Episode 19: Minimum Standards of Care and Patient Access. An Interview with Brian Nyquist, Executive Director of NICA

Transcript: Minimum Standards of Care & Patient Access with Brian Nyquist, Executive Director of NICA

Dylan McCabe: We Infuse podcast, episode number 19. Welcome to the We Infuse podcast, where we take the confusion out of infusion. And in this week’s episode, we’re going to be interviewing Brian Nyquist, the executive director of the NICA, who we have had on the show before, but we’ve got an update because the NICA, the National Infusion Center Association, has come out with some minimum standards for infusion centers and I got to tell you I’ve been in practices all across the US from California to New York and I have seen it all everything from a very small space for infusion with an uncomfortable chair and a pole with an IV bag to a nice plush setting in a standalone infusion center with lots of space in between big comfortable chairs and flat screen TVs and Wi Fi access. I mean, it just spans across the board from experiences that a patient can have in an infusion center. So Brian is going to get into how the NICA went out, went about coming up with minimum standards, what that process look like and how it’s going to change the landscape for infusion centers. and for patients. So I’m really excited for you to listen to this, especially if you’re one of those people that call us on a weekly basis that want to start an infusion practice. All right, let’s jump right in. All right. And like I said, we have a special guest on the show today, Mr. Brian Nyquist with the National Infusion Center Association. And we’re actually here. at the hotel for the first NICA national conference, which is really exciting. But Brian is going to share some stuff with us about standards of care, which is something we hear about a lot at we infuse. When we talk to people, especially they’re starting infusion centers and they say, what are the typical guidelines? And there’s just kind of a lot of gray area surrounding that. So, Brian, thanks for being on the show and kind of clearing the fog on all this.

Brian Nyquist: Yeah.

Dylan McCabe: Thanks.

Brian Nyquist: Thanks for having me on again.

Dylan McCabe: And so Brian, let’s just jump right into it. Give our listeners, I know we’ve had you on the show before, but a lot has happened since then. So give some of our listeners just a kind of a brief background on NICA and and then we’ll go into those standards of care.

Brian Nyquist: Yeah, absolutely. So National Infusion Center Association or NICA. Is a 501c3 which basically just means we’re tax exempt under that chapter of the tax revenue code. We’re formally organized as a public charity with the mission to improve patient access to provider administered intravenous and injectable medications through advocacy, education and resource development. We were formed to support patient’s access to a historically underrepresented segment of the infusion delivery channel. The non hospital, non oncology outpatient infusion facility. So the infusion center piece of our name was intended to capture all non hospital outpatient infusion sites of care model, essentially. So the historically and still today, there are two care models that really dominate the majority of the market share within this segment of the delivery channel, the specialty physician office based infusion suite and the freestanding dedicated infusion center. At NICA we refer to both of those models and any other non hospital outpatient infusion facility as quote unquote infusion center. So when we say, you know, we, we advocate for access to care in infusion centers, that’s essentially what we’re talking about. Any non hospital outpatient infusion facility. So from an advocacy perspective, we work to identify, address, and overcome access challenges, barriers to care, as well as threats to the sustainability of this care model before any of these factors become disruptive to patient’s care, so that infusion providers and their staff can do what they got into practice to do, right, care for patients. From a patient education perspective, we work to empower patients with the educational content they need to take a more active and collaborative role in managing their conditions, Which is particularly important in the case of autoimmune disease and complex chronic disease, difficult to treat disease in particular. And from a resource development perspective we develop resources like NICA’s Infusion Center Locator to facilitate patient integration into the market. by helping connect them with the most conveniently accessible and low cost care settings within their community. And we also develop resources and tools to help improve infusion providers capacity to care for patients, whether that’s help them understand how to operate more efficiently so they can treat more patients with their current infusion chair infrastructure. Or how understand the barriers to entering an adjacent state market, essentially, right? Stark law, corporate practice of medicine, can I use a physician oversight model? Do I, can I use NP oversight model? Et cetera. So, that’s who we are and that’s what we do.

