February 10, 2025 • 26 mins
In this episode of Home Is Where the Health Is, we explore the rapidly growing field of home infusion with Kristen Fano Schultze, Vice President of Home Infusion at Compassus. We discuss how home infusion improves patient outcomes, enhances accessibility—especially in rural areas—and supports health system partners. Kristen also shares a personal story that fuels her passion for transforming healthcare.
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Episode Transcript
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Ashton Jones (00:02):
Ashton, Hi everyone. I'm Ashton Jones, and
this is home. Is where thehealth is. This podcast brings
you the latest news on progressand innovation in the home based
healthcare space, in associationwith compasses. At the end of
the day, every person deservesto be cared for with compassion,
whether they're dealing with aserious illness, recovering from
(00:24):
an injury, or nearing the end oflife, and in the place they call
home, no less. That's why thispodcast features different
subject matter experts as we doa deep dive into how their work
is improving home based healthcare for patients. In today's
episode, we're discussing thevalue and growth of home
infusion with our guest,Kristen, fan of Schulze, Vice
(00:45):
President of home infusion atcompasses, we'll address the
unique benefits of home infusionfor patients and caregivers,
explore its role in improvingaccessibility and outcomes, and
share a personal story with youabout how this work transforms
lives. There's all that and morecoming up on Home is where the
health is. Hi everyone, welcomeback to Home is where the health
(01:10):
is. We're excited to have youtune in to the first episode of
our second season as we exploresome new topics, products,
partnerships and more inupcoming episodes. So today, I'm
grateful to welcome our guest,Kristen. Fano schultzy, VP of
home infusion at compasses.
Kristen, thank you so much forbeing here.
Unknown (01:30):
Yeah, thank you. Thanks for having me. I'm excited to be
here. Yeah, it's great to haveyou.
Ashton Jones (01:34):
And I know we've been talking on and off for
quite a while about getting thisepisode off the ground, so we're
very excited to be able to sharesome of the latest and greatest
with you today, and now we havea lot of growth in the infusion
space that we're able to talkabout at compasses. So
everything really came togetherso perfectly today. Lots of
exciting information to share,but I want to start off by
(01:56):
giving our listeners a littlebit more information about your
personal and professionalbackground. So wherever you want
to pick up, maybe you want tostart with the personal aspects.
Unknown (02:06):
Yeah, sure. So I am married and a mom of three
little so seven year old, a fiveyear old and a two year old, and
they are the chaos crew, is whatI call them. We live on a farm
south of Nashville, here inTennessee, and it's generational
land, so we're out recultivatingOur farm property, and then it's
(02:26):
a very rural community, so a lotof volunteer work in the
healthcare there, or lack of, ifyou will, right? No,
Ashton Jones (02:33):
that's awesome. So that's a lot of work even there,
I'm sure, taking care of theland. And yes,
Unknown (02:38):
it is, animals everywhere, all the things that
the chickens, the justeverything. Yes, it's a lot.
What
Ashton Jones (02:44):
about at compasses? Let's go all the way
back to kind of the start ofyour professional journey, if
you want to give us a shortsummary, yeah. So
Unknown (02:51):
I am a Clinical Pharmacist by background. Have
been practicing for a littleabout a decade now. Started my
career in retail pharmacy,owning my own pharmacy, moving
into home based care started asa PRN home infusion pharmacist
and just kind of grew fromthere. Have worked with three
different home infusioncompanies. Now compasses is my
(03:14):
first true integrated home basedcare company. So traditionally,
it has been value based care andhome infusion, and have since
joined in with The Hospice andhome health here at Compass. SM,
it's been exciting. We've had ithas been a ride here at
compasses over the last coupleyears. Lot of growth, lot of
change, agility, I would say,and just a lot of fun. Yeah.
Ashton Jones (03:36):
And normally I ask people how they kind of got into
the home based healthcare space.
But since you already explainedthat part, I want to ask you
about how you ended up ininfusion specifically. So is it,
you know, personal?
Unknown (03:48):
Well, I had a boss many moons ago when I was in high
school. He ran a home infusioncompany based out of Dallas,
Texas, and called me and hesaid, Hey, I think you would
really love this piece ofpharmacy. It's everything that
you've kind of said you'vewanted in your career. I said,
Sure, Martin, I'll hop right in.
And I did PRN, and fell in lovewith it, and realized that it
was the perfect blend ofcommunity, where you can support
(04:11):
patients as they come home, butalso supporting your health
system partners and and havetaken that and ran with it, and
had have been blessed enough tobe able to cultivate teams that
blend both sides of pharmacyaltogether Well,
Ashton Jones (04:27):
to be in high school doing all of that, that's
a lot of foresight on your partto know. So you've kind of just
known what you wanted to dosince you were very young,
right? Well, so
Unknown (04:37):
I come from humble beginnings. I did not come from
a healthcare background at all,found myself working in an
independent pharmacy byhappenstance, as a customer
service rep, and the owner ofthat pharmacy said, I think you
should apply for pharmacyschool. And I said, heck, now
I'm going to go to med school.
Ended up. He convinced me toapply, and I got in, and that
was all she wrote. Went topharmacy school. And so. Found a
(04:58):
love for being able to take careof my community in a way that
allows me to kind of control howI was able to take care of my
community and my patients.
Ashton Jones (05:08):
So how about your team? Can you tell me a little
bit about your team at compassesand how you've really seen it
evolve and grow over time? Yeah,
Unknown (05:17):
so I don't know if we have enough time for me to rave
about how great my teams are.
Our team is made up of somereally high caliber clinical
pharmacists, nurses, pharmacytechnicians, warehouse
coordinators, just a massivegroup of clinicians that show up
every day dedicated todelivering some of the best in
industry quality outcomes thatI've seen so when I got here two
(05:40):
years ago, the team is a tenuredteam has been with Compass and
ascension at home for a reallylong time, and they were hungry
for more. They wanted tounderstand what else they could
do in pharmacy, and have sincebeen able to develop a more
value based care mindset, wherethey're not just showing up and
filling home infusionprescriptions or compounding
(06:01):
home infusion prescriptions, butthey are doing medication
reconciliations in inpartnership with our home health
team, so they're delivering alevel of care that home health
was missing and my clinicianswere missing, and have gotten
really excited about doing that.
