Infusion Pharmacy Services

INFUSION PHARMACY SERVICES PROVIDED BY DIXIE VITAL CARE

PATIENT EVALUATION

Recommendations will be made as to the need for additional support in situations where the patient or caregiver is unable to participate in administration of the therapy. It is rare that a delivery system cannot be developed which would allow for the safe and effective administration of therapy in the home. Support personnel may be needed in some cases, but on long-term therapies the support requirements will usually decrease through continued patient education and increased patient understanding as the therapy progresses. The increased patient involvement generally produces a feeling among the patients that they are helping themselves to recuperate and generates a positive feeling about the therapy. Quality of care improves as patient involvement increases. A Dixie Vital Care professional is always available to answer any questions regarding the therapy. Referral sources will not be burdened with evaluation of patients as candidates for home infusion therapy. That evaluation will be performed by Dixie Vital Care. The need for support services will be evaluated by Dixie Vital Care resulting in cost savings for all entities. Following completion of the therapy, the patient will be asked to complete an "Evaluation of Services"form. This instrument will be used to "fine-tune" the services provided to patients in the future.

SERVICE COORDINATION

Following the patient evaluation, Dixie Vital Care will contact and arrange for ancillary services when needed. Many Vital Care locations provide other services in addition to infusion therapy.Durable medical equipment and prescription drugs can be coordinated through Dixie VitalCare. These and other services are available through Dixie Vital Care or Vital Care will coordinate these services as specified. By the utilization of the Vital Care network, referral sources will become more efficient by no longer having to contact a separate provider for each service a patient may require. The patient is presented with a coordinated system of care at home.Referral sources have the ability to monitor the onsite care through Dixie Vital Care and will be able to receive current reports on the patient's progress through the prescribed therapy from one provider. This coordination of services will aid in becoming more efficient in the provision of health care services in the home setting.

DELIVERY

There should be no differences in the medications provided in an IV bag from one provider to those of another provider. There is, however, a big difference in the manner in which medications are delivered to the patient at home. Patients often have questions regarding their therapy and medications when supplies are delivered to their home. When medications and supplies are delivered by a common carrier or the postal service, the deliveryman or postman cannot provide the patient with answers to their questions about the therapy and medications. Dixie Vital Care is different. Medications and supplies are delivered to the patient's home by a trained Dixie Vital Care representative. The initial delivery and set-up are done by a Dixie Vital Care pharmacist. This individual will be able to answer any questions that the patient may have regarding their therapy. This will help to alleviate any anxiety that the patients may be experiencing. Because medications are compounded by the local provider, changes in therapy do not cause increased expenses. Dixie Vital Care does not deliver a month's supply of medication and supplies in order to save on shipping expenses. A Dixie Vital Care pharmacist coordinates medication preparation and delivery schedules based on the specific needs of the patient. Dixie Vital Care provide referral sources with a cost efficient program that minimizes the expenses they will incur for products prepared and not administered to the patient. This savings is not available through a company that utilizes common carriers or the postal service for delivery to its patients. When a change in therapy occurs 5 or 10 days after the month's supply has been sent, they follow the same process. Medication and supplies are wasted. This is not cost effective. Dixie Vital Care offer an alternative with its program that is time efficient,cost effective, and patient friendly.

