Home is Where the HEALTH is
Home is Where the HEALTH is
Expanding Access to Care — The Growth and Impact of Home Infusion
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.
Ashton, Hi everyone. I'm Ashton Jones, and this is home. Is where the health is. This podcast brings you the latest news on progress and innovation in the home based healthcare space, in association with compasses. At the end of the day, every person deserves to be cared for with compassion, whether they're dealing with a serious illness, recovering from an injury, or nearing the end of life, and in the place they call home, no less. That's why this podcast features different subject matter experts as we do a deep dive into how their work is improving home based health care for patients. In today's episode, we're discussing the value and growth of home infusion with our guest, Kristen, fan of Schulze, Vice President of home infusion at compasses, we'll address the unique benefits of home infusion for patients and caregivers, explore its role in improving accessibility and outcomes, and share a personal story with you about how this work transforms lives. There's all that and more coming up on Home is where the health is. Hi everyone, welcome back to Home is where the health is. We're excited to have you tune in to the first episode of our second season as we explore some new topics, products, partnerships and more in upcoming episodes. So today, I'm grateful to welcome our guest, Kristen. Fano schultzy, VP of home infusion at compasses. Kristen, thank you so much for being here.
Unknown:Yeah, thank you. Thanks for having me. I'm excited to be here. Yeah, it's great to have you.
Ashton Jones:And I know we've been talking on and off for quite a while about getting this episode off the ground, so we're very excited to be able to share some of the latest and greatest with you today, and now we have a lot of growth in the infusion space that we're able to talk about at compasses. So everything really came together so perfectly today. Lots of exciting information to share, but I want to start off by giving our listeners a little bit more information about your personal and professional background. So wherever you want to pick up, maybe you want to start with the personal aspects.
Unknown:Yeah, sure. So I am married and a mom of three little so seven year old, a five year old and a two year old, and they are the chaos crew, is what I call them. We live on a farm south of Nashville, here in Tennessee, and it's generational land, so we're out recultivating Our farm property, and then it's a very rural community, so a lot of volunteer work in the healthcare there, or lack of, if you will, right? No,
Ashton Jones:that's awesome. So that's a lot of work even there, I'm sure, taking care of the land. And yes,
Unknown:it is, animals everywhere, all the things that the chickens, the just everything. Yes, it's a lot. What
Ashton Jones:about at compasses? Let's go all the way back to kind of the start of your professional journey, if you want to give us a short summary, yeah. So
Unknown:I am a Clinical Pharmacist by background. Have been practicing for a little about a decade now. Started my career in retail pharmacy, owning my own pharmacy, moving into home based care started as a PRN home infusion pharmacist and just kind of grew from there. Have worked with three different home infusion companies. Now compasses is my first true integrated home based care company. So traditionally, it has been value based care and home infusion, and have since joined in with The Hospice and home health here at Compass. SM, it's been exciting. We've had it has been a ride here at compasses over the last couple years. Lot of growth, lot of change, agility, I would say, and just a lot of fun. Yeah.
Ashton Jones:And normally I ask people how they kind of got into the home based healthcare space. But since you already explained that part, I want to ask you about how you ended up in infusion specifically. So is it, you know, personal?
Unknown:Well, I had a boss many moons ago when I was in high school. He ran a home infusion company based out of Dallas, Texas, and called me and he said, Hey, I think you would really love this piece of pharmacy. It's everything that you've kind of said you've wanted in your career. I said, Sure, Martin, I'll hop right in. And I did PRN, and fell in love with it, and realized that it was the perfect blend of community, where you can support patients as they come home, but also supporting your health system partners and and have taken that and ran with it, and had have been blessed enough to be able to cultivate teams that blend both sides of pharmacy altogether Well,
Ashton Jones:to be in high school doing all of that, that's a lot of foresight on your part to know. So you've kind of just known what you wanted to do since you were very young, right? Well, so
Unknown:I come from humble beginnings. I did not come from a healthcare background at all, found myself working in an independent pharmacy by happenstance, as a customer service rep, and the owner of that pharmacy said, I think you should apply for pharmacy school. And I said, heck, now I'm going to go to med school. Ended up. He convinced me to apply, and I got in, and that was all she wrote. Went to pharmacy school. And so. Found a love for being able to take care of my community in a way that allows me to kind of control how I was able to take care of my community and my patients.
