Home infusion is playing a growing role in the health care industry. Every day, approximately 60,000 people undergo infusion treatments from the comfort of their homes. Home and alternate-site infusion is an $11 billion industry and is projected to reach $28.3 billion by 2024. Further driving the trend toward home treatment are new Medicare coverage options making therapy more accessible for patients.
Despite the industry’s footprint, it lacks reliable, large-scale data to accurately refine its devices and drug delivery methods. Studies exploring this aspect of medical care rely on patient self-reporting for a measure as basic and critical as patient adherence. The lack of data needs to be addressed before home infusion can expand to a wider range of patients.
Hospitals, physicians and patients all stand to benefit from increased home-based infusion therapy. Hospitals will have the opportunity to send patients home earlier, reduce costs and minimize the chances of a patient catching a potentially deadly hospital-acquired infection. Prolonged hospital stays increase a patient’s chance of acquiring an infection and infected patients tend to spend 2.5 times longer in the hospital. As such, it is imperative to get patients safely home as soon as possible. Home infusion also allows patients to spend more time at home where they are most comfortable. This increases the patient’s quality of life and improves their mental well-being, both of which help to improve patient outcomes.
Doctors, for their part, can also benefit from the improved outcomes that emerge as a result of homecare when part of outcome-based payment systems. Even those who are not part of these systems will benefit from improved patient outcomes that result from correctly administered home infusion therapy.
Despite the many benefits of home infusion, risks exist whenever a patient is managing their own treatment. Recent reports indicate as many as 21 percent of patients are readmitted to the hospital within 30 days of starting treatment. These readmissions cost United States hospitals $41.3 billion in Medicare fines.
Ineffective treatment and several other issues with infusion can lead to a readmission. These issues can include new infections and line-associated complications. Some studies also suggest that adverse drug reactions are responsible for 14 to 24 percent of readmissions.
Certainly, as the home infusion industry moves forward, it must aim to reduce the readmission rate. However, to develop appropriate solutions, the industry needs better insight and transparency into what is happening with infusion treatments as patients return home.
Overcoming the Deficit
Researchers in the studies cited here recognize the limitations of their research. In the study “Risk factors for readmission in patients discharged with outpatient parenteral antimicrobial therapy: a retrospective cohort study,” researchers reported that, “As this was a retrospective, non-interventional study, there is an increased risk for recall and selection bias. The current research was unable to capture readmissions at other institutions.” Reliance on patients self-reporting their own adherence rates and inability to accurately track a patient’s medical history limit the reliability of the data currently available.
Self-reporting cases are made even more difficult when doctors treating home infusion patients contact those patients for follow-up on treatment before contacting the pharmacy to provide a refill.
Without reliable and objective data, both infusion devices and the drugs that the devices deliver will not be able to fully help patients. Many other segments of the health care industry have recognized the need for a larger quantity and quality of data, but home infusion lags.
If the home infusion industry can find a way to increase its data capture, it will help patients and expand the industry’s potential to improve patient outcomes. The best way to do this is by following the model of many other medical devices: introducing cloud connectivity and artificial intelligence to the infusion device market.
Tracking infusion devices with cloud connectivity can provide data to doctors and caregivers so they can know precisely when the patient has administered each dose and how much of the drug has been delivered.
Furthermore, doctors can use this information to check on their patients’ well-being outside of the doctor’s office while treatment is ongoing.
Connected infusion can also give drug companies and pharmacies a better sense of how drugs are being used and for how long. If a patient is readmitted to the hospital, multiple interested parties can gain a far better sense of whether readmission was caused by an adverse drug reaction or misadministration of the drug or device.
Once infusion devices are connected, they can also be paired with cellphone apps that help patients track their own infusion schedule, and/or help family members assist their loved ones with treatments, further assisting in patient adherence to treatment.
Current patient populations are much more engaged with their therapies than they have been in the past, and infusion connectivity can allow the patient better insight into their own treatment.
Connecting the Industry
Health care, like many other industries, is moving from traditional brick and mortar stores to health clinics and hospitals to peoples’ homes. The industry must ensure that the transition happens safely—and as quickly as possible—to enable a shift to outcome-based care and more effective treatment. Home infusion devices provide a prime example of a health care device that could be upgraded to improve patient outcomes and reduce the burden on hospitals through connectivity. The sooner this happens, the better.