They are the hardest work horsesI think I've ever worked with.
Like I said, I've worked formultiple home infusion
(06:22):
companies, and I will say thatthey the level of care and
consideration and compassionthat they have for our patients
and our referral sources has isunmatched. I've never worked
with an intake team the way thatour intake team takes care of
people, my pharmacists, mytechnicians, they just show up
in a way that I've not seenbefore. It's been really
humbling to watch and be a partof.
Ashton Jones (06:46):
Well, that leads us to our first topic of the
day, and today we're touching onthe value of home infusion
services delivered in the homesetting. Before we dive into
that, Kristen, can you start byexplaining what home infusion is
and kind of anyone who's notfamiliar with the service line,
what they need to know
Unknown (07:03):
home infusion is for any patient who has had surgery
or has some sort of ailment thatrequires a line to be placed or
a port to be placed so that theycan receive infusion therapy.
And what I mean by that isantibiotics, any type of total
perennial nutrition, sonutrition in the home for a
patient who may not be able toeat, hydration therapy,
chemotherapy and then chronicdisease statement management for
(07:27):
specialty patients, so a patientwho may have Crohn's disease or
rheumatoid arthritis, thosepatients would also be eligible
to receive home infusion. So
Ashton Jones (07:36):
you were recently quoted in an article from home
health care news, and thisarticle talked about how home
infusion is both the next bigthing in home based healthcare,
but also faces some barriers. Socan you touch on that a little
Unknown (07:50):
bit home infusion has been around, I'd say, 10 or 15
years, COVID really startedgrowing home infusion more than
what we had ever seen, becausepeople couldn't be in the
hospital, and we had to figureout a way to still deliver care
to these patients who needed itright providing access to care
in the home. And so what theinfusion industry saw was,
during COVID, we were allowed,in a way, it was a silver lining
(08:12):
of a very unfortunatecircumstance in our nation, but
we were allowed to bring peoplehome earlier than they had ever
been brought home and deliverinfusion therapy. So
antibiotics, total parental,nutrition, chronic disease,
state management, where patientswere having to go into the
hospital or a hospital settingto receive their infusions, now
had the ability to do it in thehome, and it allowed our
(08:34):
providers to get morecomfortable in doing that. So
you saw this massive shift moretowards the home. And what that
like I said, what that allowedus to do was not only support
our patients in an area thatthey could heal faster, their
emotional well being was better,their risk of infection was
significantly decreased,according to all the studies
that have been published sincethen, but we also got to support
(08:56):
our partners in a very differentway, which is really Exciting.
So as we all know, hospitals arelooking to decrease length of
stay. And how do you do that?
You have to get patients out ofthe hospital sooner, and one of
those ways is with campus, is topartner with our home health and
our home infusion teams andallow these patients to come
home two, three, even sometimesfour days earlier than what they
would have been able to even preCOVID. And so it's been exciting
(09:19):
to see compasses is my firstcompany that we've had all of
these different arms that allowus to really integrate with a
partner and bring our patientshome collectively. And what I
found with with compasses is ourinfusion patients specifically
get a level of care that inprevious companies they might
(09:40):
not have, and that's not sayingthat they wouldn't have gotten
great care, but we have a homehealth arm that is integrated
with us, where we know thosenurses and we can call and say,
this patient's coming home,they're going to need x, y, z,
as a pharmacist, we are lettingthe nurse know in the home what
opportunities. For care theymight run into before the nurse
(10:00):
even goes in to make heradmission, his or her admissions
at visit, yeah,
Ashton Jones (10:05):
and so you see a lot of improved outcomes due to
all of those pieces workingtogether. Yeah,
Unknown (10:12):
it's um, we when you have a home health and home
infusion company integratedtogether as closely as we are
here, you get to support thenurses and give them a level of
inside our home health nurses, alevel of insight that they
otherwise wouldn't have hadgoing in on that first day of
admission. So especially withour infusion patients, there,
they have a multi multitude ofopportunity for care from PT,
(10:36):
physical therapy, occupationaltherapy, nursing care, wound
care, etc. And so as thepharmacist, you get to kind of
guide the Home Health team in away on here's what to
anticipate, not just for thatantibiotic that you might be
helping us take care of, or thatline you might be helping us
take care of, but in all aspectsof that patient's care. So it's
(10:57):
what I would consider the truewhole patient care experience
that we get to deliver,
Ashton Jones (11:02):
and does that have an impact on maybe some of the
disparities and access to care?
I mean, maybe, you know, ruralarea compared to where we are in
Nashville. Yes,
Unknown (11:13):
when I look at infusion specifically, even without home
health, we have the ability toteach a patient bedside and
allow that patient theindependence to infuse their own
medication at home and go to ahospital or go to their doctor's
office for labs, dressingchanges, etc. There are what we
would call dead zones right inthe home health world, where you
(11:34):
may not have a home health nursethat can go provide care, but an
infusion patient lives. I livein one of those areas. My farm
is in one of those areas, andyou get to bring people home
where they can heal faster,better be around their family,
be around their kids, withoutnecessarily having to think
about other things that theymight not have access to care to
you and and I mean, that's oneof the reasons I got into it
(11:56):
right, was access to care,especially in rural communities.
And so it allows us to do that.
Ashton Jones (12:01):
That's great. What about some innovations that
you're seeing in the infusionspace? Are there things that
you're really excited aboutseeing?
Unknown (12:08):
We so pharmacists oftentimes don't sell themselves
enough. And what I mean by thatis we went to school for 468,
years, depending on your youreducation and what kind of what
type of pharmacist you became.
