The global healthcare system has been on a path of transformation for several years – due in part to an aging population but pushed forward in many ways because of COVID-19.
The United Nations predicts that by 2025 the world's population will increase by one billion – nearly a third of whom will be 65 or older as life expectancy rises. Access to “middle class comforts” and urbanization is also increasing, which can lead to more sedentary lifestyles and chronic illnesses. There is concern this will all put pressure on the global health system to manage and pay for care. That's one of the reasons we've seen a move toward a more patient-centric, community-based approach to healthcare.
As my colleague and Zebra Chief Nursing Informatics Officer, Rikki Jennings, pointed out in a recent conversation I had with her and our colleague Katie Kraverath, "Baby boomers – which make up a large portion of the healthcare workforce today – are continuing to age. Without more aggressive recruitment and training to replace them, there will not be enough healthcare workers to care for patients.” Plus, the healthcare systems in nations such as the U.S. are so driven by regulations that increased guidelines supporting community-based healthcare – including home infusion therapies – are likely to follow.
That’s why Rikki and Katie both believe home-based healthcare is the best way to reach more people in a way that is potentially not as labor-intensive – and I agree.
Katie has been working with specialty pharmacies for several years and has seen how the regulatory environment has evolved. “Over the years, as the field of specialty medication grew, so did regulations around it – particularly on medication storage and distribution,” she noted in our sit down. That's why today, many state boards of pharmacy and accreditation agencies require some type of medication temperature monitoring for inventory onsite and in transit.
“To earn URAC accreditation, for instance, specialty pharmacies must monitor temperature in all environments where medication is stored,” she says. “That includes refrigerators and freezers as well as ambient or controlled room temperature storage where they also need to monitor humidity.”
How COVID-19 Advanced Home-Based Healthcare
In the early days of the pandemic, the Center for Disease Control and Prevention (CDC) began recommending that U.S. healthcare providers start seeing patients virtually as much as possible. Temporary emergency easing of federal and state regulations combined with new health insurance payment policies also made it easier for patients and doctors to connect virtually. What followed was a 154% increase in telehealth visits during the last week of March 2020 compared to the same time the year before.
While most of these visits were likely related to COVID-19, the fact is the last year has driven about 20 years of innovation, says Rikki. “The pandemic accelerated the transition in the care that was already underway.” (This is also something Rikki discussed with Zebra’s Healthcare Customer Advisory Board in 2020 and detailed further in this blog post.)
An Increase in Home-Infusion Therapy
The pandemic touched other areas of the healthcare system as well, especially where a telehealth visit was not enough and home-based care was critical – including the delivery of home infusion therapy. In upstate New York, one provider was in the middle of a pilot study focused on the safety and effectiveness of home infusion for anti-tumor necrosis factor therapies for pediatric patients when the lockdown went into effect. Once the pandemic sent people home, more and more families asked to join the study. They quickly discovered advantages of home infusion for their children – no lost time from school or work since there was no need for travel, and infusions could be scheduled at times convenient to the families. This upswing in requests for home infusion therapies was seen nationwide as healthcare providers began looking for ways to transition patients from the hospital to in-home care to comply with stay-at-home orders and reserve hospital beds for patients very sick with COVID-19.
As a result, like telehealth, the growth in demand for and adoption of home infusion therapy is expected to continue.
What Does this Mean for Home Infusion Providers?
While many home infusion medications are stable at room temperature, excessive heat, cold or humidity exposures can still impact their effectiveness. That's why home infusion pharmacies seeking accreditation from an organization approved by the Centers for Medicare & Medicaid Services (CMS) may need to consider temperature monitoring. The Joint Commission, for example, follows the U.S. Pharmacopeia (USP) temperature guidelines for storing compound sterile preparations, which some home infusion providers may be handling. Many agencies, including URAC and the Joint Commission, also require their members to test the performance of packaging used to ship or transport medication – something specialty pharmacies have been doing for several years.
Based on what she's seen within the specialty pharmacy field, Katie believes that as the need for home infusion continues to grow, the regulatory environment will shift and become more stringent as well.
If you want to learn more about how temperature monitoring solutions are designed to work specifically for home infusion providers, this infographic is a great place to start. If you have specific questions, please get in touch with Katie directly. She’s a fantastic resource!