Dylan McCabe: Yep, and you guys do a lot and we know we could talk for hours about all the things you guys do and you going up to Washington and talking to big players on the federal government side or pharmaceutical companies. I mean, I know you guys are really busy and your website is great because when I got jumped on board with, we infuse, I wanted to learn all I could about the infusion center and use your website and the resources and the education. So it’s great. And what I really am excited to learn more about today is Kind of what you just shared the context of before we got started with this whole, you know, standards of care So, can you just give our listeners that context that you gave me and kind of help us understand the need and how you saw The need for standards of care in the infusion center.

Brian Nyquist: Yeah, absolutely. So Last kind of piece of background. So so NICA was formed in 2010 and operated remotely kind of on a part time basis as needed by two of the founders until I came on board in summer of 2015, June, actually of 2015 I kind of dove right into the deep end started interfacing with infusion providers kind of key stakeholders within the industry started touring different infusion center models across different geographic markets. And I started to really notice. Significant disparity in infusion injection practice, but also quality of care across care settings and combined with, you know, the volatility of the reimbursement environment and increasing the pressurized atmosphere to shift from volume based care to value and all of these different market forces dynamics that are really working against sustainability of the model. I, I was, there was growing concern that a non stakeholder entity. Whether it was, you know, the Joint Commission or CMS or a, you know, ACHC, NQHC, any accreditation bodies or other sort of entities would recognize the fact that this delivery channel is under regulated to some extent. And want to come in and essentially force the delivery channel to fit into a box, right? So whether that could manifest in the form of a robust accreditation type of a process or just more of a standardization of practice or quality of care, et cetera. And that concern had kind of been growing significantly over the years, particularly with this sort of explosion in med spas and these hydration clinics that are establishing venous access and, you know, potentially mixing, possibly compounding some solutions and administering those to, to consumers essentially, typically on a cash basis. So there’s growing concern that, you know, if something, if there was an adverse event in one of those facilities or even in any of these facilities. Infusion clinics it could jeopardize the broader delivery channel. So I, a couple months in I started assembling our advisory committee. And so I started sort of reaching out to key stakeholders within the infusion delivery channel and brought a bunch of organizations together to really build a diverse sample of the delivery channel. And the first goal of that adcom was to establish standards of care, standards of practice for in office infusion and injection. So we’ve been working on that since the end of 2015 we were. We started kind of looking at the top. So what would the ceiling look like? What what would standards of excellence look like, so to speak? And so that was obviously a long process, right? And about mid last year actually it was early 2018. I believe New Hampshire State Board of Pharmacy was trying to enforce USP 797 pharmacy guidelines in non pharmacy care settings, right, going around to infusion facilities and saying, hey, what you’re doing, you’re reconstituting lyophilized drug is tech, you know, quote unquote compounding. Subject to USP 797 guidelines, you need to do those preparations in ISO 5 conditions, whether that’s a pharmacy, clean room, a compounding facility, or a sterile glove box, essentially. And so, you know, NICA dove in and kind of worked to combat that issue and contain it, make sure that it didn’t, A, implement in New Hampshire and then potentially metastasize across the country. So we wound up having to update the state statutory definition of compounding to explicitly exclude these non compounding preparations, right, essentially reconstituting lyophilized product to create the FDA approved drug, right? We’re not talking about combining different active ingredients, combining multiple drugs, right? Not talking about that. Anyhow, sorry, getting away from myself a little bit. So that instance really, emphasize the need to expedite and finalize development of these standards. So at that point I, I shifted focus of the standards conversation to instead of establishing what does that ceiling look like to defining what that floor actually needs to look like. So we, we then shifted those conversations to start identifying what that minimum threshold is for in office infusion injection practice, but then also from a quality of care perspective. And so happy to announce that we’ve finally finalized and released version one of the first edition of those minimum standards. So they’re available on our website. We’re going to be, you know, announcing it in our meeting this weekend. So, very excited.

