Home Infusion Therapy is very appealing to both patients and claims professionals as an alternative to facility-based infusion therapies. Patients often prefer to move to the home setting as quickly as possible, and claims professionals appreciate the cost-effective nature of infusion therapy services provided in the home. Home Infusion can also be an intimidating service, due to the specialized nature of the service and the need for continuous communication and close coordination between the clinical provider, physician, patient, and claims professional. MSC Care Management’s skilled Infusion Therapy team removes the intimidation factor by helping customers (both claims professionals and patients) to understand the intricacies of Home Infusion and ensuring consistent, frequent communication and coordination between all parties involved – vastly improving the Home Infusion experience and reducing the potential risks associated with Home Infusion.
This article provides a brief summary of the key considerations related to Home Infusion, as well as insight into MSC’s Home Infusion solution.
What is Home Infusion Therapy?
Home Infusions include the delivery of medications through a catheter in the home administered by a nurse or patient/family. Home Infusion Therapy shifts emphasis onto a collaborative process where duties of healthcare are shared between consumer and provider.
Does home administration of IV medications provide a cost savings?
Yes. According to the IDSA (Infectious Disease Society of America), the average cost of hospital-based antimicrobial IV Therapy significantly exceeds the cost of the same treatment in the home:
DAILY infusion of antimicrobial medication in the hospital: $1000 per day
DAILY infusion of antimicrobial medication in the home setting: $300 per day
What are the legal implications and exposure to risks?
The greatest risks and potential for legal action related to Home Infusion generally arise when Home Infusion is not accompanied by appropriate clinical oversight. However, when the appropriate clinical oversight is in place, Home Infusion care is convenient, cost effective, and supports optimal outcomes in patient recovery.
MSC’s Infusion Therapy Team is lead by a clinician with an intimate understanding of the treatment process and safety measures required to ensure the safe delivery of care in the administration of IV medications for your patients.
While some states allow for Infusion trained LPNs to administer IV medications, MSC maintains a rigid policy of RN use for all Infusion Therapy administration.
24/7 access to a Registered Nurse and Pharmacist
Minimum weekly calls to the patient and family to ensure educational and practical needs are being met. Infections Precautions and signs/symptoms to report are frequently reviewed and reinforced with the patient and family.
A review of lab work and collaborative practice of nurse-pharmacist interaction to ensure appropriate and safe dose administration.
To ensure the safest administration with patient involvement, MSC coordinates all infusion medications through a disposable pump at no additional cost.
If frequency of treatment requires more than one visit by a nurse per day, MSC assists with options for the use of a continuous pump for administration of medications and to minimize skilled nursing costs.
A nurse will be available to make additional visits to the home if necessary for troubleshooting any infusion therapy issues.
Collaborative weekly conferences may be conducted between MSC’s designated Care Manager, the Home Infusion RN, and the Registered Pharmacist to review efficacy of treatment plan and identify any additional resource needs.
MSC focuses on patient safety and cost containment through a series of Must Do steps in management of IV therapy, as follows:
1) Evaluate the appropriateness of home infusion therapy for each patient:
- Is patient capable of understanding the process of administration?
- Is patient receptive to teaching?
- Can patient be trusted to comply with aseptic technique and infection precautions?
- Does the patient’s environment allow for a clean and safe site for delivery?
2) Validate credentials/licensing of the homecare provider and pharmacy:
- Does the agency meet the state requirements and MSC’s requirements for liability insurance coverage?
- Does the agency meet all requirements for clinical standards of practice?
- Does the RN have a minimum of 3 years experience with infusion therapy administration in an acute facility setting?
- Does the RN have a minimum of 3 years experience in homecare service delivery?
- Does the agency employ a quality assurance process for the regular monitoring of skills set and competence of the skilled infusion nurse?
- Does the pharmacy meet all necessary state requirements for dispensing of medications and allow for accessibility to a Registered Pharmacist 24 hours per day?
3) Evaluate appropriate level of care for the intravenous or subcutaneous catheter and validate treatment plan of care for the catheter:
- Assess the composition and placement of lines (peripheral, PICC, central, midline, implantable port) to ensure compliance with flushing protocols and dressing changes.
4) Evaluate progress of healing and patient response to treatment. Collaborate with the physician to address any treatment plan changes needed.
5) Provide reinforced education to the patient/family throughout the duration of treatment.
MSC’s team of specialists, coupled with our rigorously credentialed network of providers, work with the patient and the customer to ensure that Home Infusion care is a safe, cost-effective, high quality-of-life solution for all involved.