A defined screening framework
Apply the transplant center’s approved referral-screening criteria to available chart information. Use the result to prioritize potential candidates for review.
Kidney transplant eligibility and referralFind potential candidates.
Find potential candidates.
Connect them to transplant care.
InstaMD’s transplant eligibility solution applies deterministic rules to patient-chart evidence, helping transplant centers and referring practices identify potential referral candidates, resolve missing information and coordinate the path to evaluation.
Deterministic screening
Chart evidence evaluated against defined criteria.
InstaMD developed a rule-engine approach to transplant eligibility screening. The patient chart supplies the clinical evidence; the configured criteria determine the screening result. The transplant center reviews the findings and retains authority over clinical evaluation and waitlisting.
Findings in clinical context
Review the chart evidence behind each finding, including dates and supporting records. Document interpretation and confirm clinically significant information before progressing a referral.
Missing data needs follow-up
Distinguish a missing or outdated record from a criterion that is not met. Request additional information rather than treating absent evidence as an automatic clinical rejection.
Screening supports the decision
Potential referral fit is not a guarantee of transplant eligibility, acceptance or waitlisting. Center clinicians review the patient’s circumstances and determine next steps.
Two referral pathways
Embedded in Epic. Accessible beyond Epic.
Both pathways bring patient evidence and screening findings to the transplant center for review.
SMART on FHIR chart workflow
Launch the InstaMD solution within Epic using SMART on FHIR to review the patient context and apply the deterministic screening criteria to authorized chart data.
FHIR Bulk Data Export and upcoming appointments
Use authorized FHIR bulk exports to review patient cohorts. Combine the clinical data with available scheduling data to identify patients with appointments in the next 30 days who may fit transplant referral criteria.
Center-approved external providers
Nephrology practices, dialysis centers and other referring organizations enroll through an external-provider workflow. The transplant center approves access before the practice submits patient charts.
One patient or multiple patients
Approved practices can upload chart packages typically ranging from 10 to 400 pages, including files containing one or multiple patients. Patient-record separation and identity confirmation precede individual screening and referral review.
FHIR bulk export does not by itself guarantee appointment availability. The next-30-day cohort uses scheduling information from an authorized FHIR Appointment interface or another agreed scheduling source, depending on the Epic deployment and available permissions.
Epic and population screening
Prepare for the next 30 days of appointments.
- Connect the authorized data
Use the embedded SMART on FHIR chart workflow or an approved FHIR bulk-data feed, with the required access and patient scope.
- Build the upcoming-appointment cohort
Identify patients scheduled within the next 30 days using the available scheduling source and associate their clinical chart data.
- Apply the screening rules
Evaluate available evidence against configured referral criteria and identify potential candidates and incomplete cases.
- Review before referral
Center staff confirm the patient match, findings and missing information, then route the case for appropriate clinical review and referral action.
External-provider workflow
Bring referrals into the center from outside its EHR.
- Enroll and obtain center approval
The referring practice requests access. The transplant center approves the organization and its authorized users.
- Upload the chart package
The approved practice submits one or more patient charts, typically 10–400 pages, through the authorized upload workflow.
- Confirm each patient record
Separate multi-patient packages and verify patient identity, chart boundaries and extracted information. Keep each person’s evidence attached to the correct case.
- Review qualification together
The referring practice reviews rule-based screening results and supporting evidence alongside the transplant center.
- Resolve gaps through secure channels
The center requests missing records or clinical clarification through the approved secure workflow. The referring team supplies the requested information for review.
- Submit the referral
Complete the referral package and send it to the transplant center. Continue tracking requests, responses and the center’s disposition.
Center review and disposition
A clear decision, with the next step documented.
Review the submitted case
The transplant center reviews the referral package, chart evidence and screening findings. Incomplete cases can return to the referring team for further information.
Accept for evaluation or decline
The center may accept the referral for evaluation, request more information or decline it. Share the decision, rationale and next steps with the approved referring team.
Center-led clinical determination
Following the required evaluation, the center determines whether to approve or decline waitlisting, or defer a decision pending additional workup. Referral acceptance is separate from waitlist approval.
Keep both teams informed
Track the case through referral review, evaluation, information requests and center-recorded waitlist status. Update the referring practice as the care pathway changes.
Engagement while actively waitlisted
Continue care with RPM and PCM when appropriate.
Providers can add medically necessary Remote Patient Monitoring (RPM) and Principal Care Management (PCM) to support eligible patients during active waitlisting. Care may be led by the referring physician outside the center’s network or by an outpatient practitioner at the transplant center, according to the agreed clinical and billing arrangement.
Monitor relevant physiologic trends
Use indicated connected-device measurements, such as blood pressure or weight, to support the treating practitioner’s care plan. Review concerns and coordinate follow-up through the agreed escalation pathway.
Manage the principal chronic condition
Maintain a condition-specific care plan, medication and appointment follow-up, and coordination between the referring team and transplant center.
Choose the responsible provider
Identify which practitioner directs each service, handles escalations and maintains the care plan. Coordinate center-based and outside-network services to prevent duplication.
Verify the service independently
Active waitlist status alone does not qualify a patient for RPM or PCM. Confirm medical necessity, consent, provider eligibility and payer requirements; review ESRD-related bundling, concurrent-service restrictions and distinct activity records.
Connected teams
One coordinated pathway from chart review to ongoing care.
Submit evidence and maintain continuity
Upload approved records, review screening results, respond to center requests and provide agreed ongoing care.
Approve access and direct the transplant pathway
Approve external practices, define screening criteria, review referrals and determine evaluation and waitlisting decisions.
Configure access, data sources, referral criteria, secure communication and RPM/PCM responsibilities with the transplant center before rollout.