In this episode, Dylan McCabe interviews one of the most experienced and talented infusion nurses we know – Judy Back RN, BSN. Judy has made a career of infusion nursing excellence by being an industry pioneer and one of the first registered nurses (RN) to navigate the challenges of the in-office infusion suite model. Listen as Judy shares her passion for infusion nursing and for this growing patient care model.

WeInfuse podcast

Transcript: Episode 10- Interview with Infusion Veteran, Judy Black

Dylan: WeInfuse podcast episode, number 10, welcome to the WeInfuse podcast. My

name is Dylan McCabe. And each week we give you a behind the scenes look at the

infusion practice because we talk with infusion practices all over the US and we

interview people in the infusion industry, whether nurses, providers, consultants,

business, people, and everything in between, so that we can give you tips, tactics and a

roadmap to streamline and simplify your own practice. We like to say, we take the

confusion out of infusion, and I’m excited about this interview because it’s with Judy

Back and she’s on our client success team here at WeInfuse. But Judy has been in the

infusion space since the mid-80s, she’s been an infusion nurse. She has been in

medical device sales. She has been involved in doctor’s offices, hospitals. She’s been

involved in nurses’ education for years.

She really is an expert when it comes to how to streamline the infusion practice, how to

really focus on patients, how to make everything patient centric, because you and I both

know that it’s really easy to make this all about the numbers and the concerns and the

practice, but Judy just does a great job of bringing it back to what it’s really all about,

and that is taking the best care possible of the patient. Getting patient access for these

incredible life-changing therapies that are made possible through infusion so let’s jump

right in with the interview with Judy here we go.

All right, welcome again. And like I mentioned, we have a special guest on today and

her name is Judy Back. And, Judy, thank you for being on the show today.

Judy: Thank you for having me Dylan.

Dylan: And the cool thing about Judy is she has been involved in the infusion practice

since the eighties. She’s got a lot of experience. She’s had different experience in

different medical contexts, all over the US from medical devices to infusion therapy from

nursing homes to doctor’s offices, to hospitals she’s really seen a lot. And so it’s really

neat to have her, and she’s also on the WeInfuse team, which is really exciting. So

Judy, before we jump into my kind of standard list of questions I guess, just share some

highlights about your background and what led to this point.

Judy: Okay. Well, in 1985, I graduated with my bachelors of nursing at UTA and started

just doing general nursing, mainly in emergency rooms. And then I learned real quickly

that I love Ivy therapy and I wanted to get better at it. And so my preceptor, I said, how

can I learn to really do a good job? And she said do it just make it happen. And so she

said, okay, well, if you want to do that, then you’re going to start all the Ivies today in the

emergency room. Well kind of scared me a little bit. And I said, well, what if I miss? And

she said, well, just do it over again. You’ll get it. And after about three weeks, I thought I

was an expert.

Dylan: Oh, wow.

Judy: But it is true. The more you do it, the better you get. And it’s one of those like ride

your bicycle and you’ll get it. And then I just progressed from working in hospitals and

supervisory positions. And I was always the one they came to, and then I needed an IV

because I just never had trouble. I guess it was a gift from God. I always pray before I

start one, Oh God, please help me. Cause I don’t want to hurt the person. But so, fast

forward to 2001, I went to work for a man by the name of Robert Norris at his home

health company in Arlington, as his infusion director. He wanted to start an infusion

program during that tenure or that little bit of time there, I kind of had an idea that a

friend of mine in Abilene was doing. And I said Mr. Norris, would you like to hear about

this opportunity?

And because he’s quite an entrepreneur, he said, yea can you come over to my office

right now? I want to hear about it. So in all of that, by December of that year, we had

formed a company called innovative infusions. And that was a management company

that went into our doctor’s offices and started there. I started in the infusion center for

them. It was early on when biologics just began to come out. And, so at that time we

were also doing antibiotics. So that meant I had to have nurses around the clock or

seven days a week, because how can you take an order from a doctor for seven days of

Rocephin and not stay open on Saturdays and Sunday? So we had to open. So we had

quite a crew and it was our very first one was in Cedar Hill, Texas. And then it grew

from there to Arlington and then from there to North Richland Hills.

And before it, we just had a bunch of infusion centers that we were managing all over

Texas. And so, and they were extremely successful, some more than others. But the

one thing that we had a problem with is we were doing everything on paper, everything

from the nurse’s notes to keeping up with our inventory, to keeping up with the billing

that we were doing in our office actually did the billing for that for the physicians. So

everything was on paper. Our nurses did all the authorizations, the verifications, at first,

and they had a hard time keeping up with it. And, at the time, our, what is currently now,

our CEO of WeInfuse worked for us, Brian Johnson. And I said, Brian, you’re a

computer guy, build us something that will take all this trouble out of my head and keep

up with this better.

