Home Infusion vs. Infusion Center: How to Choose an Infusion Site of Care That Works for You
A high number of biologic medications to treat complex chronic conditions such as Crohn’s disease, rheumatoid arthritis, multiple sclerosis (MS), and many others are administered by intravenous infusion of biologic medications. These new and innovative specialty pharmaceuticals provide additional treatment options and can help improve patient outcomes.
After being prescribed and deciding to move forward with infusion therapy, patients have a critical decision – where to receive their infusion. Depending on the therapy and prescribed regimen, patients may receive treatment every month – or sometimes every couple of weeks. This means infusion patients will likely interact with their infusion provider more often than any other healthcare team. Where to receive infusions can make a direct impact on a patient’s journey to feeling better and returning to normalcy.
Many infusion therapies must occur in a medical facility like the hospital outpatient department, specialist provider office, or ambulatory infusion center. In some cases, certain therapies – like Remicade and Entyvio – may also be administered in the home with the supervision of a home infusion nurse. Depending on a variety of dynamics, a prescribing provider may recommend receiving infusions in an outpatient setting – such as an ambulatory infusion center – in certain cases and home infusion at other times.
Every patient’s situation is different. Understanding the benefits and challenges of both options will help give you additional perspective when consulting with your physician which site of care is right for you.
Patients can opt for home infusion care if they require specialized services for their infusion treatment needs. Receiving care within the comfort of a patient’s home can be a positive treatment option for patients – especially those that have difficulty traveling outside of their house – as a trained nurse will travel to the patient’s home to administer the infusion.
Convenience: Depending on the times and availability of your infusion nurse, home infusion can offer appointment flexibility and allow you to better align your treatments with your existing work or home schedule. You have the advantage of not driving anywhere to receive your medication, while avoiding inconveniences like long walks from a hospital parking garage to the infusion center.
Comfort & Routine: Since a nurse travels to your house, you may consider the setting for your infusion to be more relaxing, as you can receive treatment in your living room or other familiar area with your spouse, children, or other family or friends present. A routine should develop as you schedule more visits to your home with the same nursing team.
Patient Safety: An infusion nurse provides therapy in the privacy of your home, eliminating some exposure risk of infection that may occur in shared healthcare facilities such as the waiting room of a specialty office, parking garages, elevators, and hallways in an infusion center located inside a hospital or health hub. (NOTE: Home health nurses do visit multiple patients and enter multiple home environments throughout the day, which may contribute to a higher risk of infection spread.)
Clinical Concerns: Unlike in an outpatient infusion center – where a nurse practitioner is required to supervise every patient encounter alongside the infusion nurse – in a standard home health setting, a single nurse is assigned to a patient to administer the infusion on a particular day. In the event of an adverse reaction, this nurse is responsible for not only managing the patient’s symptoms but also onsite clinician decision-making and escalating care when needed, which may include simultaneously contacting emergency services. Even basic steps like placing an IV can sometimes prove difficult without the support of a team of clinicians onsite who can assist when needed.
Setting of Care: Home health nurses have to conduct a subjective assessment to determine if the patient’s home meets sanitary and safety standards to proceed with the infusion or injection. This assessment at times including restrictions on pets. If your home is a place of high activity – due to children, pets, housekeeping, a kitchen remodel, or other unpredictable dynamic – the home may deemed an unsafe environment for medical infusion.
Patient Experience: Often patients simply do not like the feeling that their healthcare is crossing over into their personal life. Inviting a healthcare worker into your home can make some patients feel uneasy. Others may feel an obligation to clean or prepare their home for a guest. Also, since many infusions are multiple hours long, some patients feel pressure to make the nurse feel comfortable and entertained during the visit. The home health nurse may differ visit to visit, preventing a relationship from forming while creating a level of uncertainty before each visit.
Scheduling Time Windows: If you are receiving medication from a specialty pharmacy, you may be forced to take time off of work to receive the drug during a certain delivery window. Once you’re ready to schedule an appointment, be prepared that it may be an appointment window, rather than an appointment time depending on the nurse’s schedule.
Outpatient Infusion Centers
Although many infusions still take place in the hospital outpatient department, there is a positive trend toward receiving infusion care in other ambulatory settings, such as freestanding infusion centers that are solely focused on this type of care. Often these sites of care are not only less expensive than the hospital, but can also provide a better overall experience for the patient.
