What criteria should be used to select a home infusion therapy company?

Selecting a Home Infusion Therapy Company

When selecting a home infusion therapy company, prioritize those with an experienced physician director knowledgeable in infectious diseases and OPAT, accreditation by the Joint Commission or state health department, written policies on staff qualifications and quality assurance, and 24-hour availability of physicians, nurses, and pharmacists. 1

Essential Organizational Requirements

Medical Leadership and Expertise

• The company must have a physician director or medical advisor with expertise in infectious diseases and OPAT management. 1 This position is analogous to a medical director for hospice programs and provides clinical input into policies, procedures, and quality-of-care activities. 1
• All patients should have infectious diseases expert review prior to OPAT initiation, so the company should facilitate this consultation. 1

Accreditation and Regulatory Compliance

• Verify the company is accredited or certified by the Joint Commission for Accreditation of Healthcare Organizations, state health department, or other responsible agency. 1 This ensures adherence to established quality standards. 2
• Request documentation of the company's experience in providing OPAT, including the number of years in operation and patient volume. 1

Staffing Requirements

The company must provide written standards outlining required training, experience, and licensure for all personnel: 1

• Nurses with expertise in intravenous therapy, vascular access devices, and OPAT 1
• Pharmacists knowledgeable about OPAT who prepare prescribed medications and solutions 1
• 24-hour availability of physicians, nurses, and pharmacists 1
• Case managers and billing staff knowledgeable about therapeutic issues and third-party reimbursements 1

Written Policies and Procedures to Request

Clinical Operations Documentation

The company should provide written policies regarding: 1

• Outline of responsibilities for all team members (physicians, nurses, pharmacists, case managers) 1
• Patient intake information and selection criteria 1
• Frequency of physician and nurse clinical assessments 1
• Staffing and on-call policies 1
• Frequency of clinical status reports to physicians and laboratory result reporting 1

Quality Assurance Systems

Request documentation of: 1

• Patient education materials covering safety, responsibilities, compliance, and general advice 1
• Outcomes monitoring protocols including patient response, complications of disease/treatment/program, and patient satisfaction 1
• Quality-of-care activities and how deficiencies are documented and addressed 1

Financial Transparency

• The company should be willing to share charge estimates for the proposed course of therapy upfront. 1 This allows patients to make informed decisions about insurance coverage and anticipated out-of-pocket costs before OPAT begins. 1
• Clarify coverage differences between models, as Medicare covers infusion center visits but lacks a home infusion insurance benefit, potentially creating substantial co-pays for home-based care. 1

Service Delivery Capabilities

Model Flexibility

The company should offer multiple delivery models based on patient needs: 1

• Home-based OPAT with weekly (or more frequent) home nursing visits for supplies, line care, and labs 1
• Infusion center options for patients unable or unwilling to self-infuse 1
• Ability to transition between models depending on antimicrobial agent, patient capability for self-care, and need for other medical services 1

Technical Capabilities

Verify the company provides: 1

• Registered nurses with specialized training in infusion therapy who can teach safe medication administration, monitor responses, and respond to complications 1
• Equipment and supplies including infusion pumps, administration tubing, and vascular access supplies 1
• Adequate refrigeration and storage solutions for medications requiring temperature control 1

Communication Infrastructure

The company must demonstrate: 1

• Systems for rapid communication between patients and team members 1
• Means of immediate communication (telephone access) for patients 1
• Patient confidentiality preservation in all communications 1
• Clear outline of roles for the prescribing physician in relation to case manager, medical director, nurse, and pharmacist 1

Common Pitfalls to Avoid

• Do not select a company based solely on cost. 1 Physicians remain legally responsible for deciding whether a patient should be treated as an outpatient and for assuring quality of care during OPAT. 1
• Avoid companies unwilling to share written policies and staff qualification documentation. 1 Transparency is essential for quality assessment. 1
• Do not overlook the importance of 24-hour availability. 1 Complications can occur at any time and require immediate professional response. 1
• Ensure the company has experience with your specific patient population and therapy type. 1 Not all companies have equal expertise across all OPAT modalities. 3