Because we were sometimes losing track and, I had a nurse one time that had stuffed

$20,000 worth of Remicade in the back of a refrigerator and didn’t rotate it and it had

expired. And so what a tragedy and from that WeInfuse was born over time, because

we knew we had to have a way to keep up with things. And so, I love working for

WeInfuse because I know that the customer’s best interest is at their heart. That’s why

we want to see the customer and be successful. And how can you be successful if you

don’t have a program that really works and WeInfuse works, and it’s getting better and

better every day they add something new to it. So I’m proud to say that I can impart my

knowledge to the infusion centers that we go into. And my job is to go out on the

implementation team and teach and get them going so, fast forward that far, I mean,

that’s where we are today.

Dylan: That’s so neat. And I love it. And for those listening, if, if you didn’t pick up on

that, Robert Norris is actually Reese Norris’s dad. So the founders of WeInfuse Reese

Norris and Brian Johnson, obviously Judy Back, who’s sitting across from me now in our

studio, had a large role to play in the birth of this business idea and, and Robert Norris

also did as well. And so this has all been quite a story and quite a progression of events

as the company has really evolved over time. And it’s neat to hear your background and

also obviously your heart for customer success. And so your role today, you really own

our, what do we call our customer success team? Isn’t that what we call it?

Judy: Client success

Dylan: Client success Okay. And so your role, tell our listeners a little bit about your

role. What happens when somebody signs up with WeInfuse? What role do you play in

that?

Dylan: Well, I’m on the implementation team also. So Nick is one of our client success

engineers and he and I together go in and I asked the customer a lot of questions first

about their practice and how they currently are utilizing their infusion center. And then

we build, WeInfuse around that to help them come up with a better solution for keeping

up with their infusion center. So it starts with this questions. Then we go into training, we

have some, very good video, training videos that we ask them to look at. And then we

do, either in person or webinar training, for them to get started with wind views. And it,

texts a little bit of time there’s a lot to it. So we try to focus on whoever’s going to do

what job and really make sure that they understand that they’re rolling within WeInfuse

there.

Sometimes it’s nothing but the nurse and we teach the nurse everything. Sometimes

they have a front office that takes care of some of the, the beginning parts of it. So if

they’ve already used an EMR sometimes, it’s a little bit hard to wean them off, on to

what we do. But we try to not get it. WeInfuse is really simple. It’s not complex. And, in

fact, I just left an implementation where the nurse showed me. She said, we’re so glad

to have WeInfuse because what we had before is so confusing and you’ve got to go so

many places for so many things. And she said, WeInfuse just has it right here. So I was

really glad that we were able to help, but change is not easy. And so that’s one of my

jobs is to make change as seamless and as painless as we can.

Dylan: So let’s talk about that for a minute because one of the questions I like to ask is

what is your main area of expertise? And it’s pretty clear that yours is training coming

into a practice, asking a lot of questions to figure out where their challenges are. Their

pain points are where there’s gaps in the process, and then being, being a part of that

solution. So what’s one big thing you would want our listeners to know from your area of

expertise, because you’ve seen a lot of different infusion practices, big and small,

successful, and unsuccessful? What’s one big lesson you would want our listeners to

learn from what you’ve seen as you’ve gone into these practices.

Judy: Well, for sure that the training is extremely important. And sometimes it’s hard for

me as a knowledgeable infusion nurse to go in and see gaps in their infusion and keep

my mouth shut. That’s hard for me, but I try to impart my knowledge on them and give

them ideas that can make them successful. And so education is probably the biggest

thing. I never wanted to be a teacher in an elementary school or a high school. I just

didn’t think I could do that. But when I became a nurse, I realized nursing is all about

education. It’s all about imparting your knowledge that you’ve gained over time to the

new person. Whether that new person is older are, if they’re just new to, actually

infusion. And I see some things that I would change if I had my way in some of the

practices, but, just imparting the knowledge that might help them become successful, is

exciting. And, and I think that’s probably my mo. is, is education.

Dylan: That’s so good. Yeah. And like you said, it’s, it’s hard to go into a practice

knowing what and having seen so much in most of these practices, they lived in their

own small world of how they do things. And I went to a big practice in Pennsylvania this

week and we met for two and a half hours and went through how they did everything

from intake to their benefits investigation process, to their scheduling, to their charting,

to their inventory management. And at the end of it all they said. So, you talked to a lot

of practices every week. How do we stack up? And I had to respond and say, listen I’m

not here to throw stones at anybody. I’m not here to make anybody look bad, but here’s

where there’s some parts of your process that are broken.