Ashton Jones:So how about your team? Can you tell me a little bit about your team at compasses and how you've really seen it evolve and grow over time? Yeah,
Unknown: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 some really high caliber clinical pharmacists, nurses, pharmacy technicians, warehouse coordinators, just a massive group of clinicians that show up every day dedicated to delivering some of the best in industry quality outcomes that I've seen so when I got here two years ago, the team is a tenured team has been with Compass and ascension at home for a really long time, and they were hungry for more. They wanted to understand what else they could do in pharmacy, and have since been able to develop a more value based care mindset, where they're not just showing up and filling home infusion prescriptions or compounding home infusion prescriptions, but they are doing medication reconciliations in in partnership with our home health team, so they're delivering a level of care that home health was missing and my clinicians were missing, and have gotten really excited about doing that. They are the hardest work horses I think I've ever worked with. Like I said, I've worked for multiple home infusion companies, and I will say that they the level of care and consideration and compassion that they have for our patients and our referral sources has is unmatched. I've never worked with an intake team the way that our intake team takes care of people, my pharmacists, my technicians, they just show up in a way that I've not seen before. It's been really humbling to watch and be a part of.
Ashton Jones:Well, that leads us to our first topic of the day, and today we're touching on the value of home infusion services delivered in the home setting. Before we dive into that, Kristen, can you start by explaining what home infusion is and kind of anyone who's not familiar with the service line, what they need to know
Unknown:home infusion is for any patient who has had surgery or has some sort of ailment that requires a line to be placed or a port to be placed so that they can receive infusion therapy. And what I mean by that is antibiotics, any type of total perennial nutrition, so nutrition in the home for a patient who may not be able to eat, hydration therapy, chemotherapy and then chronic disease statement management for specialty patients, so a patient who may have Crohn's disease or rheumatoid arthritis, those patients would also be eligible to receive home infusion. So
Ashton Jones:you were recently quoted in an article from home health care news, and this article talked about how home infusion is both the next big thing in home based healthcare, but also faces some barriers. So can you touch on that a little
Unknown:bit home infusion has been around, I'd say, 10 or 15 years, COVID really started growing home infusion more than what we had ever seen, because people couldn't be in the hospital, and we had to figure out a way to still deliver care to these patients who needed it right providing access to care in the home. And so what the infusion industry saw was, during COVID, we were allowed, in a way, it was a silver lining of a very unfortunate circumstance in our nation, but we were allowed to bring people home earlier than they had ever been brought home and deliver infusion therapy. So antibiotics, total parental, nutrition, chronic disease, state management, where patients were having to go into the hospital or a hospital setting to receive their infusions, now had the ability to do it in the home, and it allowed our providers to get more comfortable in doing that. So you saw this massive shift more towards the home. And what that like I said, what that allowed us to do was not only support our patients in an area that they 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 since then, but we also got to support our partners in a very different way, which is really Exciting. So as we all know, hospitals are looking to decrease length of stay. And how do you do that? You have to get patients out of the hospital sooner, and one of those ways is with campus, is to partner with our home health and our home infusion teams and allow these patients to come home two, three, even sometimes four days earlier than what they would have been able to even pre COVID. And so it's been exciting to see compasses is my first company that we've had all of these different arms that allow us to really integrate with a partner and bring our patients home collectively. And what I found with with compasses is our infusion patients specifically get a level of care that in previous companies they might not have, and that's not saying that they wouldn't have gotten great care, but we have a home health arm that is integrated with us, where we know those nurses and we can call and say, this patient's coming home, they're going to need x, y, z, as a pharmacist, we are letting the nurse know in the home what opportunities. For care they might run into before the nurse even goes in to make her admission, his or her admissions at visit, yeah,