We have always been known asbeing able to just fill
prescriptions and take care ofpatients in that regard. And
over the last I'd say, handfulof years, we've really stepped
(12:29):
into this value based caredelivery system where we the
pharmacist intake a patient andwe look at their medications,
not just from a home infusionstandpoint, but from a full
medication reconciliationstandpoint, and and so the
innovation here is we get toimpact that patient in a way
that pharmacists historicallymight not have been able to
impact patients. So that's onething. Telehealth is another,
(12:52):
where pharmacists are nowheavily integrated into
telehealth programs and how youmanage patients through
medication therapy management,etc. So quite a bit of hospital
readmissions center onmedication errors or medication
issues, and having thepharmacist as part of that
integrated team allows us toreally prevent and decrease it.
Ashton Jones (13:16):
So what are some of the misconceptions that
people have about infusion ormaybe things that you want to
address that address that youthink are really important to
kind of understanding theservice line. When I think
Unknown (13:26):
about home infusion, I think about it in two different
areas. We are a post acutesupport system. So we're
supporting patients coming homefrom the hospital, supporting
our partners with their lengthof stay initiatives. And then we
have our chronic disease statemanagement piece of the puzzle,
and that is where you get totake care of lifelong patients
who need specialty infusions.
And so I think one of themisconceptions is that all of
(13:47):
this has to be done by a nursewith a nurse in the home and
home infusion is is this perfectopportunity to empower patients
to care for themselves, orempower their caregiver to
deliver a level of care thatthey might not have ever thought
that they could. And one of mymost favorite memories is seen I
was a clinical pharmacist. I wasdoing a bedside teach for a
(14:10):
heart failure patient in thehospital, and the caregiver
realized in that moment that shewas going to get to bring her
husband home on a therapy thatshe didn't think that she was
going to be able to, one, do,but two, have the support to do.
And when I went bedside andtaught her how to administer her
husband's inotrope and how tomonitor him alongside the
(14:30):
nursing team, she burst intotears. And so I think there's a
we don't give patients enoughcredit on what they can do to
take care of themselves and anda lot of times, providers are
think or under the impressionthat a nurse is going to come in
for every infusion, and they'rethe ones administering, when in
reality, with some hand holdingand some really good teaching by
(14:53):
our clinical teams, they havethe ability to do it themselves.
Ashton Jones (14:57):
So it sounds to me like patient education. Plays a
large part in home infusion. Sohow do you begin that
conversation? Yeah, so
Unknown (15:04):
it is imperative that you get both the patient and the
patient's caregiver on boardwith the care that they're going
to be receiving. A lot ofpatients, even providers, are
still very much taken back on.
Can they do this in the home?
What is it going to take? Is anurse going to come there every
single infusion, it takes a lotof education. So we make it seem
(15:25):
easy, and it can be easy, but wesend a nurse or a pharmacist or
another clinician bedside one toclinically assess the patient
and ensure that they areappropriate for home infusion.
The second step of that isteaching them how to use the
device that they will be usingto infuse the medication in
their home, whether that's anelastomeric pump or or a
syringe, etc, the caregiver isthen taught again. So we do one
(15:49):
to two, potentially three,teaches at the bedside to show
our patient and the caregiverhow they how they will infuse.
And then we have spent a lot oftime putting together some
really great educational videosonline, so the patients have
those to reference once they gohome, and they also know to call
our on call pharmacists andnurses who will walk them
through that first infusion sothat they don't have to do it
(16:11):
alone. And that is extremelybeneficial and comforting. So
the patient comes home and theyhave they knowing that they have
that pharmacist or nurse thatthey can call after hours to
walk them through that firsthookup gives them a lot of peace
of mind, and the support is justunmatched.
Ashton Jones (16:29):
We're going to take a quick break from our main
discussion to share a story withyou, and the reason we want to
spend time on a single story isbecause when you're looking at
the big picture, you can forgetabout all the lives that are
impacted by this work, and atthe end of the day, it's about
touching a life. So I askedKristen to come prepared with a
story today to share with all ofyou something that has really
(16:51):
impacted her, bothprofessionally and personally. I
first read the story thatKristen is going to share today
on LinkedIn she had posted a fewweeks back. It was just after
the start of the year. Soeveryone was doing their Annual
Resolutions, and Kristen, youcrafted this really poignant
post about your experiences withthe healthcare system, some of
(17:13):
the personal factors that driveyour work. And then you also
talked about your New Year'sresolution, which is to drive
change in healthcare. It's agreat resolution. So can you
talk about what led up to thatpost? I
Unknown (17:27):
have had a rough go when it comes to healthcare, so
I lost my little brother. I saythis, I live in a very rural
community, so I'll start withthat very little access to
healthcare, especiallyspecialized healthcare, several
years ago, 2017 I lost my littlebrother to suicide. We don't
have mental illness. Healthcareanywhere about about an hour,
(17:50):
hour and a half, close to thefarm. And then a year to the
day, lost my mom to metastasizedlung cancer due to some
misdiagnoses. Again, ruralhealth care. And then I really
started operating with a chip onmy shoulder of, how can I
change? Just based off of thosetwo experiences, dove head first
(18:10):
into home infusion andintegrated home based care and
value based care medicine. Andthen come 2023. My dad was
diagnosed with COVID, and heunfortunately had a post COVID
complication that wentundiagnosed. We sat in the
emergency room for 24 hours.
This is where the pharmacist inme comes in. So he was
administered a medication about18 hours within his stay that
(18:34):
caused him to bleed internallyand pass away. Unfortunately,
that experience, while wastraumatic, was a fire that I
needed to be relit in myhealthcare journey and has
allowed me, over the last twoyears or year, I should say,
now, to figure out how I canchange healthcare from the
(18:58):
inside out. So being aclinician, I want to empower my
teams. I want to empower mycolleagues on the impact that
they carry on every singlepatient, and I share my
experience with anybody who willlisten, because I think it gives
them some good grounding on mywhy I don't I read a quote the
other day that says I don'tserve a company or a patient.