ADMINISTRATION

When therapy begins in the home, Dixie Vital Care will provide a pharmacist to instruct the patient and/or caregiver on the safe and effective use of equipment. If referral source contracts nursing services through another provider, Dixie Vital Care will provide those nurses with an in-service on the equipment and supplies to be used in the patient's infusion therapy.These in-service programs will be conducted prior to initiating therapy in the home to ensure the safe and effective administration of the therapy. All health care professionals should be familiar with the operation of equipment and supplies before entering the patient's home. Dixie Vital Care emphasizes the use of training programs and in services rather than using the patient's home as a training site. A trained team of professionals entering the patient's home that quickly and efficiently initiate therapy increases patient confidence and will reflect quality patient care. If therapy is initiated with the first dose in the home, Dixie Vital Care will remain with the patient throughout the time required to administer this dose. Whenever the first dose of a therapy is administered at the patient's home, Dixie Vital Care deliver an anaphylactic kit for emergency use. The patient will be evaluated for administration devices that are the most adaptable for their setting. The devices chosen for the patient are selected to ensure the safe and effective administration of the drug as well as to insure high-quality patient care. Proper selection and training of the patient and/or caregiver will result in an efficient, safe and effective delivery of therapy to the patient. When the therapy and its delivery to the patient are understood, the number of interventions required by health care professionals will be decreased with the result of quality health care and cost savings. A point that should be remembered is that the patient will have access to the Dixie Vital Care pharmacist twenty-four hours a day. These pharmacists will conduct periodic visits to the patient's home to review the patient's/caregiver's administration technique. This review will be done throughout the patient's course of therapy.

OUTCOME EVALUATION

Continued Quality Improvement and Quality Assurance are terms frequently used in healthcare. The true test of any therapy is whether it improves the patient's condition. Vital Care will work with referral sources to develop programs that evaluate the outcomes of infusion therapy for your members. Dixie Vital Care will be a partner in the total quality assurance program for home care. Through development of outcome evaluations and the utilization of information from these evaluations, referral sources and payers will realize the cost-savings offered by effective home infusion therapy and Dixie Vital Care will be able to determine the service needs of your patients. Dixie Vital Care has identified several important aspects that should be considered in outcome evaluations. Some of these include Drug Utilization Review, Route of Administration, Duration of Therapy, Venous Access used during therapy, effectiveness of therapy, patient compliance,patient participation in therapy, patient evaluation of home therapy, and physician evaluation of home therapy. Through outcome evaluations, the quality of care for patients is insured.Data collected through these evaluations will aid in the determination of its expense on a per therapy basis. Identifying diagnoses which result in costly therapies and the frequency of their occurrence will aid in projecting their future expenses. Dixie Vital Care will work to help keep expenses at a minimum while insuring that each patient receives quality care.

CAREGIVER TRAINING

Patients may not always be able to self-administer their infusion therapy. However, in many cases a family member or caregiver is willing to assist. This individual is provided training by a Dixie Vital Care professional at the site where therapy is to be administered. In addition to on-site training, the caregiver is provided with pump manuals and therapy manuals to answer questions. A Dixie Vital Care professional is always available by telephone to answer questions. These services, in conjunction with a manual, serve as effective reference materials when a professional is not in the home. Caregivers will be reviewed to ensure their aseptic technique for medication administration. If additional caregivers become involved with the patient's therapy, Dixie Vital Care will provide the training and review their techniques of medication administration. Dixie Vital Care emphasizes a complete understanding of the therapy and importance of aseptic technique to all caregivers. Through caregiver training and periodic review of administration technique, quality patient care is achieved. Proper education, training, and monitoring promotes safe and effective therapy with the desired therapeutic outcome for patients in the home setting.

PARTICIPATION IN PATIENT STUDIES

Patient data and therapy information will aid in forecasting of future costs and expenses as well as cost savings with home infusion therapy. Accurate databases to retrieve information, such as the names and types of antibiotics used in therapy, diagnosis of patients receiving home therapy, average duration of home therapy, cost analysis, as well as outcome evaluations, will be made available through Dixie Vital Care. In cases in which referral sources seek specific information on patients and therapies, Dixie Vital Care will assist by providing the data needed. The location of Vital Care providers in rural areas allows patients access to these types of therapy that are not always available through other providers. There are many research companies that offer for sale, at a significant price, projections and forecasts of what the home care market will represent in one year, three years, five years, etc. This information may not accurately represent referral sources's members. The participation in patient studies and the exchange of information between Vital Care and it's referral sources will help to plan for the health care needs of its members for the future.