ACCESS PATHWAYEngraft prototype
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AP-009

Pediatric lymphoma, urban, commercial, under 25 miles

CAR-T · Phase 4, Collection & Preparation · 19 days in stage · 6 barriers, 3 blocking

On track

Delivery

Navigation plan

12 tasks are on this plan, 0 still open. The engine suggests 18 in total from this patient's barriers, so 6 have no owner yet. Statuses persist here.

Completion criteria, in order

Three things that each have to be true before treatment can happen. Work here unblocks everything downstream, which is why it sits above the rest of the plan rather than inside it.

Step 1 · Reach a center

1 flag

referred and accepted for evaluation

In the way: Late referral / progression before treatment

  • Refer early — at first relapse / by 2nd line; do not wait

    Referring / community oncReach: Treatment center22 days overdue
    Done

Step 2 · Be accepted as a candidate

1 flag

the center recommends treatment

In the way: Caregiver & psychosocial clearance

  • Confirm the center’s caregiver requirement and any flexibility

    Nurse navigatorReach: Treatment center22 days overdue
    Done

Step 3 · Secure approval to proceed

1 flag

authorization and coverage in place

In the way: Coverage lag after approval

  • Check the payer’s current medical policy and timeline before committing

    Nurse navigatorReach: Payer / health plan22 days overdue
    Done

Feasibility and support

Work that makes treatment possible and bearable rather than permitted. Regroup it along whichever axis matches how you are working today.

Refer & establish candidacy

4 tasks

  • Set up a single point of contact / intake coordinator with the center

    Nurse navigatorReach: Treatment center22 days overdue
    Done

  • Use a standardized identification trigger (If they RECUR, refer)

    Referring / community oncReach: Internal — no outside contact22 days overdue
    Done

  • Fast-track the pre-apheresis work-up to shorten decision-to-vein time

    Treatment-center teamReach: Treatment center22 days overdue
    Done

  • Identify a pediatric cell-therapy center / open trials early

    Nurse navigatorReach: Treatment center22 days overdue
    Done

Build the access plan

3 tasks

  • Start caregiver planning now; explore paid-caregiver and respite options

    Social workReach: Caregiver / family22 days overdue
    Done

  • Connect family to caregiver stipend / paid-leave resources and advocacy

    Social workReach: Community / advocacy org22 days overdue
    Done

  • Build family-support (financial, lodging, siblings, school) into the plan

    Social workReach: Caregiver / family22 days overdue
    Done

Confirm coverage & authorization

2 tasks

  • Advocate for rapid-coverage pathways post-approval

    Advocacy / CBO partnerReach: Payer / health plan22 days overdue
    Done

  • For young adults, confirm site eligibility and coverage explicitly

    Treatment-center teamReach: Payer / health plan22 days overdue
    Done

Handoffs

An explicit transfer of responsibility, tracked separately from tasks because the failure mode is different: nobody is late and nobody is idle, the work simply has no owner until somebody acknowledges it.

Referring / community oncNurse navigator

Referral received and accepted for work-up.

Acknowledged

Every task traces back to a barrier that actually fired for this patient.

  • The plan is not separate authoring. It is the assessment projected forward.
  • That is what makes it maintainable at all.