Helping Ohioans understand and embrace organ donation

In October 2014, Ohio launched a project that would help the 123,000 Americans on the national waiting list for a life-saving organ transplant while also educating Ohioans about the important decision of becoming an organ donor.

The Swipe to Donate Life program was a collaboration between the Ohio Department of Public Safety (ODPS) and Donate Life Ohio, the state’s coalition of four of the 58 nationwide organ procurement organizations (OPOs) in the country.

According to Marilyn Pongonis, director of communications at Columbus-based OPO Lifeline of Ohio, 99 percent of the state’s registered organ donors signed up when they were getting or renewing their driver’s licenses at a local Bureau of Motor Vehicles.

Four in 10 Ohioans, however, do not sign up to be organ donors. Many people are not ready to make that decision or they have questions or are unsure what it means to be an organ donor — and it’s not the BMV’s job to provide them with that information.

Additionally, the BMV registration process lacks the option for would-be donors to specify whether they would like to be an organ, eye and/or tissue donor, which causes most registrants to unknowingly sign up for all three.

That is where OPOs come in. Staff members and volunteers go to state functions and public events — such as college football games, state and county fairs, and health expos — to educate and register interested individuals in the organ donor program.

Previously, that meant carrying around clipboards or laptops and asking Ohioans to provide driver’s license data and personal information. The process was tedious and resulted in low registration numbers. According to Pongonis, Wi-Fi connectivity to BMV’s online services was often unreliable, which made laptop-based registration impossible at some events. And when paper-based registrations were gathered, OPO staffers worried about keeping the paperwork and sensitive personal information secure on site.

When an event fell on a weekend, Pongonis said she would often have to take the paperwork home with her and make sure it was safe until she could get it to BMV the following Monday.

All those concerns prompted Donate Life Ohio to search for a way to make it easier for people to sign up at events. They decided that the answer was letting drivers swipe their licenses through a card reader and update their records.

Donate Life Ohio officials looked at how colleagues in Arizona were using swipe devices and contacted some vendors, then decided to reach out to the Ohio BMV about possible system improvements. And after exploring the option of existing vendor solutions, ODPS ultimately decided to take a do-it-yourself approach to the license-swiping technology.

For one thing, many of the devices on the market stored personal information and then downloaded it to the donor registry center at a later time, which ODPS decided was an unacceptable security risk. Officials also had concerns about the development and ongoing maintenance costs and especially about the confusing interfaces when the new tools were added to the existing system.

According to Keith Albert, chief of ODPS’ IT Project Management Office, the fact that BMV already maintains the organ donor database and delivers best-in-class customer service through its website convinced officials that there was no need to outsource the project.

The idea of swiping a driver’s license to gather information is not a new concept to Ohio either. According to Albert, the state has been doing that for 20 years — at local BMVs and in state highway patrol vehicles. By accessing the existing framework and resources, ODPS could easily optimize BMV’s existing website and attach a card reader to a mobile device.

The ODPS IT team first replaced the original Ohio organ donation website’s ASP.NET form with Microsoft’s Model View Controller in order to make it mobile-compliant and scalable to any size screen. That enhancement also allows citizens to register and edit their donor preferences themselves from any connected mobile device.

The team then bought Apple’s software development kit for $99 to create the “wrapper” application that would support the card swipe, which can only be used by OPO personnel on their iPads. The application has a SQL server backend and pulls data from an attached MagTek iDynamo 5 card reader.

No data is stored on the actual device at any time. When a card is swiped, the individual is asked to provide the last four digits of his or her Social Security number. In less than 30 seconds through a secure Verizon 4G connection to BMV’s private server, the individual’s registration is automatically updated and stored to the BMV database. Nothing remains on the iPad after the transmission is completed.

Using 4G also puts connectivity concerns to rest. “In Ohio, we’re very well wired here. There are only a few places where there’s not 4G connectivity, and those places aren’t likely to have any real events,” Albert said. “We haven’t had an issue since we’ve gone live.”

On the OPO’s end, the application is designed just for Ohio, is extremely easy to use and has been far better received by the public than the paper- or laptop-driven systems. And with the much-improved processing time, OPO staffers can increase their turnaround rate and register more interested citizens at a given event.

“It’s just been a wonderful enhancement to our outreach in the field,” Pongonis said. “We’re able to look at currently registered people and...talk to them about what that decision at the BMV meant. If they want to put restrictions on it, they can.”

Pongonis also stressed the importance of having more time to educate people about what it means to be a donor and how that decision is ultimately binding.

The cost of the project has been minimal. According to Albert, ODPS was able to execute the entire project for less than $6,000. Equipment was a separate cost funded by the Ohio Department of Health. Apple iPads ranged from $400 to $500 each, and the card reader was about $75. Donate Life Ohio bought about 12 iPads to start.

Signups in the field still fall far short of those done at local BMVs, but Pongonis said the new system has clearly improved on-site efforts. And she can tell citizens are more comfortable with the process.

“The number of folks signing up at these events has really gone up significantly,” Albert said, sometimes by as much as 300 percent. And “the citizens of Ohio got what they needed because, ultimately, someone’s life will be saved because someone signed up to be an organ donor at one of these events.”