(19:18):
Individually I serve. I have amission of my own, and I join a
company that matches my mission,right? And that's what I've done
with compasses, and what we dowith our partners that match our
mission. And so as long as Ilead with my mission, I can lead
teams with that same sort ofmentality, and they find their
why, and they go after it, whichis what we've seen in infusion
(19:38):
recently. But I say I don't doNew Year's resolutions, but I do
commitments. And my 2025commitment was, I'm going to
figure out a way to continue toimpact people so that together
as a team, we can impact andchange healthcare and the way
that healthcare is delivered.
Ashton Jones (19:58):
For second and five. Topic of today's episode,
we're going to dive into therapid expansion of infusion
services at compasses Kristin,for our listeners who aren't
familiar with compasses and itsservices, how would you describe
the service line's growth inrecent years? That
Unknown (20:15):
is a really good question. So infusion has really
taken a hold of the currentstates that we're in, meaning we
have grown substantially, hadyear over year growth in then
the census growth, types oftherapy that we've expanded
into, etc, and we've recently,now moved into multiple states.
So we started out in two stateswith brick and mortars. Now
(20:37):
we're in two additional states,Florida and Indiana, and we'll
be entering into Texas andOklahoma earlier, early this
year, 2025, our growthtrajectory has been fun to say
the least. We have a partnershipthat we follow along with, from
a footprint standpoint, thatallows us to really support our
partner and everything that theyneed from a home infusion
(21:00):
standpoint, so post acute andspecialty, and then from there,
we will continue to take care ofthe community as well, so not
just taking care of our partnerin these communities, but also
growing our community footprintoutside of the partnership,
Ashton Jones (21:13):
diving into that partnership a little bit more.
How do things kind of getestablished? And then how do you
work together to make sure thatyou are both coming together to
achieve the same goals. Yes,
Unknown (21:25):
so it is extremely important to be in lockstep with
your partner. We've been blessedwith a great partner where we've
learned a lot from one another,and we work with their
leadership team on strategy andhow to enter into the market,
and then we assist them withappropriate side of care. So for
listeners who might not befamiliar, in the infusion space,
there are many sites of care,hospital, outpatient, clinic,
(21:49):
setting and home. And what we dowith our partners is we come in
and we say, Okay, where is thebest site of care for the
patient? And then where are thepayers telling us that that
patient has to be placed? And weblend all of that knowledge and
strategy together to help bothour partner and our patients
land in the appropriate site.
Ashton Jones (22:05):
What are some of the recent advancements, or
maybe the outside factors thatare driving the growth in home
infusion? I know we talked aboutCOVID A little bit. That's a
huge driving factor, but Iimagine there are also a few
others payers.
Unknown (22:19):
Payers are one of the biggest they have. Again, post
COVID, payers realized homeinfusion specifically is one of
the lowest sites of care toreceive care in, and so they're
starting to push patients andproviders to shift their
patients out of hospitals, outof their clinics and into the
home setting. And luckily forthe patients, we now have all
(22:40):
these studies that show thatpatients actually thrive and
have better health outcomes whenthey're in the home.
Ashton Jones (22:47):
And what are some of the challenges and
opportunities in scaling homeinfusion services?
Unknown (22:52):
I would say it's regulatory bodies. So home
infusion is a space that everyState operates completely
different. And so what mightwork in a Michigan or Wisconsin
location is not going to work ina Florida location, meaning you
may have to have a brick andmortar where some states don't
require that you have a physicallocation, and you can offer your
services virtually and ship intothat state. I think that's one
(23:15):
of the driving forces of how youhave to be thoughtful and
strategic in how you grow stateby state? If
Ashton Jones (23:22):
you could look ahead five years, and I'm sure
you are in many ways, what doyou see for compasses in
relation to the infusionservices? Yeah,
Unknown (23:31):
I love this question.
So I am a forward thinker. I seeus in multiple states delivering
high level quality care, but Isee us more integrated than
we've probably ever been withincapacity between home infusion
and home health, and how we'reusing our clinical assets across
all lines of business, hospice,included, to deliver a level of
care that is unmatched in ourindustry. So infusion will not
(23:55):
only grow in the in the sense ofdelivering home infusion
services, but then grow in. Howdo we deliver pharmacy services
across all lines of business inan integrated model? So
Ashton Jones (24:09):
when you talk about partners, why would a
partner seek out compass this?
What are some of the benefits?
How do we work together to kindof improve care?
Unknown (24:18):
Hospitals are really good at the acute space and how
to deliver care acutely. Whenyou enter into the post acute
space, it's a different ballgame. It's a different payer
ball game, managed care,clinical delivery, mechanical
clinical care delivery, excuseme, and we come with that
subject matter expertise. So wecome with the ability to
strategize on how do you make apost acute business successful,
(24:41):
and I think compass, this hasdone that really, really well.
And so as a leader of ahospital, you're looking for a
partner who can lean and teachyou what you don't know, right,
or what you may have a littlebit of knowledge about. But need
that subject matter expertpartner and arm to really take
you to the next level. So
Ashton Jones (24:58):
last question I have. You, what are some of the
takeaways that you want to leaveour audience with from our
discussion?
Unknown (25:05):
Yeah, I think it's just recognizing that infusion, while
it is a pharmacy care deliverybusiness line, it offers so much
more than just pharmacydelivery, but a clinical asset
that can be beneficial acrossall service lines, and how we
plug in both in hospice homehealth, palliative care, and
then how we plug into ourpartners to support them in the
(25:26):
way that they need supported.
Well,
Ashton Jones (25:29):
that brings us to the end of this episode of Home
is where the help is. Today, wetalked about the value of home
infusion and the rapid growth ofcompasses in Fusion markets and
services. Kristen, thank you somuch for being our first guest
of season two and sharing suchinsightful information. And for
our listeners, we hope learningmore about the impact of home
(25:51):
infusion on patient care and itsfuture potential was beneficial
to you. If you liked today'sepisode and you're listening on
a streaming service, go aheadand give us a like and a follow,
and be sure to tune in nexttime, we'll host another in
depth discussion on progress andinnovation in the home based
healthcare space with anotherone of our experts. Until then,
(26:13):
this is Ashton Jones with Homeis where the health is. Thanks
for listening. You.
