In this episode, Sonia Alizzi, Corporate Director of Nursing at Southside Specialty Pharmacy, draws on her vast experience (both clinical and business related) and shares important tips for effective infusion center management.

WeInfuse podcast

Transcript: Episode 15- Important Tips for Effective Infusion Center Management with Sonia Alizzi, Corporate Dire

Dylan: We Infuse podcast, episode number 15. Welcome to We Infuse podcast and today

we have a special guest Sonya Areezy with SouthSide. She’s the director of nursing with

SouthSide Infusion Pharmacy and she’s actually been an RN. She wears different hats in

SouthSide, she’s involved with their management of infusion practice and she’s involved in

operations, she’s involved in growing the business. So she has a really neat take on infusion

therapy specifically. So Sonya, thanks for being on the show.

Sonya: Thank you, thank you for having me.

Dylan: Before we launch into my typical questions I like to ask, I want to give Sonya a

chance to just share a little bit about her background. So just, I guess, tell our listeners kind

of what led you up to this point and your background in a clinical setting and what got you

involved with SouthSide?

Sonya: Sure. In 1994, I started with infusions or my introduction to infusions with infectious

disease. I was the clinic practice manager for that doctor’s office doing PICC lines at the

bedside and then we were mixing our own antibiotics and sending patients home with them.

So I got a little taste of that and fell in love with it.

Dylan: That’s great. So you went from being an RN to working with infusion patients and

then how long have you been with SouthSide?

Sonya: I’ve been with them for 14 years now. So from being a practice manager, I went on

to work for Helix. I was a clinical educator there. I was a corporate nurse teaching nurses

how to put in PICC lines at the bedside, got very redundant, missed the patient side of it and

dealing with the physicians and so I went on to work with SouthSide where I started home

health services. I was their director of nursing for home health, loved that there was an

aspect of infusion there because we were doing home infusions, did a lot of that and then

went on and started branching out our own infusion services for the company and doing

infusion management services.

Dylan: That’s great. So let’s just take a minute for people that don’t know, or maybe haven’t

heard about SouthSide, kind of give us an overview of what SouthSide does because I know

predominantly some people may think of SouthSide specialty pharmacy, but there’s much

more to it than that.

Sonya: Absolutely. So originally we started off with retail pharmacy, grew our services into

the specialty side and now we’re really big into the infusion side where we have our own

standalone infusion locations where patients can come in and be serviced seven days a

week, as well as doing the infusion management side where we’ll go into physician offices

and do the whole scope of services turnkey for managing the practice.

Dylan: And then you guys are also involved in, I think you said home health, are you also

involved in home infusion?

Sonya: Home infusion, home health, we own our own home health company. We own our

own home medical equipment company and I think that’s it.

Dylan: Yep and the in office infusion suite, so you guys are involved in a lot.

Sonya: Yeah.

Dylan: That’s awesome; and so with all of that going on, it might be kind of hard to pinpoint,

but when you say that you guys have a main area of expertise or a main focus?

Sonya: I’d say that it’s probably in the specialty realm and then our in growing infusion

services, it’s rapidly growing, every year we grow at least 20, 25%.

Dylan: Wow and I know we were talking earlier during the conference as those of you that

are listening, we’re actually recording this during a break from a large Texas rheumatology

conference but I think you mentioned that one of your goals at SouthSide is to be kind of a

one stop shop.

Sonya: Absolutely. That was our model initially to be the one stop shop. So we were

seeking where we could have a niche in the service market and basically it was to get one

referral and be able to service it from beginning to end. So definitely if we’d gotten a referral

from a case manager in the hospital, a patient needs to go home, we’re able to get them a

wheelchair, get them their infusion services and get them their nurse all out of the same hub.

Dylan: Okay. So for people listening to this and we have a pretty broad range of listeners

from physicians to nurses, to business people who are thinking about launching infusion

practices or acquiring them, what’s one big takeaway you would want our listeners to learn

from that? What’s the benefit to having a one stop shop as opposed to somebody maybe

thinking, well, I think it may be better to go here for this thing and go to another company for

that?

Sonya: Well, having a one stop shop, I think it helps you keep your client in house so that

you’re not losing them to maybe a company who can do or offer more services than yourself.

Obviously some of the pros are that the revenue can be good but there are some risks

associated with that. So just basically do your homework.

Dylan: That’s good. Yeah. You have a lot more control over that experience, patient

experience, client experience. That’s good. That’s great. Well, let’s switch gears and talk

specifically about infusion therapy with the in-office infusion practice. What’s one maybe

consistent or big challenge that you guys have encountered with in-office infusion therapy?

