who agreed to field test the idea.

A week or so later, I spoke at UCSF Transplant Grand Rounds. John Roberts, previous UNOS President, was my host.

Transplant surgeons from Japan and S. Korea who were in the audience thought Nudge video was an amazing idea, and over dinner we discussed how to create such videos for use in their countries.

OPOs in Nevada, Georgia and California have started to use similar videos (separate ones for tissue and organs, in English and in Spanish) that we co-created with them.

Short summary:

Nudge videos increase consent by LNOK.

It is so gratifying to see how hundreds of additional lives have been improved (tissue) or saved (organ) by such a simple innovation already in these field experiments with the potential to scale ten fold in the coming years if more OPOs make it a standard practice in their approaches.



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