Ashton, Hi everyone. I'm Ashton Jones, and
this is home. Is where thehealth is. This podcast brings
you the latest news on progressand innovation in the home based
healthcare space, in associationwith compasses. At the end of
the day, every person deservesto be cared for with compassion,
whether they're dealing with aserious illness, recovering from
(00:24):
an injury, or nearing the end oflife, and in the place they call
home, no less. That's why thispodcast features different
subject matter experts as we doa deep dive into how their work
is improving home based healthcare for patients. In today's
episode, we're discussing thevalue and growth of home
infusion with our guest,Kristen, fan of Schulze, Vice
(00:45):
President of home infusion atcompasses, we'll address the
unique benefits of home infusionfor patients and caregivers,
explore its role in improvingaccessibility and outcomes, and
share a personal story with youabout how this work transforms
lives. There's all that and morecoming up on Home is where the
health is. Hi everyone, welcomeback to Home is where the health
(01:10):
is. We're excited to have youtune in to the first episode of
our second season as we exploresome new topics, products,
partnerships and more inupcoming episodes. So today, I'm
grateful to welcome our guest,Kristen. Fano schultzy, VP of
home infusion at compasses.
Kristen, thank you so much forbeing here.
Unknown (01:30):
Yeah, thank you. Thanks for having me. I'm excited to be
here. Yeah, it's great to haveyou.
Ashton Jones (01:34):
And I know we've been talking on and off for
quite a while about getting thisepisode off the ground, so we're
very excited to be able to sharesome of the latest and greatest
with you today, and now we havea lot of growth in the infusion
space that we're able to talkabout at compasses. So
everything really came togetherso perfectly today. Lots of
exciting information to share,but I want to start off by
(01:56):
giving our listeners a littlebit more information about your
personal and professionalbackground. So wherever you want
to pick up, maybe you want tostart with the personal aspects.
Unknown (02:06):
Yeah, sure. So I am married and a mom of three
little so seven year old, a fiveyear old and a two year old, and
they are the chaos crew, is whatI call them. We live on a farm
south of Nashville, here inTennessee, and it's generational
land, so we're out recultivatingOur farm property, and then it's
(02:26):
a very rural community, so a lotof volunteer work in the
healthcare there, or lack of, ifyou will, right? No,
Ashton Jones (02:33):
that's awesome. So that's a lot of work even there,
I'm sure, taking care of theland. And yes,
Unknown (02:38):
it is, animals everywhere, all the things that
the chickens, the justeverything. Yes, it's a lot.
What
Ashton Jones (02:44):
about at compasses? Let's go all the way
back to kind of the start ofyour professional journey, if
you want to give us a shortsummary, yeah. So
Unknown (02:51):
I am a Clinical Pharmacist by background. Have
been practicing for a littleabout a decade now. Started my
career in retail pharmacy,owning my own pharmacy, moving
into home based care started asa PRN home infusion pharmacist
and just kind of grew fromthere. Have worked with three
different home infusioncompanies. Now compasses is my
(03:14):
first true integrated home basedcare company. So traditionally,
it has been value based care andhome infusion, and have since
joined in with The Hospice andhome health here at Compass. SM,
it's been exciting. We've had ithas been a ride here at
compasses over the last coupleyears. Lot of growth, lot of
change, agility, I would say,and just a lot of fun. Yeah.
Ashton Jones (03:36):
And normally I ask people how they kind of got into
the home based healthcare space.
But since you already explainedthat part, I want to ask you
about how you ended up ininfusion specifically. So is it,
you know, personal?
Unknown (03:48):
Well, I had a boss many moons ago when I was in high
school. He ran a home infusioncompany based out of Dallas,
Texas, and called me and hesaid, Hey, I think you would
really love this piece ofpharmacy. It's everything that
you've kind of said you'vewanted in your career. I said,
Sure, Martin, I'll hop right in.
And I did PRN, and fell in lovewith it, and realized that it
was the perfect blend ofcommunity, where you can support
(04:11):
patients as they come home, butalso supporting your health
system partners and and havetaken that and ran with it, and
had have been blessed enough tobe able to cultivate teams that
blend both sides of pharmacyaltogether Well,
Ashton Jones (04:27):
to be in high school doing all of that, that's
a lot of foresight on your partto know. So you've kind of just
known what you wanted to dosince you were very young,
right? Well, so
Unknown (04:37):
I come from humble beginnings. I did not come from
a healthcare background at all,found myself working in an
independent pharmacy byhappenstance, as a customer
service rep, and the owner ofthat pharmacy said, I think you
should apply for pharmacyschool. And I said, heck, now
I'm going to go to med school.
Ended up. He convinced me toapply, and I got in, and that
was all she wrote. Went topharmacy school. And so. Found a
(04:58):
love for being able to take careof my community in a way that
allows me to kind of control howI was able to take care of my
community and my patients.
Ashton Jones (05:08):
So how about your team? Can you tell me a little
bit about your team at compassesand how you've really seen it
evolve and grow over time? Yeah,
Unknown (05:17):
so I don't know if we have enough time for me to rave
about how great my teams are.
Our team is made up of somereally high caliber clinical
pharmacists, nurses, pharmacytechnicians, warehouse
coordinators, just a massivegroup of clinicians that show up
every day dedicated todelivering some of the best in
industry quality outcomes thatI've seen so when I got here two
(05:40):
years ago, the team is a tenuredteam has been with Compass and
ascension at home for a reallylong time, and they were hungry
for more. They wanted tounderstand what else they could
do in pharmacy, and have sincebeen able to develop a more
value based care mindset, wherethey're not just showing up and
filling home infusionprescriptions or compounding
(06:01):
home infusion prescriptions, butthey are doing medication
reconciliations in inpartnership with our home health
team, so they're delivering alevel of care that home health
was missing and my clinicianswere missing, and have gotten
really excited about doing that.