They’re really broken. And you guys are flirting with disaster in a couple of areas. And I

say that to help you, we want to, our goal that WeInfuse is to be much more than a

software company. We want to come alongside you and to help, help you simplify, help

you streamline, help you maximize your process. So you can take care of patients really

well, but so you can also be successful as a business. And that’s what we have to do.

And you kind of have to do a dance. You have to be smooth about it and smart about it

and caring about it because you don’t want somebody to feel bad when they’ve worked

really hard to develop a process that they’ve worked on maybe for months or even

years. And then you come in and say, you missed a few major details over here.

Judy: Well, and Dylan, you know that one of the things that we all have to remember is

the number one thing we’re looking out for is the patient. As a nurse, that’s preached

into our head in our education processes becoming a nurse, it doesn’t matter when it all

comes down to the end result, it’s the patient that we’re looking out for, not our

business. Although we do have to really be careful about it, because if we’re not careful

with that, we’ll, we won’t be there for the patient. But we have to remember that the

ultimate goal is to get that patient, the treatment that they need and deserve and have

been prescribed for them correctly and all. And WeInfuse does a great job of keeping up

with what number one the insurance company has allowed them to do and keeping up

with dates because dates are important.

If WeInfuse too early, we might not get paid. And we don’t want that. We want, that was

one of our pain points in innovative infusion is sometimes we got those dates mixed up.

We saw the patient, nurses are notorious. Very, if you got them in the chair, we’re going

to infuse them. We’re going to stick them and we’re going to give them the medicine. So

we don’t let them get that far with WeInfuse. We just don’t let them even get on the

schedule unless the date is correct. And so, to me, that is so exciting to know that we’ve

got that, we’ve, we’re taking that issue and wrapping up in a little package in WeInfuse

and preventing that. Now, sometimes people get frustrated because, well, I want to put

them on the schedule, but look at your date. You don’t want to put him on the schedule.

You might really think you want to put them on the schedule, but you really don’t until

you’ve got an authorization to say you can,

Dylan: Right? You don’t want to schedule them even a day early before that

authorization approval, then

Judy: absolutely not.

Dylan: Well, let’s, let’s switch gears with all that you’ve seen in the infusion practices

and the experience that you’ve had, what’s a consistent challenge that you see these

practices deal with on a, on a weekly basis. Cause you’ve seen a lot of different infusion

practices. What’s one pain point that tends to stick out the most?

Judy: Probably those authorization dates and inventory. Inventory is a huge thing in the

infusion world. Of course, we all know that the very best way financially to get ahead is

to buy and bill, but doctors are scared to buy and bill, because they’ve been bitten by

buying too much, not enough, the patient gets there and you don’t have their drug there

because somebody forgot to order it or it is not taken care of correctly. And it ends up

expiring before you use it. And inventory’s expensive, especially today in today’s world

with the biologics. So you gotta be really careful. So with WeInfuse, that’s all taken care

of, literally, the system tells you exactly what vial to pick up and use that day. And when

we first start teaching that sometimes nurses go, well, that’s ridiculous. I’m just going to

go get the vial I want.

No, you’re going to get the vial that has the right lot and right expiration that WeInfuse,

told you to get, because that’s what’s going to rotate your drugs and keep them from

expiring. So that is a big thing. Knowing what you have in inventory, how many dollars

you have there. And our system allows you to see that the exact dollar figure that’s

pretty sobering sometimes/. When you think you might have $200,000 sitting in your

refrigerator. And so it does help you to sober up, so to speak in your knowledge of, yes,

I do have that much in there. Then WeInfuse doesn’t want you to buy what you don’t

need. So if you, if the system will tell you, yes, you need five vials of Remicade for and

through the next week are five vials of whatever. And it does that by having the patient

on the schedule and the system knows exactly how many vials that patient’s going to

get. So you don’t overbuy, but you make sure you have enough. And so of course,

buying and billing, and then we have another section which is specialty pharmacy. So if

your insurance company says, yes, you must buy it through Alliance or CVS, then we

have a way to keep up with that. So when it does come into the infusion center, it’s

documented as that patient’s drug for that particular, infusion time.