Sonya: I think one of the biggest challenges is trying to present a proforma or a forecast on

how that office is going to turn out for the company so that it’s a win win for both parties. A lot

of physician’s offices don’t have a full grasp of how many patients they have. They don’t

have a full grasp of what insurances reimburse. I think that becomes the biggest challenge

for us trying to forecast and really that’s it.

Dylan: And so why do you think that’s so challenging? Does it come down to their ability to

have a good sales process? What do you think is the key to growing that successfully?

Sonya: So I think that the problem is that they’re not capturing the data. If they’re sending

things out, then they’re not really capturing what their revenue source could be. They’ve

never maybe done any infusion management services, so they’ve never bought any

medication. They don’t know what the reimbursement is from blue cross versus United. They

don’t really have an idea of how to even start that up. So I think that that’s really part of the

problem. That’s why it’s hard to get a good forecast from them.

Dylan: That’s a good point and we see that a lot too when we offer our software, we go into

a practice and try to analyze their workflow and I’m not involved in forecasting or anything

like that, but we go in there and analyze their workflow and we’ll find a situation where

somebody is keeping track of inventory in a notebook on paper and they’re updating it once

a week. I was in an office two weeks ago in the Northeast and they had over: I said, how

much inventory do you have on hand now, if you could put a dollar value to it, she said, oh,

somewhere around 330,000 and I said, and how are you updating it? She said, well, here’s

my notebook is my system works great and I said, well, what are you recording? She said,

well right here, look, I’ve got Remicade, I count, I’ve got 10 vials, I put Remicade 10 and I

said, well, what about the size of the vial? The NDC, the lot, the expiration date? I don’t need

to keep track of that. We order more Remicade every week or so and I’m thinking if you were

to transfer two, five, $10,000 out of your personal bank account at a time, I think you’d pay

very close attention to it. You’d probably have to be doing it online or at least have a record

of it. You wouldn’t be doing it in a ledger on a notebook.

Sonya: Absolutely.

Dylan: I mean, it’s just crazy and meanwhile, this fridge it’s in the corner of this infusion

suite, it’s got over 300 grand going in and out of it every week. So that’s one thing we’ve

seen as well is that you go into a physician practice and everybody’s so clinically focused

that they don’t focus enough on the business details and we like to say, you need to have

equal parts, clinical passion and business acumen. Otherwise it’s just not going to work.

Sonya: That’s right. That’s right.

Dylan: So it’s interesting to hear…

Sonya: Well people pay attention when they’re losing money, that’s when they start paying

attention. So that’s the part where we want to come in and help them with that and if we can

get them to really highlight some of their pain points, then we want to be a solution for them

and granted, we need the background information. We need the forecasting in order to help

them.

Dylan: That’s great and I’m sure you’ve got stories of practices you guys have come into and

help them get turned around and get back on their feet financially.

Sonya: Absolutely. I think initially part of our hiccups have been with new practices and

trying to convince offices that they will be profitable in the long run. The start-up takes some

time, once you get ramped up it will work out for the company.

Dylan: Yeah. And I think with that, I know with some physician practices, just to be straight

here, some of them don’t want to use a management company because they think, well, this

management company is going to take revenue.

Sonya: That’s right.

Dylan: I had a conversation with the doctor’s office last week and they’re really struggling

with some billing issues and they called us, they call We Infuse because we have a software

platform to help you manage your practice. I said, frankly, you need a management

company, you really do, because they’re going to do billing services, they’re going to take

away the risk of buying the drugs. They’re even going to help with staff, processes, people,

all this stuff that no software platform on earth can do and that’s what you need and this

particular physician still didn’t want that. But I tried to also let them know that when you work

with a company like you guys, a lot of times you will also build other revenue streams at the

offices and this particular office wasn’t doing any home infusion at all. So I tried to tell them,

if you work with a management company, whether it’s SouthSide or Helix, they’re all going to

try to add revenue streams.

Sonya: A hundred percent, it’s a partnership.

Dylan: And so that’s something that a lot of physicians either don’t know to do or are scared

to do. Maybe they’ve heard a story where it didn’t work out well or whatever, but it’s always

good. I mean a percentage of something is way better than nothing.

Sonya: Well, you’re going to lose it in the long run if you’re not managing it correctly

yourself, or I get the calls where the doctors wanted me to send a nurse because their nurse

didn’t show up and they’ve got 15 patients scheduled that day. You already lost money that

day. Your patients are only going to put up with that for so long. So with management

services, you can have another backup nurse they’re readily available, or your nurse can

actually take vacation and it doesn’t impact your revenue because we’ll supply another nurse

for you.

