1. IT Update November 12, 2015

2. Agenda  Opening RemarksJames Gleason  IT UpdateAlex Tulchinsky

3. IT Advisory Committee (ITAC) Background  Formed in 2012 under Bob Merion’s leadership  Committee charter  “Assist the UNOS CAC in fulfilling its oversight duties for UNOS operations by providing external expertise regarding information technology efforts…” specifically...  Assists the CAC to develop a strategic plan for Information Technology (IT) needs of the corporation and oversees the execution of the IT plan  Identifies strategic priorities in IT, and assists the CAC in setting standards for organizational IT performance  Oversees the work of the corporation in fulfilling the IT-related requirements of the OPTN contract.

4. ITAC 2014/15 Composition ITAC Chair: ITAC members from UNOS board (3 voting members, serving 2 years):

5. ITAC 2014/15 Composition (cont’d) ITAC advisors from the IT community (3 non-voting members, serving 2 years): Haris F. Basit Arthur (Art) L. Glasgow Rick Hasz ITAC UNOS staff and board leadership :

6. ITAC Past Accomplishments  Performed an assessment of UNOS IT organization & leadership  Performed an assessment of current and future IT workload  Reviewed past and planned IT delivery performance  Recommended leadership and organizational improvements  Recommended significant UNOS IT staff increase/development  Recommended IT process improvements  Oversee the implementation of board approved IT actions supporting those recommendations  Provided direct access and consultation with user community

7. ITAC 2014/15 Goals  Oversee the implementation of board approved IT actions and supporting recommendations to include...  Continued recruitment to full staff  Oversee continued IT organizational and process improvements  Monitor system development and service delivery per schedules  Insure continued leadership and financial support for IT effort across fiscal calendars  Provide client and expert guidance for IT futures  Insure service is anchored in client need and satisfaction  Continued IT translation services to the CAC and UNOS board (i.e. make IT communications user understandable)

8.  Projects  Customers  Technology  Data  Culture IT Update

9. June 2014 – November 2014 Jun-13 & Prior Non-BoD Nov-13 20142015 Q2Q3Q4Q1Q2 AprilMayJuneJulyAugSeptOctNovDecJanFebMarchAprilMayJune Uniform National Pancreas Allocation HLA Equiv. Donor Screening w/ Qualified Specimens Improve Vessel TIEDI C# ConversionTIEDI and OMB Changes Patient Safety – Living Donor Events KAS - Phase IRevised Kidney Allocation System (KAS) - Phase IIHLA C & HLA DBQ Clarify A2-A2B KPD - Phase 4 (EW/WF) Ped Liver Remove ICU Req & Modify Liver Hepatoblastoma LAS & Diagnosis Data Element <12 Update DCD Integrate DonorNet Import/Export into ETTUpdate PDDTE Membership Inactive Screening TIEDI and OMB Changes Re-Instate No Appeal     

10. 201420152016 Q4Q1Q2Q3Q4Q1 OctNovDecJanFebMarchAprilMayJuneJulyAugSeptOctNovDecJanFebMarch (#4) Improve Vessel Disposition Reporting Add Serum Sodium to MELD Score Deceased Donor HLA Typing TIEDI and OMB Changes Living Liver Donor Follow-up (#1) Require Reporting Whether Donor Screening Tests are Completed Using Qualified Specimens Pancreas Serum Lipase KAS Phase II HLA C & HLA DBQ Patient Safety - Living Donor Events Imminent & Eligible Death Aborted Living Donor Recovery (#2) HLA Equivalency Tables Histo Policy KPD Histo Testing Policies LAS & Diagnosis Data Element <12 Ped Liver ICU Req & Liver Hepatoblastoma (#3) Potential Donor-Derived Disease Transmission Reporting Review Min Screening Req for Deceased Donor Clarify A2-A2B Membership Inactive Screening 2015 Projects Timeline ABO Blood Type Policy Mods Donation after Circulatory Death Reinstate "No Appeal / No Withdrawal Proposal to Align OPTN Policies with 2013 PHS Guidelines Modify Pediatric Heart Allocation HCC Exception Score Cap Delay HCC Exception Score Consent to Authorize HOPE Act Living HOPE Act Deceased Jun-13 & Prior Nov-14 Nov-13 Non-BoD Jun-14 HOPE Act HOPE Act Prep Work

