Facility-level improvements
confusion
Providers and policymakers identified three facility-level improvements: (1) increasing clinic capacity for DRM testing on-site via POC assays, (2) improving systems for tracking the return of results, and (3) incorporating more diverse voices into multidisciplinary discussions.First, providers and policymakers suggested increasing testing capacity by making POC DRM testing available on-site. Although providers recognized that this would involve increasing human capacity and acquiring equipment, one provider emphasized that this is a matter of changing culture and would require minimal effort. Other providers commented that having DRM testing technologies on-site would allow providers to decide more quickly which regimens to administer to a patient.Second, providers and policymakers desired a system that tracks DRM testing results within each facility. One policymaker, for example, expressed concern over the misfiling of DRM testing results which had resulted in delayed modification of treatment plans for patients and delayed care. One lab coordinator expressed confusion as to whether results from the lab were received by the facility or not, expressing desire to improve systems for tracking the return of DRM testing results from the lab to the facility.Third, providers and policymakers strongly approved of the collaborative multidisciplinary team discussions within the studies, advocating for the expansion and diversification of these discussions to include clinicians and technicians from different facilities. One policymaker believed this would allow for a greater exchange of skills, knowledge, improve case management, and patient care coordination. Providers and policymakers also expressed interest in holding regular multidisciplinary discussions, on a monthly basis (they were held ad hoc during study follow-up depending on case volumes).