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Abstract

Xpedite was a computer-based information system developed by the United Network for Organ Sharing (UNOS) to enhance organ procurement and placement from cadavers. Using state-of-the-art development approaches and technology at the time of its development, Xpedite was built around Lotus Notes, facsimile machines, and alphanumeric pagers. It was developed to integrate and streamline the collection, transfer, and exchange of data on available organs more fully. The concept was to shorten the time from organ availability (i.e., donor death) to transplant, thus reducing organ wastage. Xpedite met design and operational performance goals (i.e., a reduction in placement times and data errors), yet its operation was terminated after barely twenty-four months of operation. Adoption of the new technology throughout the transplant community was limited due to inexperience with integrated information technology systems and the resistance to change that accompanied Xpedite's launch. The individual and organizational resistance was a surprise to UNOS. The technical and organizational lessons learned from this experience helped UNOS with developing subsequent information technology infrastructure components. The complexity of the technology support environment and low levels of user adoption for Xpedite ultimately led to an evolution beyond this tool, resulting in an Internet-based environment that would be more robust, easier to maintain, and better able to support user needs.

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