This would take business savvy, and math. So last year, Tayur ran his idea past Regina Herzlinger, a Harvard Business School professor who teaches a course on innovation in healthcare. She charged a group of her students to build a business case to convince insurers to include OrganJet’s service as a benefit for those in need of a kidney transplant. After weighing the cost of dialysis, the potential loss of productivity, and the possible benefit of an earlier transplant, the team concluded that an insurance company could afford to cover OrganJet without increasing premiums. With this, Tayur brought the analysis to Highmark, a health insurer in Pennsylvania.
“I must say, I was very attracted to the idea,” said Don Fischer, the chief medical officer at Highmark. “[Tayur] is a very methodical systematic thinker. We need more people like that.” Fischer, who used to work as a pediatric cardiologist, remembered how children and their parents would travel across the country for a transplant with funds raised by their churches or communities. This was a similar concept, he noted. While Fischer told me that Highmark hasn’t committed to including OrganJet to its benefits, he praised the idea for being “a very workable solution … We think it’s a very novel idea,” and Highmark is currently considering it.
Tayur, who knows these sorts of decisions take time, isn’t in a rush. After all, he hadn’t thought much about transplants at all until that dinner just four years ago. And now, his potentially controversial idea might make change. “I’m not the first guy to wake up and say ‘Oops, there’s geographic disparity.’ But then I pop in and say, ‘How about I propose something that requires no change in the law, no UNOS sign-off, no redistricting, and I’m going to work with the insurance companies?’ The reception has been positive and I wonder if one of the reasons is that, in the last 30 years, many other ideas have gone nowhere.”
Transplant surgeons hope that Tayur’s project could spur policy-makers to action. “I hope if OrganJet takes off, people will say, what are you doing shipping patients? Going to that extreme just shows how ridiculous the community is being,” Markmann told me. At Northwestern, Skaro agreed. “If that’s what’s going to need to happen to garner the attention that’s necessary to make change, so be it. In any event, it’s an ingenious idea.”
These days, Tayur gets a “steady drumbeat” of a few emails per week from people throughout the country who are suffering from kidney or liver failure. No one has used one of OrganJet’s private jets to fly to an organ yet. Those who’ve signed up for the service have all been able to get a commercial flight in time, before having to resort to the private plane waiting in the wings. But they are grateful. And while Tayur is still the software guy, driven by the fun of solving a difficult problem, he notes that, almost unexpectedly, a sense of gravitas has crept into his work. “What started as a purely curious thing has become real,” he said, smiling. One of his most recent projects was optimizing ad placements, for products like Coke or Sprite, in video games. “The ultimate irony would be that a flippant guy like me would end up helping people.”