Dylan McCabe: That is exciting. And that’s a really neat story. And I know from visiting infusion practices all around the U. S., mostly provider offices, but also standalone infusion suites infusion centers, I have seen the broad spectrum from going into an office where it’s a little chair and connected to the break room where you’ve got like crumbs of cupcakes and stuff on the break room table because it was somebody’s birthday and then you’ve got a chair in the corner with a pole that looks like it’s 30 years old with an IV bag attached to it. And that’s the infusion chair. I’ve seen that. And then I’ve also seen a beautiful infusion center where you walk in and there’s, you know, five feet in between each chair and the chairs are these big, nice, Comfortable chairs and there’s flat screen TVs and it feels like you’re walking almost into a resort or a spa And the people have blankets on and internet access and it’s really like a dream setting for somebody that needs to sit in an infusion Chair for four or six hours or an hour, however long So it’s amazing that there hasn’t been any standards of care up until this point and you guys saw the need and jumped on It and so as you went through that, how did you go through that process of knowing what to do? I mean, it’s not like you can say I Okay, as a standard of care, they must have this specific leather chair that’s so comfortable. I mean, how do you go about making those guidelines?

Brian Nyquist: Yeah, it’s a difficult process because what we didn’t want to do was inadvertently restrict access to care, right? We didn’t want to inadvertently restrict good acting infusion facilities and operations ability to treat patients. So it was a long process. A lot of conversations, a lot of back and forth started pulling in some outside stakeholders as well to sort of supplement the expertise on on the adcom to kind of answer some of those questions. And we had kind of had to start in certain areas, right? Focus on specific areas, right? Okay. Preparation. What is, what does everybody feel needs to be? you know, the minimum in terms of preparing these drugs. And so throughout that conversation, right, we obviously identify a number of different aspects of that process that we could and arguably should standardize in some sense. And then, you know, at some point, the conversation needs to shift to, okay, Is this a minimum threshold or is this more of a is this a need to have, or is this a nice to have, right? Is this a minimum standard or is this a broader standard of excellence? And so then that was kind of the finalization process within each of those subcategories. And and then eventually we, you know, finally got to a point to where we felt comfortable with. What that floor essentially looked like, and we think it’s a it’s we think it’s a solid start for defining that minimum threshold. And so we’re relying on the rest of the delivery channel to give us some feedback. Let us know. Are any of these problematic? Are there any other aspects of. Of the preparation or administration process, any aspect of quality of care practice of infusion injection therapy services any aspect of the patient experience that we really need to try and standardize at a minimum. We’re relying on stakeholders for that feedback to shape subsequent additions of these minimum standards. And these were built essentially to reduce those disparities in quality of care and practice to make sure that consumers, patients, right, can rely on safe, consistent, high quality infusion and injection preparations, irrespective of what access point they have available within their particular market. So we’re It’s in everybody’s best interest to, to kind of engage with us and work to make sure that these standards are applicable, that they’re appropriate they’re not overly burdensome, that we’re not inadvertently restricting access to care among certain care models and that, right, we’ve got a solid foundation upon which we can really drive and define what excellence looks like, right, in terms of outpatient fusion injection therapy.

Dylan McCabe: That’s so good. And that should be the goal, right? I mean, we’re treating patients with life changing drugs. Yeah,

Brian Nyquist: you’re putting drug into their veins. Once that happens, It’s impossible to, to undo it. Right? So if there is an adverse event, an adverse reaction you can’t just undo it. You have to manage that reaction essentially. So it’s absolutely critical that we standardize practice And quality of care, at least at that minimum threshold.

Dylan McCabe: So good. Well, then let’s, so let’s jump into what are, what is the list of what are the list of rules or guidelines you guys put in place?

