How many infusion patients did we serve?

Regardless of what business you are in, it is important to know the number of customers served, where they came from and what services or products were provided.  Knowing the number of prospective, current and former customers and understanding as much as you can about them gives you valuable insight into your business.  Although we count “customers” and “services” a little different, this is no less important in home infusion therapy.

In home infusion therapy this is called census management.  Sounds simple, but not always so.  Patient census is most commonly referred to as the “midnight census” in a hospital.  That is, how many patients are in a bed in the hospital when the clock strikes midnight.  This is an easy count.  This number is referred to as a patient day and hospitals have been managing their census by patient days for years.  In home infusion therapy, we are not confined by hospital walls and there is more of a focus on the therapies that are being provided.  Therefore we need to manage by therapy days more than patient days.  In home care when we produce a census that counts each patient once, regardless of the number of therapies they are on, it is referred to as an unduplicated census.  So, we need to manage by therapy, focusing on key therapies, but also know how many patients we are serving.  Finally, since insurance companies typically reimburse by therapy, a patient with multiple therapies will cost less to serve than multiple patients, each with one therapy.  How well do you understand your patient and therapy census?

Some home infusion providers, and software vendors, fall into the trap of trying to identify the primary therapy.  The problem with this is when you only look at the primary therapy, you loose visibility of very important census and therapy information.  The second problem is that keeping up with the primary therapy as physician orders change is a tedius process and seldom followed through on.  This would be like tracking revenue by only primary payer.  It’s easy but it doesn’t give you a very accurate picture of your business.

The key to accurately reporting therapy and patient census is to be able to produce total and distinct numbers.  If you are using a system like CPR+ that does not allow you to establish specific cases by therapy, the therapy is only recorded at the order level.  It is carried through to the delivery ticket and is only accurate if you have only one therpy on a delivery ticket.  If we determine that a patient is served when a prescription is filled or a delivery made and have the ability to have total and distinct counts, we are able to see our patient and therapy census in total and in an unduplicated formats.  This is essential to census management.  This will also take out the margin of error that is caused by patients not being discharged on a timely basis and patients who are on and off service due to hospitalization.

So, how many patients did you serve last month?  How many therapies?  How many IV Antibiotic patients?  How many IV Antibiotic patients who also had other therapies?  The answers to these questions are just the beginning to understanding your business.