Infusion therapies have been used in rheumatology practices for many years. As far back as 1914, Dr. Holger Møllgaard introduced the concept of intravenous gold to treat TB, which they thought rheumatoid arthritis (RA) was related to . This therapy was a common treatment option for many years, though thankfully these days are long gone. Evidenced based and efficacious treatment options became available with the approval of Remicade (infliximab) in 1999 for rheumatoid arthritis (RA). The adoption of Remicade and the development of new i.v. treatments for inflammatory rheumatic and metabolic bone disorders has significantly expanded the use of infusion therapies by rheumatologists.
Infusion as a Major Treatment Option for Rheumatoid Arthritis
According to the Centers for Disease Control and Prevention, rheumatic diseases remain the number one cause of disability in adults in the United States. Rheumatology wasn’t even a specialty in the early years of the 20th century, and treatment for these debilitating diseases were either bed rest or corticosteroids as recently as the 1940s and 50s.  As you can imagine, there wasn’t much need for in-office infusion capabilities when the treatment plan was prescribing pills and sleep! The approval of Remicade to treat RA kickstarted a huge shift in the treatment environment. The Massachusetts General Hospital Rheumatology Clinic reflected on these changes by pointing out “physicians, nurses, and other staff had to change the way they worked to get the right medication to the right patient. No longer did patients simply leave with a handwritten prescription for methotrexate or prednisone. Post-visit tasks for faculty, fellows, and staff now required prior-authorization paperwork for the use of biologic agents, “peer-to-peer” discussions with payers when applications were refused, and appeals to foundations to cover drug costs when primary payers would not foot the bill.” This shift was not limited to what treatment options were available, but also saw a shift in how RA was being treated. These new medications were not only reactive, but proactive and can actually slow down the degenerative quality of the disease. As a result, this forced a focus on early and aggressive intervention. Often time this means infusion therapy is introduced much earlier in the treatment process then in the past. 
The Switch to Outsourced In-Office Infusion
In the past and currently, rheumatologists treat RA patients with infusion therapy by referring them to hospitals, stand-alone clinics, or to hematologist/oncologist offices. However, with so many RA patients needing infusion therapy, it no longer makes sense to refer them out and hope they get the care they need.
It’s clear that moving infusion treatment into your office is a better fit in terms of treating patients. The follow up, the care, it’s all under one roof and can be properly managed. However, trying to incorporate infusion on your own is like adding a start-up business to your practice. There is a much better, more fluid, and safer financial option to creating in-office infusion: outsourcing the management. By outsourcing the management piece, you and your staff can focus on what really matters - patient care.
|Treatment Benefits |
- High-quality care in a comfortable and familiar setting
- Allows for direct drug side-effect surveillance and supervision by their neurologist
- Allows of optimized follow-up care
- Ability to educate both nurses and patients on the infusion drugs being used
- No time managing prior authorizations
- No more finding infusion sites for patients
- No more fighting denials
- More time to dedicate to new initiatives
- Reduced financial risk
- Reduced clinical liability to the practice
- Improved patient-physician relationships
- Increased revenue for your practice
- Greater patient compliance
- Improved patient satisfaction
- Better patient experience
- The comfort of their physician nearby
Want to learn more about outsourcing infusion management for your practice?
 https://academic.oup.com/rheumatology/article/51/suppl_6/vi28/1787530 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3882956/#i1537-2073-13-2-95-b24