Brian Nyquist: Yeah. We knew that it’s not overly robust. So this document as it stands is, I think about 12, 12 pages or so. Let’s see. So, a big piece of it is just making sure that facilities have a institutional policy or procedure and at minimum these areas, right? And just for example some of those areas are preparation administration of IV injectable medications describing at a minimum and then we’ve got six criteria. Assessing, documenting, education, clinical competency among personnel performing these preparation administration activities. We’ve got some sub criteria there as well. Having a policy for patient education. And defining what criteria should be included in that education program at a minimum. We’ve got a piece talking about observation of patients undergoing infusion therapy. Clinician to patient ratios, medication storage, handling, and disposal. Labeling prepared medications see other pieces documentation, right? Documenting when these medications are administered in compliance with the principles of documentation. And then we’ve got some criteria as well as to what the, those, the documentation needs to, need to include it at a minimum. Some of the other Aspects that were standardizing with this document. Let’s see informed consent. We touch on patient assessments, vitals that need to be collected as a baseline. And then at various time points. Again, we have another piece on that observation piece. We dive really deep into preparation. And this right, as I kind of alluded to the, with the USB 797 piece to really provide a clear distinction between compounding preparations. That would fall under a state board of pharmacies jurisdiction and oversight and then preparations that wouldn’t that would fall outside of that Jurisdiction.

Dylan McCabe: so for some for our listeners that may not have never heard the phrase usp 797 and then those two different kinds of preparation break that down so that they so There’s no confusion over that and why is that such an important area?

Brian Nyquist: Yeah So usp Is the united states pharmacopoeia convention? So it’s a non profit organization essentially that was formed by pharmacists and they’re, they produce guidance essentially. One of the chapters their general chapter 797 refers to compounding sterile products or CSPs that they refer to. And so they have a whole chapter, incredibly robust chapter, hundreds of pages. It’s all about compounding these sterile products, essentially and the conditions under which those products need to be prepared, et cetera. All these different pieces, you know, storage, all the, all these different pieces. And some state boards of pharmacy have tried to sort of extend the scope of their jurisdiction into these nonclinical settings. By claiming that, you know, reconstituting drug, and in some cases, right, puncturing a saline bag is compounding, which is nonsense, absolute nonsense. And so we, I thought it was absolutely important for us to really build in a clear distinction between compounding, And non compounding preparation, essentially because that distinction doesn’t exist anywhere. The only sort of literature that we could reference in, in those battles was FDA’s definition of compounding. And there was a clear discrepancy between, at the FDA’s definition of compounding. and what it did not include. And then USP’s outdated definition from their old chapter 797 and their definition of compounding, which has been updated of the new chapter that was released June 1st of this year. And that definition does now bring the new definition aligns better with the FDA’s definition, which is great. And so we, I actually postponed release of these standards so that. I could see the new definition and make sure that these standards didn’t conflict with that definition and that there was some alignment there. Obviously we didn’t want to introduce some conflict there where there was already conflict. Yeah. And so what is,

Dylan McCabe: and so bringing a standard of care in that area of preparation, what does that mean for the physician’s office that has an infusion suite or for the standalone infusion center? Ask that again. Sorry. What is it, I guess, how does that apply to, you know, the physician office that has an infusion suite with a few chairs or a standalone infusion center? Now that you guys are going to push for this standard of care and keep the two types of preparation separate, how does that apply to them?

