Table 2.

Challenges in implementation of care coordination model for patients treated with HCT

ChallengeDetails
Variation at patient and provider levels, leading to differences in gaps in care at each level Heterogeneity of clinical and sociodemographic profiles of patients 
Differences in the capacity, infrastructure, organizational commitment, and available resources of the practices and transplantation centers 
Reimbursement challenges Lack of incentive for providers to work collaboratively 
Unclear reimbursement policies on components of the model, such as patient navigators, telemedicine services 
Coverage gaps/poor coverage for post-HCT care (once the standard transplantation benefits package is completed) 
Information technology challenges Lack of functionality to help with care coordination issues 
Lack of interoperability of electronic medical record systems 
Assuring clinical competence for complicated but highly specific diagnostic and management issues Requires buy-in from all stakeholders for promoting educational efforts to enhance care for patients treated with HCT in both the pre- and post-HCT phases 
Developing close collaborative networks to help provide timely and optimal care for issues that are beyond the scope of their knowledge and training 
Paucity of community resources Lack of community-based programs to provide optimal medical and psychosocial care to patients treated with HCT 
ChallengeDetails
Variation at patient and provider levels, leading to differences in gaps in care at each level Heterogeneity of clinical and sociodemographic profiles of patients 
Differences in the capacity, infrastructure, organizational commitment, and available resources of the practices and transplantation centers 
Reimbursement challenges Lack of incentive for providers to work collaboratively 
Unclear reimbursement policies on components of the model, such as patient navigators, telemedicine services 
Coverage gaps/poor coverage for post-HCT care (once the standard transplantation benefits package is completed) 
Information technology challenges Lack of functionality to help with care coordination issues 
Lack of interoperability of electronic medical record systems 
Assuring clinical competence for complicated but highly specific diagnostic and management issues Requires buy-in from all stakeholders for promoting educational efforts to enhance care for patients treated with HCT in both the pre- and post-HCT phases 
Developing close collaborative networks to help provide timely and optimal care for issues that are beyond the scope of their knowledge and training 
Paucity of community resources Lack of community-based programs to provide optimal medical and psychosocial care to patients treated with HCT 
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