Dr Saira Jan Shares Oncology Therapeutics Home Infusion Program Findings

Saira Jan, PharmD, MS, of Horizon Blue Cross Blue Shield of New Jersey discussed the primary findings of their collaborative pilot program with Rutgers Cancer Institute of New Jersey and RWJ Barnabas Health. In response to the COVID-19 pandemic, the program was created to promote home infusion of oncology therapeutics instead of receiving them at an oncology infusion center.

Jan went into more depth about the program and its findings during the AMCP Nexus session, "Implementation of a Novel Oncology Home Infusion Model" on October 18. At Horizon Blue Cross Blue Shield of New Jersey, she is the vice president and chief pharmacy officer. Jan is also professor emerita at Rutgers University's Ernest Mario School of Pharmacy.

Transcript

What were the primary findings of the pilot program, especially in terms of patient and provider experience?

It is one thing to say we are improving the delivery and making it accessible for the members to get it at home, but what is the member experience? What is the provider experience? We have gotten really good feedback from the members. The most positive experiences and testimonials have come from the members because they really liked the convenience of being at home. Even if they have side effects after the chemotherapy, they are at home, they are comfortable, they have a lot of access to the nurses, and, even through FaceTime, the providers—so they could talk—they could have that engagement with them, even after the infusion nurse had left the house.

Secondly, from a hospital perspective, this actually was very helpful from a provider perspective because what they did was that they backfilled those chairs with other infusions; they had limited capacity. So, now, when you move these infusions to home, those chairs then were utilized for other infusions that the hospital did not have enough chairs for, so that was a win for all of the stakeholders that were involved in this. The providers, initially, were a little skeptical, and we had the leadership really talk to them and say, "These are the drugs that the patient will be infused with at home, let us know if you have any concerns." Once they started doing it, their comfort level improved over time. Now, without thinking, they would refer the patients.

We also had a process developed as we started doing this intake and moving patients to home that we had to actually hide in the hospital setting a couple of technicians who could do the the process of identification and going through all the paperwork and everything else. That was something that was an operational enhancement in that original process, but that took away a lot of work burden from the hospital. Some of these infusions and chemotherapies could be 5 hours, 6 hours, 2 hours. If you take that time out of the resources at the hospital where we now have nursing shortages; during COVID-19, it was worse, but it still has not gone back to normal. Giving that [infusion] at a patient's home gave them [nurses] more resources to attend to other patients. Now, as the COVID-19 has subsided, going forward, it is something that is really being triggered by convenience, triggered by the fact that it is very convenient for the member to get it at home and not travel distances to get the infusion.

The other thing that was actually very important, which was not only because of COVID-19, but we learned that a lot of patients would miss chemotherapy. If you miss a cycle, then the next cycle is postponed. So, you are really impacting the outcome of those therapies, and that was unusual circumstances, which was really enlightening for us to understand that sometimes people miss. Now, people can't miss when somebody's going to their homes and delivering the care. That was, I think, big learning that it [home infusion] is not only conducive to improve member experience, but it also helps in the outcomes of the therapy in general.