Brian Nyquist: Well, from an infrastructure perspective could potentially negate the need for them to. retrofit their facility to incorporate a sterile pharmacy clean room, right, in which they would have to prepare these medications or incorporate a sterile glove box in which they would prepare these medications. There, there are a number of aspects where I think it’s beneficial. That’s probably the main one. Other than that, we’re seeing a shift Potential shift within the commercial insurance landscape. I’ve been hearing reports of commercial insurers reaching out to infusion facilities and inquiring into whether or not they are accredited. And what accreditation processes are out there that could be applicable, et cetera. One of our adcom organizations actually is having to navigate an accreditation process right now to just maintain their contract with a payer, essentially, just to be able to get reimbursed for drug administered to their beneficiaries. And so that was another piece, what kind of expediting. The finalization and release of these standards and then NICA is going to now be working to drive these minimum standards among payers among CMS as well, and try to incorporate this deeply into the regulatory landscape, essentially we’ve been working with state boards of nursing in a number of states. I’ve been corresponding with every state board of nursing across the country as well as that represents U. S. territories and they’ve been hungry for something like this because they don’t have the teeth to go into these facilities, right? For example, med spas, hydration clinics, et cetera to really regulate the, what’s going on there because, you know, In many cases, they’re the individuals preparing and administering these drugs aren’t nurses. So boards of state boards of nursing don’t have jurisdiction or oversight over those individuals, and they don’t have any oversight over the facility level. So, so I think that’s another benefit. If we’re able to get these standards incorporated into that sort of accreditation, quote unquote workflow within commercial insurance companies. I think that would be a huge win. It’s it’s. infinitely less robust and administratively burdensome than The current accreditation processes that are available out there. It’s more applicable. It was developed by infusion providers and nurses for infusion providers and nurses. And yeah, I think it would serve a solid platform, particularly if we’re able to build out or not if, but when we’re able to build out that broader standards of excellence and potentially build out a standards program through which we can essentially offer some sort of credentialing of at the facility level to. Provide a mechanism that this facility can demonstrate that, hey, not only have I met the minimum standards, but I’ve strived to, to exceed those and now achieve these standards of excellence. So I think it makes sense for us to provide a mechanism through which we can distinguish those facilities against others that haven’t met those standards of excellence. And if we’re able to get to that point and get insurance companies to accept That credential essentially to satisfy their perceived requirements for an accreditation. That would be an enormous win for the delivery channel.

Dylan McCabe: Yeah. You guys are really raising the bar in a good way, but not raising it too high. And you’re also ensuring there’s consistency and safety across sites across the U S and I, the thing that comes to my mind is, I mean, I know it’s a silly analogy, but you know, if you go to, Like a famous restaurant chain, you can ensure that you have the same experience in New York as you do in Texas or wherever. And you guys are kind of bringing about uniformity in a clinical setting to make sure a patient can have a safe, consistent experience in one site and in one state and in another state and make sure everybody’s on the same page when it comes to best practices. And that’s so good. I mean, this is done in every single other business line in the world. You know, So it’s interesting, you know, you think, I mean, it’s kind of a light bulb moment that you had to bring this about. And it’s kind of strange that nobody had a light bulb moment like this before, but you guys seem to be really at the tip of the spear with a lot of new. New things that you’re pushing forward to, to just raise the bar for everybody.

Brian Nyquist: So on that piece, I would say I was certainly not the first to come up with it. There are at least two other organizations that have standards within the infusion delivery channel. But NICA standards really focused on, on meeting an unmet, an area of unmet need. So for example, infusion nurses society, INS has their standards. And that was really focused on kind of hospital based infusion sort of oncology focused. IGNS, the immunoglobulin nurses society also has standards that’s explicitly and specifically focused on administration of IVIG and different immunoglobulin products, sub Q as well as IV. NICA standards really focus on non hospital, non hazardous drugs. In an outpatient setting primarily biologics which has been sort of an area underrepresented from a standards perspective. So, not the first, I certainly can’t take credit and wouldn’t want to take credit for being the first to identify that need. But we, we definitely identified an unmet need in that regard. And we work to fill that before, an outside organization that doesn’t understand the characteristics, complexities, dynamics of the delivery channel the challenges in managing, you know, patients with complex, chronic like diseases like autoimmune diseases are difficult to treat potentially life threatening diseases, et cetera. And so we thought it was critically important to come in, fill that need and provide that minimum threshold from a standards perspective, to make sure that as to your point, consumers can rely on. Safe, consistent, high quality infusion injection preparations, irrespective of what access point is available within their particular market.

