Table 1 Overview of stages and key stakeholders involved in implementing the model
STAGE | STAKEHOLDER | Action |
|---|---|---|
1. Planning and training | Decision-makers (MHS Central District) | Strategic planning; assigning and training project staff |
2. Identifying HCV patients | Expert in data extraction | Identify potentially eligible HCV patients using existing data in the MHS computerized databases |
3. Initial communication | Assigned nurse-coordinator (in each sub-district) | Contact local MHS clinics with documented HCV patients; contact managing physicians and patients |
4. Laboratory testing | Nurse-coordinator, managing physician | Coordinate referrals to HCV testing and FibroScan/FibroTest |
5. Eligibility criteria 1: GT1 & F3-F4 | Nurse-coordinator | Follow-up laboratory test results and communicate with patients |
a. If not eligible | Nurse-coordinator | Refer to gastroenterologist and managing physician for follow-up |
b. If eligible | Nurse-coordinator or assigned physician | Set up expedited appointment with assigned gastroenterologist |
6. Consultation with gastroenterologist | Gastroenterologist | Evaluate suitability for treatment |
7. Eligibility criteria 2: gastroenterologist recommendation | Assigned physician | Follow-up on gastroenterologist recommendations |
a. If not eligible | Assigned physician; nurse-coordinator | Refer to gastroenterologist and managing physician for follow-up |
b. If eligible | Assigned physician | Contact assigned clinical pharmacist |
8. Medication Approval Center | Assigned clinical pharmacist | Submit request for medication approval; coordinate with assigned physician and gastroenterologist to complete any missing information |
9. Supply medication to pharmacies | Assigned clinical pharmacist; Central District pharmacist | Ensure supply to pharmacy closest to the patient’s residence; coordinate with AbbVie representatives, with the MHS purchasing department and with pharmacies in each district |
10. Patient training in medication use | Assigned clinical pharmacist | After approval and record of first purchase, patients are contacted by telephone and trained in medication use in their mother tongue |
11. Regular patient follow-up | Gastroenterologist and family physician | Continued follow-up of patient during and after treatment |