Lower Cost: Outpatient infusion centers are relatively 60% less costly than receiving an infusion in a hospital and are typically on par with home infusion. These care settings are covered by Medicare, Medicaid, and most other commercial insurance carriers, and certain infusion centers offer financial counseling and patient support when enrolling in copay assistance programs offered by many pharmaceutical manufacturers.
Clinical Setting: In most infusion centers, infusion nurses administer the medication – supervised by a nurse practitioner – in a setting that allows for close monitoring of the infusion or injection. These settings have multiple clinicians and other staff readily available in the event of an adverse reaction. Many facilities have additional emergency support protocols and tools – including defibrillators and anaphylaxis medications – to respond quickly to an escalating medical event.
Convenience: In the past, receiving infusions in a medical facility meant a drive to the hospital, parking in a garage, riding multiple elevators, and walking long hallways before finding the infusion room. Today many outpatient infusion centers are located close to a patient’s home or work, with convenient parking options and direct entry into the center – making it easier for patients to weave treatment into their daily routines.
Scheduling: All outpatient infusion centers operate independently from one another and have differing operating hours. If the free-standing infusion center near you operates with standard medical office hours, you may be required to take off work to receive your infusion or injection. Some might offer evening and weekend appointments, so it’s vital to check before choosing an outpatient center.
Shared Infusion Rooms*: The physical setup of the infusion room(s) will vary by infusion center. Traditional infusion centers feature many infusion chairs lined up in an open room. Not only does this provide a lack of privacy and limits a patient’s options for activities during the infusion such as watching TV or a movie, but it also increases the exposure risk from other patients.
*In the wake of COVID-19, many infusion centers with a shared room are attempting to create adequate social distancing by leaving empty chairs in between patients.
Nurse-to-Patient Ratios: Outpatient infusion centers have a team of certified nurses that share the responsibility of their patient population. There are benefits to having multiple clinicians available for medical support, but often times infusion nurses must tend to the needs of a large number of patients at the same time, with many infusion centers using a 1:6 or greater nurse-to-patient ratio. It’s important to understand these nurse-to-patient ratios as you choose the right option for you.
The IVX Health Difference
Simply put, patients who need ongoing infusion or injection treatment deserve better options for when, where and how they receive care. Located in the communities where people live and work, IVX Health exclusively serves those with complex chronic conditions by delivering high-quality, personalized care in a private, comfortable setting so patients can continue to live their best lives.
Minimizing Exposure Risk: Many specialty care services that are attached to or located inside a hospital or health hub – which may increase the risk of infection spread from shared facilities such as waiting areas, patient rooms, and other common spaces. IVX Health patients are sheltered from these higher-risk care settings by visiting our stand-alone centers that care exclusively for those who are immunocompromised.
100% Private Rooms: IVX Health always provides every patient with a private room, both for patient comfort but also to minimize infection risk. Patients can relax in their own suite, watch TV, or even take a nap, while still practicing safe social distancing.
1:3 Nurse-to-Patient Coverage: IVX Health always uses a 1:3 nurse-to-patient ratio or smaller. That means at IVX, patients always receive personal attention, and nurses are available to respond at a quicker pace to a patient’s needs.
No Waiting: With IVX Health’s “By Appointment Only” model, patients never wait in a shared waiting room, as their private infusion suite is always ready upon their arrival. In addition, IVX Health sees patients from 7AM-7PM, Monday through Saturday, ensuring patients can find a time that is most convenient for them.
As the COVID-19 outbreak continues to evolve, IVX Health has taken additional steps and approaches to our day-to-day clinical operations to ensure the safest environment possible for our patients and staff. Please read more about our COVID-19 preparedness here.
Managing Chronic Conditions at IVX Health
If biologics are a part of your chronic illness treatment plan, then consider choosing IVX Health for your ongoing care needs. IVX Health makes it possible to receive your therapy in a comfortable, convenient, and private environment.
With a private suite for every patient, you can watch your favorite Netflix show or movie on the big screen TV in each room or use a laptop or other mobile device to surf the web. We also offer flexible appointment scheduling – including evenings and Saturdays – at any of our convenient locations.