How Pharma Can Enhance Infusion Clinic Operations

Infusion Clinics (ICs) face a delicate balancing act. They must strive for operational excellence while simultaneously navigating the realities of competition, patient care challenges, and compliance requirements. It’s a difficult challenge, and as ICs adapt to evolving demands, there’s a growing need for pharmaceutical manufacturers to step up with tailored support. 

From streamlining medication access to advocating for policy changes, manufacturers can significantly impact how ICs manage patient experience, operational efficiencies, and compliance. Helping ICs to improve productivity should be important to manufacturers due to the shared goal of ensuring patients have access to their medications and stay on them for better treatment outcomes. And both providers and ICs likely prefer to work with manufacturers that provide additional support. Here are actionable recommendations for ICs that can foster collaboration, enhance clinic performance, and ultimately improve patient outcomes.

1. Focus on the patient experience

Specialty pharmacies and pharmacy benefit managers (PBMs) sometimes require medications to be processed elsewhere, creating competition for ICs. This results in lost margins to the IC, who can counter this where possible by hiring pharmacists for in-house pharmacy.

ICs can draw patients to their facilities by focusing on improving the patient experience and going the extra mile by offering “white glove” treatment. This includes finding ways to reduce wait times, assisting with travel to and from appointments, quickly setting up translators when needed, and providing private rooms—specially tailored for families and children. Clinics that excel at noticing body language cues and troubleshooting problems patients may not openly share also stand out.

Additionally, creating a comfortable atmosphere and simply being a good human can go a long way. Recognizing the patient experience—often filled with intimidation, needle sticks, long appointments, and boredom—helps ease fears and builds trust.

There are additional measures ICs can take to further improve the patient experience:

• AI Integration: While artificial intelligence is still slow to adoption for most ICs, it has potential to significantly improve scheduling processes.
• Staff Training: The importance of having well-trained staff cannot be overstated. Soft skills are crucial for effective communication and building patient trust.
• Prior Authorization Expertise: Having a PA expert in-house is essential. They possess deep knowledge of insurance coverage, coding, and more. It’s risky to discover coverage issues after administering an infusion.
• Addressing Scheduling Challenges: Frequent changes in scheduling can lead to operational inefficiencies, such as the potential waste of medications if they are mixed too soon and the appointment is rescheduled.

Ensure Compliance 

Ensuring compliance involves having the right external support to maintain education (HIPAA included!), validate processes, and monitor adherence to checkpoints. Getting any of these aspects wrong can have significant financial implications.

The Balance Between Ideal and Practical Operations

For those directly involved either working with or at ICs, much of this may seem obvious. However, what stands out was the constant tension between striving for an ideal operation and making the best of current resources. Change can be daunting and may require a step back before progress is made.

Here are suggestions for how pharmaceutical manufacturers can better support Infusion Clinics:

Streamline Access to Medications

• Simplify the Prior Authorization Process: Work directly with payers to streamline the prior authorization (PA) process. Developing templates or tools that help ICs quickly gather the necessary documentation could reduce delays in treatment.
• Understand Payer Nuances: Recognize the differences between major payers and their requirements. For example, knowing that certain payers often deny a PA on the first attempt can prepare ICs to persist rather than give up.

Enhance Communication and Collaboration

• Dedicated Support Teams: Establish dedicated support teams for ICs that provide quick access to information about medications, coverage issues, and patient support programs.
• Regular Updates and Training: Offer regular updates on any changes in medication protocols, reimbursement codes, or regulatory requirements. Providing ongoing training to IC staff on these topics can help them stay informed and compliant.
• Offer HR Training: This could take the form of human resources tips and tools for hiring people with the right technical capabilities and soft skills.

Advocate for Favorable Policies

• Engage in Policy Advocacy: Actively engage in advocacy efforts to support policies that benefit ICs and their patients, such as ensuring fair reimbursement rates and reducing regulatory burdens.
• Support Access to Care: Advocate for broader access to infusion therapies, particularly for underserved or rural populations. This could involve lobbying for better insurance coverage or expanding Medicare/Medicaid benefits for infusion services.

Facilitate Networking and Best Practice Sharing

• Organize Workshops and Conferences: Host or sponsor workshops, webinars, and conferences (like NICA) that bring together IC professionals to share best practices, discuss common challenges, and network with peers.
• Create a Knowledge Exchange Platform: Develop an online platform where ICs can share their experiences, solutions, and innovations, fostering a community of practice.

Tailor Solutions to IC Needs

• Customization of Support: Recognize that not all ICs are the same. Offer customized support and solutions based on the specific needs of different clinics, whether they are small, independent operations or part of a larger healthcare system.
• Responsive Feedback Loops: Establish channels for ICs to provide feedback on pharmaceutical products and services. Use this feedback to continuously improve offerings and address any emerging challenges they face.

By implementing these recommendations, even in part, pharmaceutical manufacturers can play a crucial role in enhancing the effectiveness, efficiency, and sustainability of Infusion Clinics, ultimately leading to better patient care and outcomes. Both providers and ICs could benefit from this added support, while also putting the manufacturer in a more competitive position from those that do not have this partner mindset.

About Patty Trainor

Patty Trainor is a Senior Director at leading market research firm KS&R. Patty has dedicated 20+ years in the healthcare space and in understanding stakeholder influences and outcomes. She is also KS&R’s Pharmacy SME with experience interviewing buyers and executives in IDNs and Pharmacy Chains to understand corporate initiatives impacting HCPs and Pharmacies in respective systems. In addition, she has led hundreds of qualitative and quantitative research studies across a multitude of stakeholders to understand drivers behind purchasing/prescribing/dispensing practices, patient motivators, and more to shed light on the patient (and prescription/vaccines) journey.