Virtual Infusions at SanfordMay 21, 2019 09:15AM ● By Med Magazine
Administering chemotherapy can be challenging for even the most experienced providers. Some high risk agents require a level of expertise that may be hard to come by in lower volume rural cancer centers.
In the past, complex patients who needed high risk chemotherapy drugs were often sent to Sioux Falls for treatment. But since 2016, Sanford has been running a program designed to make it safer for more of these patients get treatment in their home communities. They call the concept ‘virtual infusions’.
“The idea is that an oncology professional who is managing a cancer infusion center in the tertiary care setting also helps manage rural infusions virtually using telemedicine, the telephone and the Electronic Medical Record,” Susan Halbritter, CNP, of Sanford Hematology/Oncology in Sioux Falls told MED.
Halbritter says nurses in small rural infusion centers are often good generalists but are not necessarily oncology specialists. Providing direct access to a specialist like herself or another CNP in the Sioux Falls infusion center can help these nurses manage patient symptoms, get questions answered quickly, and confidently give high risk medications. Not only does the approach improve patient safety, but it can also save time.
“Prior to this program, the nurse in the rural center does the assessment, then if they have a question they call the clinic and get the receptionist,” says Halbritter. “The receptionist forwards the call to the nurse and then the nurse has to try to catch the physician between patients, relay the question, then reverse the process.”
“Meanwhile, the patient is sitting in a rural infusion center waiting to find out if they are even going to get treatment that day.”
If a patient has a reaction during infusion in a rural center, the treatment is usually stopped and the patient may only end up getting a partial dose. Virtual infusions give rural nurses the tools they need to manage symptoms as they arise, often allowing treatment to continue so the patient gets the full recommended dose.
In Sioux Falls, Halbritter or another CNP is always on hand in the infusion center. That person carries a dedicated internal phone at all times, giving any nurse with a question immediate access to an answer. Sanford spent a year standardizing policies and procedures between Sioux Falls and centers in Vermillion, Armour, and Worthington, Minnesota where the program is offered. The result is a streamlined process that has increased confidence for everyone involved.
“There used to be a short list of medications that doctors would allow to be administered outside of the tertiary care center,” says Halbritter. “Thanks to this process, we have increased the volume in these rural centers, kept more patients closer to home, and elevated the bar everywhere.”