Dylan McCabe: Yeah, and the patient’s probably thinking that’s what they get when they go to a physician’s office anyway. They’re probably thinking somebody is definitely exercising oversight to make sure I’m safe. And I’m going through a great process. Yeah, from a consumer

Brian Nyquist: perspective, right, that’s what we’re used to in other industries.

Dylan McCabe: Right, but they’re not behind the scenes like we are in so many of these offices. And, you know, we see the broad spectrum of differences from Correct. You know, I mean, there’s some doctor’s offices, frankly, I, of course, I have the freedom to say this, that I wouldn’t want to go into. After seeing what it looks like in the back of the office and, you know, drugs being prepared next to a sink with a bowl of oatmeal in it. I mean, I would hope that if I’m going to go in there, I’m going to get better treatment from the nurses and the staff and the doctor. And I’m not trying to throw anybody under the bus, but I think people are so busy and there is an opportunity and there’s not a standard of care specifically for the infusion suite with biologics in an outpatient setting. And so it’s great that you guys are doing this and, you know, ensuring again, everybody has a consistent, safe process.

Brian Nyquist: Yeah, and that was exactly the point, right? So when we started, that was the goal was to reduce those disparities within those office based infusion and injection clinics, right? Those clinical facilities with the explosion in the number of these med spas, hydration clinics. The focus is kind of shifted a little bit to making sure that consumers can get safe, high quality, consistent care or treatment, so to speak services really in those settings as well. Because there’s huge concern, enormous concern that it was a matter of time before somebody who didn’t really understand what they were doing. You know, administered a product to a patient or a consumer rather that was contaminated because of poor practices in preparing or storing, et cetera. Adverse event, God forbid somebody, somebody died. And then, you know, regulators come in and say, Whoa, this is a really big issue. State boards of pharmacy come in and say, see, we, you know, we’ve been trying to tell you guys all of these products need to be in, you know, prepared in a compounding facility, et cetera. I mean, I’m still hearing stories. One of our, one of our board members was in a med spa the other day and noticed that they were drawing their flush syringes from a saline bag and then turn around and use that saline bag for a medication for somebody. They’re preparing medications and storing them, in some cases for a week before it was administered to a patient, which is terrifying. And the worst practice. Exactly the type of practices that we’re trying to eliminate with these minimum standards to make sure that Those practices aren’t happening, the consumers and patients are not being put at risk when they’re coming in to receive treatment, right? Consumers don’t know anything. Particularly those that are walking into these infusion clinics, hydration clinics, hydration stations, right? Hangover clinics, whatever. Variety of business models that that are kind of popping up, but that’s where we’re at

Dylan McCabe: and that’s we get calls every week from people starting vitamin infusion clinics or hydration businesses from across the U S I mean, multiple calls a week from people who typically don’t know what they’re doing. They don’t know about the business model at all. They don’t know about the clinical side. All they’ve heard is Hey, I have a friend in Nevada who started this hydration business and they are just printing money. Yeah. And it’s cash. We don’t want to go. Yeah. We want to go set up next to concert venues and just. give hydration infusions all night long for a hundred bucks a pop, you know, and I’m thinking, man, you got, and they don’t know what to do and they don’t know where to start. And so it’s, again, it’s just so great that you guys are doing this to make sure people get safe, consistent care, great experience when they go to get what they need.

Brian Nyquist: Yeah, I think those facilities are providing value, right? They’re

Dylan McCabe: Sure.

Brian Nyquist: We just want to make sure that they’re providing at least a minimum standard of care and practice to make sure that all consumers are safe.

Dylan McCabe: And so good. And so just for the sake of time, I mean, we could go on and of course, I always learn a ton from you every time we give me an opportunity to talk. So, so there’s so many more questions I want to ask but we do, I want to try to make this that’s where it’s not too long. Maybe we might have to do part two after the NICA event, but man, thank you so much for being on the show again. And again if anybody wants to learn more about this, they can go to the website, right?

