“There's a certain self-satisfaction to being clever for its own sake," Sridhar Tayur said. Tayur is a professor and software entrepreneur who made his name developing novel algorithms to help businesses like Kellogg decide where, when, and how many Poptarts of different types to produce, store, and distribute. He has now—seemingly on a whim—shifted his focus to organ transplantation.
"It has nothing to do whether you helped somebody or made money or got a prize,” Tayur said. “All of those things matter. But there’s this joy when you're sitting alone in your room and you say, ‘Aha! I thought about something in a new way.’”
This time, that something is a particularly intractable issue in organ transplantation. The supply and demand imbalance between organs and the people who need them means that wait lists in New York or San Francisco might be twice that of, say, Kansas or Tennessee. The problem was brought to public attention in recent years by Steve Jobs, who used his resources to travel across the country for a liver transplant. For decades, doctors and policymakers have debated how to move organs or change allocation maps in an effort to eliminate these disparities.
Now, Tayur proposes to turn the problem on its head. OrganJet, his brainchild, is a company that uses an online app to help patients find out where in the country they could go to get a liver or kidney the fastest, and then promises a private jet to fly them there at a few hours’ notice when the organ becomes available.
It might all sound a bit crazy. At 49, Tayur doesn’t have any training in healthcare or in the field of medical ethics. He is a Carnegie Mellon University-chaired professor of operations management with a Ph.D. in operations research, a field that uses mathematical modeling to solve business problems. He knows little about the intricate process of transplanting an organ from one human being into another. But Tayur, who founded and recently sold a supply chain start-up called SmartOps, knows a lot about supply and demand, and how to fix problems. And thanks to his charisma and unique outsider approach to innovation, traditionally staid medical institutions are listening.
“I thought immediately that it was a fantastic idea,” Anton Skaro, a transplant surgeon at Northwestern University Feinberg School of Medicine, told me. “You’re talking about years and years before policy and reforms can get a foothold and reverse this inequity. If you can’t get the organs to the people, get the people to the organs.”
One night in October 2010, Tayur was out to Thai food with Baris Ata, then an associate professor at Northwestern University. Ata studies the organ transplantation system and the topic of geographic disparities in organ transplantation came up.
When it comes to transplantation, the country is divided into 58 groups called “donor service areas,” which make up 11 different regions. When an organ becomes available, it’s offered up to the patient highest in the list in that donor service area. If there’s no eligible match, the search is expanded to the region and, finally, to the country at large. One problem with this system is that the regions were created years ago, and today, some regions have more sick people than others. This means that patients in some areas of the country face longer wait times and a higher chance of dying while waiting for a transplant.
Patients can be evaluated to get on the waiting list in multiple different cities at one time, as Steve Jobs did when he needed a liver transplant. In fact, transplant centers are mandated to mention this option, called “multiple listing.” But given the resources and wherewithal required to find the program with the shortest wait time, and to then make plans either to move or to get there quickly should an organ become available, few people ultimately use that option. There’s been no shortage of proposals with the goal to correct what many see as an unacceptable status quo, in which geography dictates transplant accessibility. But mired in often-politicized debate, change moves slowly.
As a result, the problem was described to Tayur simply as “not solvable.”
This piqued his interest. And in the days that followed, Tayur, who splits his time between Pittsburgh and Boston, started to wonder what he would do if he needed a kidney or a liver. He thought he would list in a hospital somewhere that had shorter wait times, and when the organ became available, he’d get a jet to fly there. “Then I started thinking, how rich would you have to be? Maybe you don’t need to be Steve Jobs and own a jet, maybe you just need access to one. It was a puzzle.”
Tayur knows the private-jet industry. It turns out that to use a private jet, you don’t actually need to own a plane. That’s where the concept of “fractional jets” comes in. For a premium, you can pay to have access to a shared jet, when you need it. This, Tayur told me, is why I’ve never seen a rock star on a commercial flight. Back in the 1990s, Tayur developed complex algorithms to help a fractional-jet company decide which planes to send where, in order to minimize flight time and total cost while accounting for a host of factors like maintenance, crew skills, and future trips. Decades later,while leading his software company, SmartOps, he found himself flying throughout the country to convince companies they could benefit from his software, which would help them with “supply-chain optimization”—that is, how many products to produce and how to distribute them. With a punishing schedule, commercial flights were out and Tayur became a fractional-jet customer himself.
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