Ashton Jones:and so you see a lot of improved outcomes due to all of those pieces working together. Yeah,
Unknown:it's um, we when you have a home health and home infusion company integrated together as closely as we are here, you get to support the nurses and give them a level of inside our home health nurses, a level of insight that they otherwise wouldn't have had going in on that first day of admission. So especially with our infusion patients, there, they have a multi multitude of opportunity for care from PT, physical therapy, occupational therapy, nursing care, wound care, etc. And so as the pharmacist, you get to kind of guide the Home Health team in a way on here's what to anticipate, not just for that antibiotic that you might be helping us take care of, or that line you might be helping us take care of, but in all aspects of that patient's care. So it's what I would consider the true whole patient care experience that we get to deliver,
Ashton Jones:and does that have an impact on maybe some of the disparities and access to care? I mean, maybe, you know, rural area compared to where we are in Nashville. Yes,
Unknown:when I look at infusion specifically, even without home health, we have the ability to teach a patient bedside and allow that patient the independence to infuse their own medication at home and go to a hospital or go to their doctor's office for labs, dressing changes, etc. There are what we would call dead zones right in the home health world, where you may not have a home health nurse that can go provide care, but an infusion patient lives. I live in one of those areas. My farm is in one of those areas, and you get to bring people home where they can heal faster, better be around their family, be around their kids, without necessarily having to think about other things that they might not have access to care to you and and I mean, that's one of the reasons I got into it right, was access to care, especially in rural communities. And so it allows us to do that.
Ashton Jones:That's great. What about some innovations that you're seeing in the infusion space? Are there things that you're really excited about seeing?
Unknown:We so pharmacists oftentimes don't sell themselves enough. And what I mean by that is we went to school for 468, years, depending on your your education and what kind of what type of pharmacist you became. We have always been known as being able to just fill prescriptions and take care of patients in that regard. And over the last I'd say, handful of years, we've really stepped into this value based care delivery system where we the pharmacist intake a patient and we look at their medications, not just from a home infusion standpoint, but from a full medication reconciliation standpoint, and and so the innovation here is we get to impact that patient in a way that pharmacists historically might not have been able to impact patients. So that's one thing. Telehealth is another, where pharmacists are now heavily integrated into telehealth programs and how you manage patients through medication therapy management, etc. So quite a bit of hospital readmissions center on medication errors or medication issues, and having the pharmacist as part of that integrated team allows us to really prevent and decrease it.
Ashton Jones:So what are some of the misconceptions that people have about infusion or maybe things that you want to address that address that you think are really important to kind of understanding the service line. When I think
Unknown:about home infusion, I think about it in two different areas. We are a post acute support system. So we're supporting patients coming home from the hospital, supporting our partners with their length of stay initiatives. And then we have our chronic disease state management piece of the puzzle, and that is where you get to take care of lifelong patients who need specialty infusions. And so I think one of the misconceptions is that all of this has to be done by a nurse with a nurse in the home and home infusion is is this perfect opportunity to empower patients to care for themselves, or empower their caregiver to deliver a level of care that they might not have ever thought that they could. And one of my most favorite memories is seen I was a clinical pharmacist. I was doing a bedside teach for a heart failure patient in the hospital, and the caregiver realized in that moment that she was going to get to bring her husband home on a therapy that she 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 and taught her how to administer her husband's inotrope and how to monitor him alongside the nursing team, she burst into tears. And so I think there's a we don't give patients enough credit on what they can do to take care of themselves and and a lot of times, providers are think or under the impression that a nurse is going to come in for every infusion, and they're the ones administering, when in reality, with some hand holding and some really good teaching by our clinical teams, they have the ability to do it themselves.