Dylan: That’s a great point. It’s just a level of safety there. That’s great. Well, tell me this with

everything that you’ve been through and I love learning about the infusion therapy space, but

I’m relatively new at it and always learning and I know that with your experience clinically

and with SouthSide, I’m sure you’ve seen a lot. What’s a big aha moment or a light bulb

moment where you’ve seen there’s something really important that people need to focus on

in in-office infusion?

Sonya: I think really for us, the light bulb moment is that there is money to be made and you

are helping patients that would prefer to be seen in-house. They would prefer not to go to an

oncology center to receive their treatment for Crohn’s or rheumatoid arthritis. They prefer to

be seen at the doctor’s office. So I think this, the fact that you can bring that service to them

in the doctor’s office has been a very much an aha moment for us.

Dylan: Why is it do you think for people that aren’t familiar with this space, why would the

patient prefer to do it versus at a hospital or in the home?

Sonya: I think when you’re going out to another location, there’s no personal service to you,

just random nursing, a bunch of patients, you’re a number, you’re not an actual patient.

You’re treated differently than the other patients, there may be a priority for the cancer

patients over your treatment. I just think there are some things to be said for doing it in a

doctor’s office versus going out.

Dylan: That’s a good point. I heard Brian Johnson mention the other day that when you have

a patient for infusion therapy, especially if they’re coming to the office, once every month or

two, they really kind of become like family. Because if they’re going to sit in that chair for an

hour, two hours, four hours, you get to know them pretty well.

Sonya: Absolutely. It’s no different than a woman going to the nail salon and knowing her

tech, they trust you. They trust you enough to start an IV, they trust you enough to actually

give them their treatment and to respond and know how to respond if they have a reaction.

So it’s very much a connection that you make with your patient.

Dylan: That’s a good point. Obviously it’s a clinical setting and they need to be there, but just

from a customer service standpoint, there’s no way a hospital or some kind of outpatient

infusion center where they don’t have that personal relationship. There’s no way anybody

would stay there. If they could go somewhere where they have relationships.

Sonya: Absolutely, we see it all the time.

Dylan: I’m sure. Well, tell me this with, I know you guys are growing, you mentioned some

numbers earlier, you guys are growing pretty quick. So what are you most excited about with

SouthSide right now?

Sonya: I think I’m most excited to expand outside of Texas. So, we’re definitely expanding

outside of Texas and for us, that’s a big goal that we had wanted to do and we’re actually

achieving that goal this year. So for us that’s really it.

Dylan: That’s great. Do you guys have any targets to focus on first?

Sonya: Minnesota will probably be our first one.

Dylan: Okay, great, catch up on some cold weather?

Sonya: Oh yeah. I’ve been down there a couple of times and it’s extremely cold.

Dylan: Yeah. It’s beautiful up there too.

Sonya: Oh, it’s amazing and great food, I have to tell you, it is amazing.

Dylan: Oh, okay. Yeah, that’s great.

Sonya: You’ll be down there, I’m sure when we get our stuff down there with you all.

Dylan: Oh yeah, absolutely. Be a good reason to get some good fishing in. Well I guess with

everything, I mean, there’s so much we could talk about, but we’re going to wrap it up. So

what’s one parting piece of advice for our listeners?

Sonya: It’s that homework, you really got to know your business. You’ve got to know your

insurances. You’ve got to know which ones, what plans you’re enrolled in and you’ve got to

know what the reimbursements could look like. You need to know what your medication mix

is like and like you said, you can’t have it on a piece of paper. You’ve got to keep tight

metrics and what your business looks like before you get involved in anything.

Dylan: That’s great advice. Well, I’m really glad that you took us up on the offer, we reached

out to you asking you to join the program. So thanks for making time for it and I know that

the listeners got a lot out of it because you guys have a lot to offer and with your experience,

it just brings a lot to the table. So thanks a lot.

Sonya: Thank you. Appreciate it.

Dylan: And for those of you that are listening and have not done so, be sure to check out

more podcast episodes on weinfuse.com and if you haven’t seen a demo of the software and

would like to see one, be sure to request a demo today, just head over to weinfuse.com to

get more valuable content on the infusion practice

Guest Speaker: Owner of Curbside Infusion Services, Sonia Alizzi, has over 20 years of experience in infusion administration. Prior to opening Curbside, Sonia worked as Director of Nursing, Director of Clinical Business Development, and Senior VP of Infusion at Southside Specialty Pharmacy.