They are the hardest work horsesI think I've ever worked with.
Like I said, I've worked formultiple home infusion
(06:22):
companies, and I will say thatthey the level of care and
consideration and compassionthat they have for our patients
and our referral sources has isunmatched. I've never worked
with an intake team the way thatour intake team takes care of
people, my pharmacists, mytechnicians, they just show up
in a way that I've not seenbefore. It's been really
humbling to watch and be a partof.
Ashton Jones (06:46):
Well, that leads us to our first topic of the
day, and today we're touching onthe value of home infusion
services delivered in the homesetting. Before we dive into
that, Kristen, can you start byexplaining what home infusion is
and kind of anyone who's notfamiliar with the service line,
what they need to know
Unknown (07:03):
home infusion is for any patient who has had surgery
or has some sort of ailment thatrequires a line to be placed or
a port to be placed so that theycan receive infusion therapy.
And what I mean by that isantibiotics, any type of total
perennial nutrition, sonutrition in the home for a
patient who may not be able toeat, hydration therapy,
chemotherapy and then chronicdisease statement management for
(07:27):
specialty patients, so a patientwho may have Crohn's disease or
rheumatoid arthritis, thosepatients would also be eligible
to receive home infusion. So
Ashton Jones (07:36):
you were recently quoted in an article from home
health care news, and thisarticle talked about how home
infusion is both the next bigthing in home based healthcare,
but also faces some barriers. Socan you touch on that a little
Unknown (07:50):
bit home infusion has been around, I'd say, 10 or 15
years, COVID really startedgrowing home infusion more than
what we had ever seen, becausepeople couldn't be in the
hospital, and we had to figureout a way to still deliver care
to these patients who needed itright providing access to care
in the home. And so what theinfusion industry saw was,
during COVID, we were allowed,in a way, it was a silver lining
(08:12):
of a very unfortunatecircumstance in our nation, but
we were allowed to bring peoplehome earlier than they had ever
been brought home and deliverinfusion therapy. So
antibiotics, total parental,nutrition, chronic disease,
state management, where patientswere having to go into the
hospital or a hospital settingto receive their infusions, now
had the ability to do it in thehome, and it allowed our
(08:34):
providers to get morecomfortable in doing that. So
you saw this massive shift moretowards the home. And what that
like I said, what that allowedus to do was not only support
our patients in an area thatthey could heal faster, their
emotional well being was better,their risk of infection was
significantly decreased,according to all the studies
that have been published sincethen, but we also got to support
(08:56):
our partners in a very differentway, which is really Exciting.
So as we all know, hospitals arelooking to decrease length of
stay. And how do you do that?
You have to get patients out ofthe hospital sooner, and one of
those ways is with campus, is topartner with our home health and
our home infusion teams andallow these patients to come
home two, three, even sometimesfour days earlier than what they
would have been able to even preCOVID. And so it's been exciting
(09:19):
to see compasses is my firstcompany that we've had all of
these different arms that allowus to really integrate with a
partner and bring our patientshome collectively. And what I
found with with compasses is ourinfusion patients specifically
get a level of care that inprevious companies they might
(09:40):
not have, and that's not sayingthat they wouldn't have gotten
great care, but we have a homehealth arm that is integrated
with us, where we know thosenurses and we can call and say,
this patient's coming home,they're going to need x, y, z,
as a pharmacist, we are lettingthe nurse know in the home what
opportunities. For care theymight run into before the nurse
(10:00):
even goes in to make heradmission, his or her admissions
at visit, yeah,
Ashton Jones (10:05):
and so you see a lot of improved outcomes due to
all of those pieces workingtogether. Yeah,
Unknown (10:12):
it's um, we when you have a home health and home
infusion company integratedtogether as closely as we are
here, you get to support thenurses and give them a level of
inside our home health nurses, alevel of insight that they
otherwise wouldn't have hadgoing in on that first day of
admission. So especially withour infusion patients, there,
they have a multi multitude ofopportunity for care from PT,
(10:36):
physical therapy, occupationaltherapy, nursing care, wound
care, etc. And so as thepharmacist, you get to kind of
guide the Home Health team in away on here's what to
anticipate, not just for thatantibiotic that you might be
helping us take care of, or thatline you might be helping us
take care of, but in all aspectsof that patient's care. So it's
(10:57):
what I would consider the truewhole patient care experience
that we get to deliver,
Ashton Jones (11:02):
and does that have an impact on maybe some of the
disparities and access to care?
I mean, maybe, you know, ruralarea compared to where we are in
Nashville. Yes,
Unknown (11:13):
when I look at infusion specifically, even without home
health, we have the ability toteach a patient bedside and
allow that patient theindependence to infuse their own
medication at home and go to ahospital or go to their doctor's
office for labs, dressingchanges, etc. There are what we
would call dead zones right inthe home health world, where you
(11:34):
may not have a home health nursethat can go provide care, but an
infusion patient lives. I livein one of those areas. My farm
is in one of those areas, andyou get to bring people home
where they can heal faster,better be around their family,
be around their kids, withoutnecessarily having to think
about other things that theymight not have access to care to
you and and I mean, that's oneof the reasons I got into it
(11:56):
right, was access to care,especially in rural communities.
And so it allows us to do that.
Ashton Jones (12:01):
That's great. What about some innovations that
you're seeing in the infusionspace? Are there things that
you're really excited aboutseeing?
Unknown (12:08):
We so pharmacists oftentimes don't sell themselves
enough. And what I mean by thatis we went to school for 468,
years, depending on your youreducation and what kind of what
type of pharmacist you became.