Dylan: it’s so good. And I, I really do like showing our inventory system as well and kind

of showing it off because it’s so automated and keeps on top of all this. So what’s an

example of it? Like, so I’m at a practice I met with a practice recently and they don’t

have an inventory management system. They don’t have a spreadsheet and notebook,

nothing there, their inventory management system is we order, they say, we, they would

say, we order based on who’s coming on the schedule, we look at the schedule and we

order exactly those drugs on a weekly basis. And then I said, okay, but how do you

account for when you order those vials? And they come in, how do you know exactly

which ones came in, how big the vials are, what size in DC law, all that, do you write

any of this down?

And they said, no, we, we look at it and we compare it against the calendar, what we

need. And I said, okay, let me just, so I understand correctly, you’re saying when you

get, $50,000, $100,000 worth of vials in your inventory management system is to look at

them with your eyes and then look at the calendar with your eyes. And you’re literally

not writing a single thing down or putting a single thing. Yep. That’s how we do it. And

we’ve never had a problem. And I said, and I told them, you’re flirting disaster, you’re

flirting disaster. But their defense was, and it makes sense. We’ve never had an issue

with this. And I said, well, you’re going to, and whether it’s three months from now or six

months from now, we’re going to be talking about it.

And I told them whether you guys use WeInfuse or not. Obviously I think it’s the best

system out there, but you guys have to get something, whether it’s an Excel

spreadsheet or some way to track all of this, because my mind is thinking somebody

could, like, you mentioned, vials could get pushed to the back. Even if you might get an

extra vial or you might be missing a vial somebody could steal. I mean, you hate to think

that, but somebody could. I mean, you got a $10,000 vial on hand or an $800 vial on

hand. And so what do you think could be some things that could go wrong with an

inventory management system?

Judy: One of the big things is if it’s a weight-based drug, what if you have the exact

number of vials you need for that, but you, they come in and they’ve gained 10 pounds

from their last infusion. So they require an extra vial and you don’t have it. So our

system has a par level that they can establish on drugs that are weight-based drugs.

We really recommend a small par level. Doesn’t have to be big, but that you have five or

10 extra vials just in case of that

Dylan: For those higher volume drugs.

Judy: And so, so you’re able to track it like that. So, so you could pick one, an extra

vile, if you need to, for that, that patients extra, that they might need,

Dylan: Then that goes back to your initial thing. So you can take care of that patient that

day. It’s a patient focused strategy. That’s good, that’s a good point. Well let’s share

another story, with what you’ve experienced so far in the infusion practice, what’s,

what’s a big light bulb moment you’ve had, whether it’s about patients or it’s about

processes or whatever, just what’s one big thing that kinda guide you on a daily basis in

this world.

Judy: Well, Dylan it goes back to my initial talking to Mr. Norris when I first started and I

had a friend in Abilene, Texas, that was doing this. And, I said, I think, I think we can do

this. And I think it’s going to be a huge benefit for patients that don’t need to be in the

hospital. And Mr. Norris said I’m one of them. I had an injury to an elbow and it was

infected. And the doctor put me in the hospital for seven days on Rocephin. I didn’t need

to be in a hospital. All I needed was the Rocephin, but at that time there was no way to

get it except go into the hospital. So it was a very painful time for him to just sit there

while he was getting his Rocephin. So I said, well, that’s the prime example on how we

can help set these practices up with an infusion center and physicians can manage that

as, as clinically manage it. Our nurses can give it and the patient gets to sleep in their

bed at night. How awesome is that?

And so really that was so early, that was before very many biologics were out at all. In

fact, I believe Remicade was the very first biologic we ever gave. We were doing a lot of

antibiotics and, and making fluids people would be dehydrated. And, we would give

them a bag of fluid. And a lot of it was coming from the practice that we were in. The

doctor was seeing patients rather than send them to the hospital. He put them in the

infusion center. And so our nurses would take care of them, make sure that they were

back on their feet and they got to sleep in their bed so talk about a moment and it still

exists today where a patient doesn’t have to go in the hospital to get these things.

And hospitals don’t want those patients anyway. They really don’t they sometimes

think they did, but they’re not great revenue generators. And so, but the patient’s happy

they’re right there. They know there’s a physician present at our nurse practitioner. And

if they, if something happens, we’ve got a backup. And so it’s, it’s golden. It’s like the

best of the best where you can go get your drug and still go home. I have a really good

friend that came down with CIDP, which is a neurological disease, and they have to

have IVIG. And I was able to talk to her about a physician that I knew that did that

literally from having almost a walker, needing a walker to get around from totally no

Walker now and going about her business. She and her husband did a lot of traveling

now they’re back to traveling because she was able to go into that infusion center every

three weeks, get her IVIG and it has turned that disease process around.

Dylan: That’s awesome.