11. HOPE Act Impacts Screening Requirements for Deceased Donor 2013 PHS Guidelines HOPE Act Serologies Affecting Match Run Appearance Infectious Disease Verification Process Waitlist DonorNet Match Patient Safety Membership TransNet TIEDI KPD

12. Historical Perspective

13. 2013 – End of Year 1Y [2012] < 1Y [2013] 3Y [2010] 2Y [2011] 5Y [2008] 4Y [2009] 21 – Pipeline 39,010 hours 2 – In Progress 7650 hours 2000 4000 6000 8000 10,000 12,000 14,000 16,000 18,000 20,000 0 IT Effort Estimate in Hours Age [year of BOD approval] 10,530 (5) 10,940 (4) 7650 (2) 2240 (3) 9090 (4) 6210 (5) 2013 – In Progress 1)Kidney Waiting Time Modifications 2)Update the Calculated PRA (CPRA)

14. 2014 – End of Year Projection 1Y [2013] < 1Y [2014] 3Y [2011] 2Y [2012] 5Y [2009] 4Y [2010] 24 – Pipeline 24,620 hours 5 – In Progress 16,560 hours 2000 4000 6000 8000 10,000 12,000 14,000 16,000 18,000 20,000 0 IT Effort Estimate in Hours Age [year of BOD approval] 16,690 (12) 800 (3) 1430 (1) 1180 (2) 3150 (3) 7 Delivered 22,740 hours 300 (1) 7350 (1) 2240 (3) 5940 (1) 1540 (1) 290 (1) 2014 – Completed 1)Kidney Waiting Time 2)Update CPRA 3)Reorganize hemodynamic data on Heart Justification form 4)Modify Requirements for Mandatory HTLV-I/II 5)Patient Safety Reporting 6)PA/KP Allocation 7)KAS – coming December 4 th 2014 – In Progress 1)Ped Lung Diagnosis – Other Specify 2)TIEDI OMB 3)Revise LAS 4)Potential Donor Derived Disease Transmission reporting 5)Living Liver Donor Follow-up

15. 2015 – End of Year Projection 1Y [2014] < 1Y [2015] 3Y [2012] 2Y [2013] 5Y [2010] 4Y [2011] 6 + ? – Pipeline 7560 hours + ? 3 – In Progress 1740 hours 2000 4000 6000 8000 10,000 12,000 14,000 16,000 18,000 20,000 0 IT Effort Estimate in Hours Age [year of BOD approval] 21 Delivered 35,880 hours 1620 (2) 7560 (6) 120 (1) 2015 – Completed 1.Ped Lung Diagnosis Other Specify 2.Reinstate No Appeal/No Withdraw 3.Donor Screening using Qualified Specimens (#1) 4.TIEDI OMB 5.Require HLA C and HLA DQB 6.Patient Safety System - Living Donor 7.Clarify A2/A2B 8.Ped Liver Remove ICU 9.Ped Liver Hepatablastoma 10.Revise LAS 11.Consent to Authorization 12.Vessel Disposition Reporting (#4) 13.Potential Donor-Derived Disease Transmission Reporting (#3) 14.Imminent and Eligible Death 15.HLA Equivalency Tables (#2) 16.Minimum Screening for Deceased Donors 17.Add Serum Sodium to MELD 18.Comprehensive Histo Compatibility Rewrite 19.Living Liver Donor Follow-up 20.2013 PHS Guideline Review 21.HOPE Act - June 2015? 2015 – In Progress 1)Donation after Circulatory Death 2)Cap HCC @ 34 3)Delay HCC

16. 2015 – End of Year Projection 1Y [2014] < 1Y [2015] 3Y [2012] 2Y [2013] 5Y [2010] 4Y [2011] 6 + ? – Pipeline 7560 hours + ? 3 – In Progress 1740 hours 2000 4000 6000 8000 10,000 12,000 14,000 16,000 18,000 20,000 0 IT Effort Estimate in Hours Age [year of BOD approval] 2 year total projects delivered 28 58,620 hours (including HOPE Act) 1620 (2) 7560 (6) 120 (1)

17. Customers

18. Technology

19. Current State Small Changes … Become Big Efforts… User Interface & Application Layer Business Logic & Data Layer Request

20. Database Business Logic Front End User Interface Target State Business Logic Front End Database Modular Services operating independently of one another Small changes have limited impact Algorithm layer Data layer Request

21. Information Security Update

22. Disaster Recovery & Business Continuity

23. Data Information Architecture AutomateCollect Exchange Organize Analyze Format Store

24. Culture

25. Thank You! Questions?