We have always been known asbeing able to just fill
prescriptions and take care ofpatients in that regard. And
over the last I'd say, handfulof years, we've really stepped
(12:29):
into this value based caredelivery system where we the
pharmacist intake a patient andwe look at their medications,
not just from a home infusionstandpoint, but from a full
medication reconciliationstandpoint, and and so the
innovation here is we get toimpact that patient in a way
that pharmacists historicallymight not have been able to
impact patients. So that's onething. Telehealth is another,
(12:52):
where pharmacists are nowheavily integrated into
telehealth programs and how youmanage patients through
medication therapy management,etc. So quite a bit of hospital
readmissions center onmedication errors or medication
issues, and having thepharmacist as part of that
integrated team allows us toreally prevent and decrease it.
Ashton Jones (13:16):
So what are some of the misconceptions that
people have about infusion ormaybe things that you want to
address that address that youthink are really important to
kind of understanding theservice line. When I think
Unknown (13:26):
about home infusion, I think about it in two different
areas. We are a post acutesupport system. So we're
supporting patients coming homefrom the hospital, supporting
our partners with their lengthof stay initiatives. And then we
have our chronic disease statemanagement piece of the puzzle,
and that is where you get totake care of lifelong patients
who need specialty infusions.
And so I think one of themisconceptions is that all of
(13:47):
this has to be done by a nursewith a nurse in the home and
home infusion is is this perfectopportunity to empower patients
to care for themselves, orempower their caregiver to
deliver a level of care thatthey might not have ever thought
that they could. And one of mymost favorite memories is seen I
was a clinical pharmacist. I wasdoing a bedside teach for a
(14:10):
heart failure patient in thehospital, and the caregiver
realized in that moment that shewas going to get to bring her
husband home on a therapy thatshe didn't think that she was
going to be able to, one, do,but two, have the support to do.
And when I went bedside andtaught her how to administer her
husband's inotrope and how tomonitor him alongside the
(14:30):
nursing team, she burst intotears. And so I think there's a
we don't give patients enoughcredit on what they can do to
take care of themselves and anda lot of times, providers are
think or under the impressionthat a nurse is going to come in
for every infusion, and they'rethe ones administering, when in
reality, with some hand holdingand some really good teaching by
(14:53):
our clinical teams, they havethe ability to do it themselves.
Ashton Jones (14:57):
So it sounds to me like patient education. Plays a
large part in home infusion. Sohow do you begin that
conversation? Yeah, so
Unknown (15:04):
it is imperative that you get both the patient and the
patient's caregiver on boardwith the care that they're going
to be receiving. A lot ofpatients, even providers, are
still very much taken back on.
Can they do this in the home?
What is it going to take? Is anurse going to come there every
single infusion, it takes a lotof education. So we make it seem
(15:25):
easy, and it can be easy, but wesend a nurse or a pharmacist or
another clinician bedside one toclinically assess the patient
and ensure that they areappropriate for home infusion.
The second step of that isteaching them how to use the
device that they will be usingto infuse the medication in
their home, whether that's anelastomeric pump or or a
syringe, etc, the caregiver isthen taught again. So we do one
(15:49):
to two, potentially three,teaches at the bedside to show
our patient and the caregiverhow they how they will infuse.
And then we have spent a lot oftime putting together some
really great educational videosonline, so the patients have
those to reference once they gohome, and they also know to call
our on call pharmacists andnurses who will walk them
through that first infusion sothat they don't have to do it
(16:11):
alone. And that is extremelybeneficial and comforting. So
the patient comes home and theyhave they knowing that they have
that pharmacist or nurse thatthey can call after hours to
walk them through that firsthookup gives them a lot of peace
of mind, and the support is justunmatched.
Ashton Jones (16:29):
We're going to take a quick break from our main
discussion to share a story withyou, and the reason we want to
spend time on a single story isbecause when you're looking at
the big picture, you can forgetabout all the lives that are
impacted by this work, and atthe end of the day, it's about
touching a life. So I askedKristen to come prepared with a
story today to share with all ofyou something that has really
(16:51):
impacted her, bothprofessionally and personally. I
first read the story thatKristen is going to share today
on LinkedIn she had posted a fewweeks back. It was just after
the start of the year. Soeveryone was doing their Annual
Resolutions, and Kristen, youcrafted this really poignant
post about your experiences withthe healthcare system, some of
(17:13):
the personal factors that driveyour work. And then you also
talked about your New Year'sresolution, which is to drive
change in healthcare. It's agreat resolution. So can you
talk about what led up to thatpost? I
Unknown (17:27):
have had a rough go when it comes to healthcare, so
I lost my little brother. I saythis, I live in a very rural
community, so I'll start withthat very little access to
healthcare, especiallyspecialized healthcare, several
years ago, 2017 I lost my littlebrother to suicide. We don't
have mental illness. Healthcareanywhere about about an hour,
(17:50):
hour and a half, close to thefarm. And then a year to the
day, lost my mom to metastasizedlung cancer due to some
misdiagnoses. Again, ruralhealth care. And then I really
started operating with a chip onmy shoulder of, how can I
change? Just based off of thosetwo experiences, dove head first
(18:10):
into home infusion andintegrated home based care and
value based care medicine. Andthen come 2023. My dad was
diagnosed with COVID, and heunfortunately had a post COVID
complication that wentundiagnosed. We sat in the
emergency room for 24 hours.
This is where the pharmacist inme comes in. So he was
administered a medication about18 hours within his stay that
(18:34):
caused him to bleed internallyand pass away. Unfortunately,
that experience, while wastraumatic, was a fire that I
needed to be relit in myhealthcare journey and has
allowed me, over the last twoyears or year, I should say,
now, to figure out how I canchange healthcare from the
(18:58):
inside out. So being aclinician, I want to empower my
teams. I want to empower mycolleagues on the impact that
they carry on every singlepatient, and I share my
experience with anybody who willlisten, because I think it gives
them some good grounding on mywhy I don't I read a quote the
other day that says I don'tserve a company or a patient.
(19:18):
Individually I serve. I have amission of my own, and I join a
company that matches my mission,right? And that's what I've done
with compasses, and what we dowith our partners that match our
mission. And so as long as Ilead with my mission, I can lead
teams with that same sort ofmentality, and they find their
why, and they go after it, whichis what we've seen in infusion
(19:38):
recently. But I say I don't doNew Year's resolutions, but I do
commitments. And my 2025commitment was, I'm going to
figure out a way to continue toimpact people so that together
as a team, we can impact andchange healthcare and the way
that healthcare is delivered.
