Optum Infusion Pharmacy

Nancy Kramer

Virtual visits for home infusion therapy and other specialty care needs were nearly nonexistent prior to 2020. With no clear reimbursement path to support the cost of technology, development of a telehealth program was not a priority for most providers.

The emergence of the COVID-19 pandemic in early 2020 brought with it a trifecta of factors supporting the growth of virtual visits:

• Pandemic-related hospital lockdowns prohibited the pre-discharge teaching visits that were often an expectation.

• Access to inexpensive virtual visit technology increased.

• Patient preference shifted to reduce unnecessary encounters in their home.

As a result, virtual care became more widely accepted as payers adapted their policies to allow for telehealth visits, providers offered more virtual care options and patients grew more comfortable using digital platforms. This transition was seamless for many, and options for staying connected with family and friends became mainstays for connecting with health care providers. At Optum, virtual care remains a critical component of our patient engagement strategy and has quickly evolved to meet the changing needs of patients.

“At Optum, virtual care remains a critical component of our patient engagement strategy and has quickly evolved to meet the changing needs of patients.”

Expediting Optum’s Telehealth Program

Mandatory lockdowns were initiated in mid-March 2020, for most of the country, and Optum launched its first-ever telehealth program on March 30, 2020 – within weeks of required quarantines. There was a need to move quickly but most importantly, safely. Optum protected patient privacy with a secure platform; ensured consistency across the organization by providing resources and in-depth training; and monitored quality through data collection and analysis of factors such as the number of consults by therapy type and utilization of virtual visits per month. Consumer feedback was obtained verbally after every single session and still is today (recent data shows an NPS score of 93, indicating a continuous positive patient experience).

Optum’s goal is to provide the same high-quality care and teaching in a virtual setting. Several patient touchpoints, such as medication consultations, have greatly benefitted from virtual care options. Not all patient encounters are appropriate for a virtual visit, such as the need for hands-on patient care, device care and maintenance, or nurse administration of immunotherapies, but Optum works to ensure policies are in place to guide what is acceptable and safe for patients and staff despite how care is administered.

Optum’s Unique Approach to Virtual Care

Optum’s approach is simple – identify appropriate candidates, get connected with them virtually, and introduce home infusion therapy and any clinical teaching required to be successful at home. Ideal patients have a caregiver, bear the mental capacity and physical dexterity to perform self-infusions, and have access to technology required to participate in a virtual visit session. Once it is verified that a patient can participate in a virtual visit, Optum sends a link for a preset appointment via their smartphone, tablet, or computer. Patients are then guided by a clinician through a supply unboxing and step-by-step demonstration of how to infuse at home, along with written teaching materials in their initial delivery.

One of Optum’s early referrals was for an elderly COVID-19 positive patient, who was in the hospital with an infection and having difficulty breathing. After a few days of recovery, her doctor ordered IV antibiotics to be administered at home. She had immediate reservations about doing her own infusion at home, especially as her daughter was able to help but couldn’t come to the hospital to learn properly. The patient began to think that her only choice was a nursing home until Optum explained that she could be discharged to be at home with her family and have her daughter participate in virtual teaching visits, allowing her to receive home infusion therapy.

The teaching sessions were successful. After two virtual visits, the patient’s daughter was deemed independent with providing the infusions. The facilitation of the virtual visits made the transition from hospital to home much easier for the patient and her family, and the patient completed her course of antibiotic therapy at home with no complications.

Looking Ahead

We saw firsthand how a digitally enabled system can deliver the right care at the right time in any location while creating a positive patient experience. From the beginning of 2020 through the third quarter of 2021, we have conducted over 600 virtual infusion visits and 94% of patients reported they felt more confident in their therapy after the session.

Given positive patient responses and notable cost savings, we recognize there is a significant opportunity to continue to support patients in this new virtual format. As an organization, we’re committed to refining and growing our virtual visit offerings to create a more convenient and accessible health care experience for all.