Brenda Wright is vice president, Clinical Services at Option Care. She brings more than 20 years of home infusion and specialty pharmacy experience to Option Care, where she leads quality initiatives and supports new product introductions. Visit optioncare.com.
Home infusion is a significant player in the evolving health care landscape—it offers an alternative to inpatient therapy. This type of treatment involves administering medication, nutrients or fluids intravenously (IV) in the comfort of a patient’s home or at an alternate site, which meets an individual’s specified needs. With more than two million patients receiving home infusion therapy annually, this trend in health care shows no signs of slowing down.
Home and alternate treatment site infusion services may vary depending on availability and health care coverage, and may range from IV medications and supplies to coordinating necessary home health care services. A combination of clinical care experience and patient-centered therapy management can help a home infusion provider rise above the rest.
The best home infusion care plans are customized. They are built around the individual needs of patients and their physicians, where a multidisciplinary team brings together pharmacists, nurses and dietitians to care for people with complex and chronic conditions. Easing the patient’s transition from hospital to home is a top priority.
Patients and caregivers can better understand home infusion health care services through the following step-by-step protocols:
1. Coverage Is Verified
An intake specialist will verify insurance and connect the patient to appropriate reimbursement assistance resources, if needed. Recognizing the cost benefits, most private insurers cover home infusion, as do most Medicare Advantage plans. While the home infusion industry has been advocating for expanded coverage, Medicare Parts B and D do not currently cover the clinical services required for home infusion, so verification of coverage before proceeding with home infusion is critical.
2. An Individualized Plan Is Developed
A multidisciplinary team—including the physician, home infusion nurse, pharmacist and clinical liaison—collaborates to create a customized approach for the patient following the doctor’s care plan. The pharmacist conducts a full case review to confirm therapy choice and suggests treatment adjustments if warranted. In addition, the pharmacist reviews labs and communicates regularly with the patient to discuss the treatment plan, risk of side effects, comorbidities and the goals of therapy.
3. The Patient Is Educated
Prior to hospital discharge, the home infusion nurse meets with the patient to facilitate hands-on learning focusing on administering medication, using and maintaining the equipment, properly storing medications and the importance of adhering to therapy. After the patient is discharged home, training is reinforced and teaches how to take an active role in their own health, empowering them to provide good self-care.
4. Ongoing Support Is Provided
Nurses, pharmacists and other staff provide ongoing support according to the care plan and the patient’s daily needs. Some individuals may require a nurse to administer each infusion. With such a wide range of patient circumstances, this demonstrates why a customized care plan is essential. At a minimum, the patient receives a weekly check-in call to inquire about health status, response to therapy, side effects and other issues that are then relayed to the physician. Furthermore, patients are provided with 24/7 phone access to their dedicated care team to address any questions or concerns that may arise.
Following these protocols helps ensure that patients receive clinically appropriate, high-quality care, and significant benefits and cost savings are realized.
An increasing number of patients require ongoing infusion of anti-infectives—including antibiotics, antifungals and antivirals. Intravenous infusions such as these are often prescribed to treat infections, which can effectively be managed in the home setting. By prescribing these antibiotics prior to discharge, this allows patients to continue therapy without the burden of a lengthy hospital stay. Not only is this more cost effective than hospital or skilled nursing facility-based therapy, it also reduces exposure of these vulnerable patients to dangerous and increasingly antibiotic-resistant health care-associated infections (HAIs).
Improvements in delivery devices have simplified administration of anti-infective infusion, which typically is given once or twice a day for two to six weeks, depending on diagnosis. When dispensed by a high-quality home infusion provider, one that offers extensive education, robust clinical management and ongoing support throughout the continuum of care—most patients can safely and effectively self-infuse through the appropriate vascular access delivery device.
Handling a broad range of infections, including cellulitis, osteomyelitis, urinary tract infections, diabetic foot ulcers, endocarditis and pneumonia, can help reduce hospital readmissions.
The aging population and growing incidence of chronic conditions promises to increase the need for home infusion therapy. When administered by a quality provider that delivers patient-centered comprehensive clinical management across the continuum of care, this improves outcomes and reduces costs, allowing patients to work, attend school, continue activities and most importantly, enjoy life.