Ashton Jones (19:58):
For second and five. Topic of today's episode,
we're going to dive into therapid expansion of infusion
services at compasses Kristin,for our listeners who aren't
familiar with compasses and itsservices, how would you describe
the service line's growth inrecent years? That
Unknown (20:15):
is a really good question. So infusion has really
taken a hold of the currentstates that we're in, meaning we
have grown substantially, hadyear over year growth in then
the census growth, types oftherapy that we've expanded
into, etc, and we've recently,now moved into multiple states.
So we started out in two stateswith brick and mortars. Now
(20:37):
we're in two additional states,Florida and Indiana, and we'll
be entering into Texas andOklahoma earlier, early this
year, 2025, our growthtrajectory has been fun to say
the least. We have a partnershipthat we follow along with, from
a footprint standpoint, thatallows us to really support our
partner and everything that theyneed from a home infusion
(21:00):
standpoint, so post acute andspecialty, and then from there,
we will continue to take care ofthe community as well, so not
just taking care of our partnerin these communities, but also
growing our community footprintoutside of the partnership,
Ashton Jones (21:13):
diving into that partnership a little bit more.
How do things kind of getestablished? And then how do you
work together to make sure thatyou are both coming together to
achieve the same goals. Yes,
Unknown (21:25):
so it is extremely important to be in lockstep with
your partner. We've been blessedwith a great partner where we've
learned a lot from one another,and we work with their
leadership team on strategy andhow to enter into the market,
and then we assist them withappropriate side of care. So for
listeners who might not befamiliar, in the infusion space,
there are many sites of care,hospital, outpatient, clinic,
(21:49):
setting and home. And what we dowith our partners is we come in
and we say, Okay, where is thebest site of care for the
patient? And then where are thepayers telling us that that
patient has to be placed? And weblend all of that knowledge and
strategy together to help bothour partner and our patients
land in the appropriate site.
Ashton Jones (22:05):
What are some of the recent advancements, or
maybe the outside factors thatare driving the growth in home
infusion? I know we talked aboutCOVID A little bit. That's a
huge driving factor, but Iimagine there are also a few
others payers.
Unknown (22:19):
Payers are one of the biggest they have. Again, post
COVID, payers realized homeinfusion specifically is one of
the lowest sites of care toreceive care in, and so they're
starting to push patients andproviders to shift their
patients out of hospitals, outof their clinics and into the
home setting. And luckily forthe patients, we now have all
(22:40):
these studies that show thatpatients actually thrive and
have better health outcomes whenthey're in the home.
Ashton Jones (22:47):
And what are some of the challenges and
opportunities in scaling homeinfusion services?
Unknown (22:52):
I would say it's regulatory bodies. So home
infusion is a space that everyState operates completely
different. And so what mightwork in a Michigan or Wisconsin
location is not going to work ina Florida location, meaning you
may have to have a brick andmortar where some states don't
require that you have a physicallocation, and you can offer your
services virtually and ship intothat state. I think that's one
(23:15):
of the driving forces of how youhave to be thoughtful and
strategic in how you grow stateby state? If
Ashton Jones (23:22):
you could look ahead five years, and I'm sure
you are in many ways, what doyou see for compasses in
relation to the infusionservices? Yeah,
Unknown (23:31):
I love this question.
So I am a forward thinker. I seeus in multiple states delivering
high level quality care, but Isee us more integrated than
we've probably ever been withincapacity between home infusion
and home health, and how we'reusing our clinical assets across
all lines of business, hospice,included, to deliver a level of
care that is unmatched in ourindustry. So infusion will not
(23:55):
only grow in the in the sense ofdelivering home infusion
services, but then grow in. Howdo we deliver pharmacy services
across all lines of business inan integrated model? So
Ashton Jones (24:09):
when you talk about partners, why would a
partner seek out compass this?
What are some of the benefits?
How do we work together to kindof improve care?
Unknown (24:18):
Hospitals are really good at the acute space and how
to deliver care acutely. Whenyou enter into the post acute
space, it's a different ballgame. It's a different payer
ball game, managed care,clinical delivery, mechanical
clinical care delivery, excuseme, and we come with that
subject matter expertise. So wecome with the ability to
strategize on how do you make apost acute business successful,
(24:41):
and I think compass, this hasdone that really, really well.
And so as a leader of ahospital, you're looking for a
partner who can lean and teachyou what you don't know, right,
or what you may have a littlebit of knowledge about. But need
that subject matter expertpartner and arm to really take
you to the next level. So
Ashton Jones (24:58):
last question I have. You, what are some of the
takeaways that you want to leaveour audience with from our
discussion?
Unknown (25:05):
Yeah, I think it's just recognizing that infusion, while
it is a pharmacy care deliverybusiness line, it offers so much
more than just pharmacydelivery, but a clinical asset
that can be beneficial acrossall service lines, and how we
plug in both in hospice homehealth, palliative care, and
then how we plug into ourpartners to support them in the
(25:26):
way that they need supported.
Well,
Ashton Jones (25:29):
that brings us to the end of this episode of Home
is where the help is. Today, wetalked about the value of home
infusion and the rapid growth ofcompasses in Fusion markets and
services. Kristen, thank you somuch for being our first guest
of season two and sharing suchinsightful information. And for
our listeners, we hope learningmore about the impact of home
(25:51):
infusion on patient care and itsfuture potential was beneficial
to you. If you liked today'sepisode and you're listening on
a streaming service, go aheadand give us a like and a follow,
and be sure to tune in nexttime, we'll host another in
depth discussion on progress andinnovation in the home based
healthcare space with anotherone of our experts. Until then,
(26:13):
this is Ashton Jones with Homeis where the health is. Thanks
for listening. You.
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