Judy: It’s the best, it’s just the best. And it’s, and so, but all those things cost money

they cost time. They have, you must have expertise. And so having, WeInfuse as a part

of all that and helping to manage that process is what re that’s what WeInfuse really

does is manages a process from the patient’s, insurance, the patient’s, treatment note,

the patient’s inventory, the patient’s schedule. It does all of that and does it really well?

Dylan: Yea I know it’s nice to come into a practice and just keep thinking of the one I

met with most recently, and these nurses turned into project managers with these

patients in the infusion practice, because there’s so many moving parts. There’s a

process that can take weeks at a time and you have to follow up, check up on details

and keep the process going. And, and I get excited knowing that WeInfuse in this, we’re

not trying to totally just promote WeInfuse on this podcast, but it’s true. It’s nice to come

in there and say, hey, we can simplify a very complex process and enable you to relax a

little bit and focus more on the clinical part of why you really got into all this. And that is,

that is exciting. So well, there’s so much we could, I mean, we could talk for hours about

your experience and all the, all the things that are going on in infusion. What would you

say is one kind of last parting piece of advice for our listeners?

Judy: Keep on infusing. Don’t give up because you’re making a difference in the

patient’s lives. There was a time that I did some work for an oncology device company.

And, so I had an opportunity to go into oncology centers and of course that’s where lots

of lives are being changed in that. And I think that’s great. but I love this part of it where

it’s maybe not quite as intense in the therapy, but yet we know we’re making a

difference in patient’s lives from something like my friend has the neurological disease

and, and MS is a big one. We have a new drug we’re given for MS. And I’m just a part

of all that. And I see it every day and now there’s a new, potentially new Alzheimer’s

drug. That’s going to come out.

That’s an infusion drug that boy, when that comes out, it’s going to bust it wide open,

and infusion centers are going to be a part of that, just like they are with patients that

have crones are rheumatoid arthritis or any of those real, autoimmune diseases that

biologics can make a huge difference for. It’s exciting to see the progression of the

patient. And I get to see that even though my job is to get WeInfuse into these practices,

but I get to see that because I’m right there with the patient. So I get to enjoy that. and

the nurses always telling me this is a patient that came in and all the, all the history of

that patient and how well they’re doing, they share that with me just cause I’m a nurse

so that’s exciting for me to be able to see that

Dylan: That is, I love that keep, keep infusing as Judy’s parting advice. And it is

amazing. It’s amazing to see how people’s lives are changed and they get their freedom

back. They get their freedom to do the kinds of things they want to do. And it’s so good

and so anyway, thank you so much for being on the program, Judy, and, and your

experience, and obviously your influence in your heart here at WeInfuse. I love working

with you. And so it’s been great to have you on the podcast.

Judy: Thank you, Dylan.

Dylan: All right. That sums up our interview with Judy and I love what she said when I

asked her what’s one parting piece of advice, and she said, keep infusing. And I’ve

heard wonderful stories about how patients’ lives have been changed through infusion

therapy, but you know what? You can’t keep infusing very well. If you don’t have

processes in place that streamline the whole benefits investigation process, the

scheduling billing, and then the ability for the nurse to chart in a way that’s fast and

easy, but also very effective. And that’s what WeInfuse offers. So if you haven’t done so

yet, be sure to go to WeInfuse.com and request a demo. If you haven’t seen our

software in its full glory, you will be impressed because it really just makes your life

easier. It helps to automate some parts of the process, but really it’s just designed to

help manage that overall workflow from beginning to end, when it comes to the AIC, the

ambulatory infusion center or the provider office that also does infusions or whatever

the case may be.

If you have an infusion practice you need, WeInfuse. So be sure to check us out.

WeInfuse.com, schedule your demo today and see for yourself. I think you’ll be glad you

did. If you guys have any questions or you have any major issues that you are

challenged by, and you’d like to hear about in future podcasts, be sure to ask us,

mention it on our Facebook page, go to Facebook and do a search for WeInfuse inside

of Facebook. Be sure to make a comment on our Facebook page. We’d love to interact

with you there. And we also have a LinkedIn group, a closed LinkedIn group for people

involved in the infusion space. Be sure to search for that group and join the dialogue

there as well. Guys, this has been exciting to be with you on this journey. My name is

Dylan McCabe, and we will catch you in the next episode.

Guest Speaker: Judy Back, RN, BSN, Clinical Nurse Educator at EQUASHIELD, received her BS as a Registered Nurse from the University of Texas at Arlington in 1985. She has since worked for numerous clinical companies, including as a Nurse Liaison for WeInfuse.