Ashton Jones:So it sounds to me like patient education. Plays a large part in home infusion. So how do you begin that conversation? Yeah, so
Unknown:it is imperative that you get both the patient and the patient's caregiver on board with the care that they're going to be receiving. A lot of patients, even providers, are still very much taken back on. Can they do this in the home? What is it going to take? Is a nurse going to come there every single infusion, it takes a lot of education. So we make it seem easy, and it can be easy, but we send a nurse or a pharmacist or another clinician bedside one to clinically assess the patient and ensure that they are appropriate for home infusion. The second step of that is teaching them how to use the device that they will be using to infuse the medication in their home, whether that's an elastomeric pump or or a syringe, etc, the caregiver is then taught again. So we do one to two, potentially three, teaches at the bedside to show our patient and the caregiver how they how they will infuse. And then we have spent a lot of time putting together some really great educational videos online, so the patients have those to reference once they go home, and they also know to call our on call pharmacists and nurses who will walk them through that first infusion so that they don't have to do it alone. And that is extremely beneficial and comforting. So the patient comes home and they have they knowing that they have that pharmacist or nurse that they can call after hours to walk them through that first hookup gives them a lot of peace of mind, and the support is just unmatched.
Ashton Jones:We're going to take a quick break from our main discussion to share a story with you, and the reason we want to spend time on a single story is because when you're looking at the big picture, you can forget about all the lives that are impacted by this work, and at the end of the day, it's about touching a life. So I asked Kristen to come prepared with a story today to share with all of you something that has really impacted her, both professionally and personally. I first read the story that Kristen is going to share today on LinkedIn she had posted a few weeks back. It was just after the start of the year. So everyone was doing their Annual Resolutions, and Kristen, you crafted this really poignant post about your experiences with the healthcare system, some of the personal factors that drive your work. And then you also talked about your New Year's resolution, which is to drive change in healthcare. It's a great resolution. So can you talk about what led up to that post? I
Unknown:have had a rough go when it comes to healthcare, so I lost my little brother. I say this, I live in a very rural community, so I'll start with that very little access to healthcare, especially specialized healthcare, several years ago, 2017 I lost my little brother to suicide. We don't have mental illness. Healthcare anywhere about about an hour, hour and a half, close to the farm. And then a year to the day, lost my mom to metastasized lung cancer due to some misdiagnoses. Again, rural health care. And then I really started operating with a chip on my shoulder of, how can I change? Just based off of those two experiences, dove head first into home infusion and integrated home based care and value based care medicine. And then come 2023. My dad was diagnosed with COVID, and he unfortunately had a post COVID complication that went undiagnosed. We sat in the emergency room for 24 hours. This is where the pharmacist in me comes in. So he was administered a medication about 18 hours within his stay that caused him to bleed internally and pass away. Unfortunately, that experience, while was traumatic, was a fire that I needed to be relit in my healthcare journey and has allowed me, over the last two years or year, I should say, now, to figure out how I can change healthcare from the inside out. So being a clinician, I want to empower my teams. I want to empower my colleagues on the impact that they carry on every single patient, and I share my experience with anybody who will listen, because I think it gives them some good grounding on my why I don't I read a quote the other day that says I don't serve a company or a patient. Individually I serve. I have a mission 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 do with our partners that match our mission. And so as long as I lead with my mission, I can lead teams with that same sort of mentality, and they find their why, and they go after it, which is what we've seen in infusion recently. But I say I don't do New Year's resolutions, but I do commitments. And my 2025 commitment was, I'm going to figure out a way to continue to impact people so that together as a team, we can impact and change healthcare and the way that healthcare is delivered.
