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Table 1 Overview of stages and key stakeholders involved in implementing the model

From: Multi-disciplinary patient-centered model for the expedited provision of costly therapies in community settings: the case of new medication for hepatitis C

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