Developing and Launching a New Home Infusion Program
Oregon Health & Science University (OHSU) is the state’s only academic health center, serving patients at locations throughout Oregon and southwest Washington, as well as at its main Portland campus, where OHSU Hospital and Doernbecher Children’s Hospital are located. OHSU launched its home infusion pharmacy in 2017 to complement its ambulatory infusion capabilities, and, by any measure, it has been successful. OHSU was the first site for Excelera’s home infusion consulting program.
Developing a home infusion program was a natural evolution for OHSU. Pressure had been mounting on the capacity of OHSU’s ambulatory infusion centers for some time. Insurers were also pressing for alternative sites. Some patients who had received infusions at OHSU for years were required by third-party payers to switch to one of the other home infusion providers in the area. This break in continuity was not only disruptive to patients but sometimes to clinical communication.
The challenges OHSU faced in actually executing its home infusion plan were somewhat unexpected. First, some of the same insurers were not necessarily interested in adding another home infusion vendor to their networks. Second, OHSU found that its own providers were less familiar with home infusion than expected, since ambulatory infusion had been standard practice.
While getting insurers on board was challenging, OHSU insisted on including home infusion coverage in contracts for inpatient and outpatient services. OHSU chose to proceed with a soft launch prior to signing some of these contracts.
Successful provider education included “road shows” at clinics and department leadership meetings, conversations with department chairs about the benefits of home infusion, and training on writing referrals and orders for home infusion. Providers were also given the same materials that new patients receive.
Excelera consulted with OHSU beginning about 14 months prior to planned launch. Excelera worked on the project plan, project management, ancillary services contracting, information systems coordination, and models for staffing, workflow, and finance, as well as providing other services and best practices from its comprehensive home infusion blueprint and playbook.
OHSU’s home infusion program has experienced robust growth. Patient volume doubled from launch to Month 12, and it doubled again from Month 12 to Month 24. Patients are very satisfied with the program, particularly the greater scheduling flexibility. Therapies provided include antibiotic infusion, parenteral nutrition, specialty medications, enzyme replacement, and electrolyte replacement.
Providers are pleased that chairs are now available at ambulatory clinic infusion sites for quicker scheduling of new patients and those whose health requires closer monitoring and observation. Providers have also found home infusion exceptionally helpful in accommodating patients with mobility issues.