Ashton Jones:For second and five. Topic of today's episode, we're going to dive into the rapid expansion of infusion services at compasses Kristin, for our listeners who aren't familiar with compasses and its services, how would you describe the service line's growth in recent years? That
Unknown:is a really good question. So infusion has really taken a hold of the current states that we're in, meaning we have grown substantially, had year over year growth in then the census growth, types of therapy that we've expanded into, etc, and we've recently, now moved into multiple states. So we started out in two states with brick and mortars. Now we're in two additional states, Florida and Indiana, and we'll be entering into Texas and Oklahoma earlier, early this year, 2025, our growth trajectory has been fun to say the least. We have a partnership that we follow along with, from a footprint standpoint, that allows us to really support our partner and everything that they need from a home infusion standpoint, so post acute and specialty, and then from there, we will continue to take care of the community as well, so not just taking care of our partner in these communities, but also growing our community footprint outside of the partnership,
Ashton Jones:diving into that partnership a little bit more. How do things kind of get established? And then how do you work together to make sure that you are both coming together to achieve the same goals. Yes,
Unknown:so it is extremely important to be in lockstep with your partner. We've been blessed with a great partner where we've learned a lot from one another, and we work with their leadership team on strategy and how to enter into the market, and then we assist them with appropriate side of care. So for listeners who might not be familiar, in the infusion space, there are many sites of care, hospital, outpatient, clinic, setting and home. And what we do with our partners is we come in and we say, Okay, where is the best site of care for the patient? And then where are the payers telling us that that patient has to be placed? And we blend all of that knowledge and strategy together to help both our partner and our patients land in the appropriate site.
Ashton Jones:What are some of the recent advancements, or maybe the outside factors that are driving the growth in home infusion? I know we talked about COVID A little bit. That's a huge driving factor, but I imagine there are also a few others payers.
Unknown:Payers are one of the biggest they have. Again, post COVID, payers realized home infusion specifically is one of the lowest sites of care to receive care in, and so they're starting to push patients and providers to shift their patients out of hospitals, out of their clinics and into the home setting. And luckily for the patients, we now have all these studies that show that patients actually thrive and have better health outcomes when they're in the home.
Ashton Jones:And what are some of the challenges and opportunities in scaling home infusion services?
Unknown:I would say it's regulatory bodies. So home infusion is a space that every State operates completely different. And so what might work in a Michigan or Wisconsin location is not going to work in a Florida location, meaning you may have to have a brick and mortar where some states don't require that you have a physical location, and you can offer your services virtually and ship into that state. I think that's one of the driving forces of how you have to be thoughtful and strategic in how you grow state by state? If
Ashton Jones:you could look ahead five years, and I'm sure you are in many ways, what do you see for compasses in relation to the infusion services? Yeah,
Unknown:I love this question. So I am a forward thinker. I see us in multiple states delivering high level quality care, but I see us more integrated than we've probably ever been within capacity between home infusion and home health, and how we're using our clinical assets across all lines of business, hospice, included, to deliver a level of care that is unmatched in our industry. So infusion will not only grow in the in the sense of delivering home infusion services, but then grow in. How do we deliver pharmacy services across all lines of business in an integrated model? So
Ashton Jones: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 kind of improve care?
Unknown:Hospitals are really good at the acute space and how to deliver care acutely. When you enter into the post acute space, it's a different ball game. It's a different payer ball game, managed care, clinical delivery, mechanical clinical care delivery, excuse me, and we come with that subject matter expertise. So we come with the ability to strategize on how do you make a post acute business successful, and I think compass, this has done that really, really well. And so as a leader of a hospital, you're looking for a partner who can lean and teach you what you don't know, right, or what you may have a little bit of knowledge about. But need that subject matter expert partner and arm to really take you to the next level. So
Ashton Jones:last question I have. You, what are some of the takeaways that you want to leave our audience with from our discussion?
Unknown:Yeah, I think it's just recognizing that infusion, while it is a pharmacy care delivery business line, it offers so much more than just pharmacy delivery, but a clinical asset that can be beneficial across all service lines, and how we plug in both in hospice home health, palliative care, and then how we plug into our partners to support them in the way that they need supported. Well,
Ashton Jones:that brings us to the end of this episode of Home is where the help is. Today, we talked about the value of home infusion and the rapid growth of compasses in Fusion markets and services. Kristen, thank you so much for being our first guest of season two and sharing such insightful information. And for our listeners, we hope learning more about the impact of home infusion on patient care and its future potential was beneficial to you. If you liked today's episode and you're listening on a streaming service, go ahead and give us a like and a follow, and be sure to tune in next time, we'll host another in depth discussion on progress and innovation in the home based healthcare space with another one of our experts. Until then, this is Ashton Jones with Home is where the health is. Thanks for listening. You.