Brian Nyquist: Yeah. Yep. They can go to our website. Navigate to it. We’ll be hard launching after NICA 2019. So next week we’ll kind of hard launch and announce it and kind of where to find it on our website, but folks can go to our website and they can download it right now start sharing it, start looking over it, work, start to incorporate into their infusion injection workflow. Start giving us feedback, right? Where are there areas that we missed? Are there areas we need to look at? Did we go a little too heavy in certain areas? All things that we need to know. So this is the first edition. I’m excited to hear how the delivery channel receives it and how well it’s received, what they think about it. Can’t wait to hear that feedback. I think we’re going to be getting a lot here this weekend at NICA 2019. I’m excited.

Dylan McCabe: Definitely. I don’t know about you

Brian Nyquist: guys.

Dylan McCabe: Yeah, this is the, I’m most excited about this conference. I mean, we go to conferences every month. It’s turned

Brian Nyquist: into a little, something a little bigger than we had anticipated. It started as a, just an idea to, you know, try to bring 50 people together to talk about infusion access has evolved into to what we’re looking forward to this weekend. Right? We got Well over 500 people showing up to, to talk about challenges, issues, et cetera. What we need to do to preserve, optimize, and expand access to high quality, consistent, safe infusion injection care.

Dylan McCabe: Promises to be a great event sold out very quickly. I mean, we were even in the last week leading up to the event, had a lot of people reach out to us at we infused to say, Hey, we want to come to the NICA conference. You know, do you know if you can get us like a special pass or can you pull any strings? Like, Hey, sorry, we infuse a Nike or two separate organizations. I’m going to the event just like you are. And sorry, it’s sold out. So, and it’s great that you guys are already planning for next year.

Brian Nyquist: Yeah. So we were fortunate enough to be able to keep scaling up. Thankfully, the venue was able to accommodate us in that regard, but there’s obviously a limit, always a limit. And we have, we hit that limit. So we, we weren’t able to accommodate anybody else. We have literally maxed capacity in every one of the session rooms. In the exhibit hall in the Brazos room where we’re doing the keynote lunch in it’s, it was, there was overwhelming response. A lot of people apparently were excited to come and it’s turned into kind of a premier networking event for anything medical benefit, drug landscape related. So we got most of the major manufacturers with an asset in the medical benefit, drug landscape that are here. All the major national wholesaler distributors are going to be here. Some of the biggest infusion providers across specialties. That represent markets across the country. We got folks from Puerto Rico that are coming. It’s exciting. So again, give me the opportunity. I’ll talk for days.

Dylan McCabe: Well, thanks again. And for those of you listening, if you want to connect with Brian Nyquist, you can find him on LinkedIn. You can also check out their website. It’s infusioncenter. org, right? Correct. Infusioncenter. org. You can check out all the great resources they have there and find these standards of care as well. So, much more to go from there, but again, check out their website and be sure to connect with Brian to learn more. And Brian, thanks so much for being on the show. Thanks for having me again, Dylan. Always a pleasure. Alright, that wraps up my interview with Brian Nyquist. Be sure to check out their website infusioncenter.org and if you are in an infusion practice today, be sure to check out our website, check out our blog, and request a demo of our software. We will schedule a discovery call with you to learn about your specific workflow and really give kind of a detailed analysis of strengths, weaknesses, opportunity, and threat analysis. Of what your workflow looks like today and how we can possibly improve it. Just go on over to WeInfuse. com and request a demo on our website today. Thanks for joining us. This is Dylan McCabe with the WeInfuse podcast and I will catch you in the next episode.

Guest Speaker: Brian Nyquist, MPH is the Executive Director at the Infusion Nurses Society (INS), and CEO at the National Infusion Center Association (NICA). He works to ensure the safety and efficiency of the community-based infusion center, and emphasizes the value of these cost-effective alternatives to hospital care. Prior to joining NICA, Brian was a Policy Analyst for the Texas House Committee on Public Health.