Aaron Smith and Callie Turk, Co-Founders of FlexCare Infusion Center in Oklahoma City, OK, share their journey starting a stand-alone infusion center together. Both Aaron and Callie share a passion for creating innovative infusion clinics that are more effective, less expensive, easier for physicians and overall better for patients. FlexCare opened its doors to patients in Oklahoma in June 2019. To learn more about FlexCare Infusion Center, visit www.flexcareinfusion.com.

WeInfuse podcast

Transcript: Starting an infusion center: An interview with Aaron and Callie from FlexCare Infusion Center

Dylan McCabe: WeInfuse Podcast episode number 21. Welcome to the WeInfuse Podcast, my name is Dylan McCabe and in each episode, we give you a behind the scenes look at the infusion practice and the interview industry experts, CEOs, nurse practitioners, and all types of people down in the trenches, in the infusion practice and in this particular episode, we’re going to interview Aaron Smith and Callie Turk, who started a standalone infusion center in Oklahoma City. This is definitely the longest episode we’ve ever recorded, but the key to this episode is we’re going to get down into the details of what it’s really like to start an infusion center, some of the pain points with drug formulary, payer contracting referral-based, stuff like that, we’re really going to get into it. So if you want to start an infusion center, or if you’re having some bumpy processes going on right now in your current infusion center, this episode is for you, let’s dive right into it. Okay. Like I said, we have a special interview here with Aaron Smith and Callie Turk. So guys, thanks for being on the show.

Callie Turk: Thank you for having us.

Aaron Smith: Thanks for inviting us.

Dylan McCabe: Now Aaron and Callie are the Co-founders of FlexCare Infusion Center in Oklahoma City, right?

Aaron Smith: That’s correct.

Callie Turk: Correct.

Dylan McCabe: And this is a standalone multi-specialty infusion center?

Callie Turk: Yes, it is.

Dylan McCabe: Right. And so Aaron is the acting CEO/Sales and Marketing of the organization and Callie is kind of internal operations?

Callie Turk: Correct.

Aaron Smith: That’s correct.

Dylan McCabe: Okay, good deal.

Aaron Smith: And anything else, including taking out the trash or whatever.

Dylan McCabe: That’s the life of the entrepreneur; well for those listening and we have listeners across the board from private equity guys to physicians, to nurse practitioners, to just people across the infusion landscape. So tell everybody, I guess, just kind of a little bit about your background and what got you into this space in the first place.

Aaron Smith: Okay. I’ll start; we’ll start with the broad knowledge and then go to the skill area. I’ve been in healthcare and healthcare management for about 20 years. I originally started in the diabetes and diabetes education area through software, a partner and I had opened up a software company that we choose to manage those facilities and through that company we were eventually acquired by Health Waves, which was a population health company, but they had a healthcare market that had about 150 hospital systems, including the ambulatory education centers that they used our software for and stayed with them for about five years and then actually followed the market leader, there Health Waves followed her from Health Waves over to Optum and Optum with infusion rehab. Anyway, it was through that move to Optum slash Briova that I got sight of the infusion, the specialty infusion area and the prior 12 years or 13 years, sometimes when I’m being a little bit glum, I think back about the technology and the workflows and the running of the clinics and it was hard to, especially once we got into population health where the focus became much more around keeping a healthy and it became a hard to understand the, how the effort placed into all of the systems really at the end of the day did much good. When I moved over to Optum and at Optum was working there with their innovations group and over their innovations group in a couple of key areas, one was measuring the outcomes of these medications and then the other had to do with optimizing the physician field. They had a rather large group of nurses across the country that they were doing it with. It was in the work of measuring the outcomes that I realized the sort of unfound diamonds of these specialty medications. They didn’t work for everybody as our outcomes indicated, but for those that they worked for, they were life changing without question life altering from people who would no longer be able to participate and be able to participate in life activities because of symptoms that just frankly kept them away to people who were disabled to the point that they couldn’t and seen how some of these medications have the ability to stop the progression and in some cases reverse it so that these people can continue to lead their lives. It was amazing. It was certainly a lot more fulfilling than then knowing that you had a program out there to keep 3000 employees from smoking and three participated for two months. So it was a very exciting time whenever I moved over there and that’s also where I met Callie and Callie was working with me on the outcomes collection. It was over that time as we went through I was, not going to lie I was getting the edge to figure out a way to go back out on my own again, because while you can help people in a 200,000 person organization, you’re a lot closer to the people that you can help whenever you’re in an organization with five or six. So I was getting the edge anyway and was looking very closely at the technology space and began to understand that there really, even without the technology, just in the pure operational side, there was not only an opportunity, it was really a market need and some of the markets for these infusion centers because there were patients who were struggling to get access to some of the drugs, because there weren’t enough of the centers available that could serve, specifically the Medicare and Medicaid market, but also some commercial markets, especially for the higher risk drugs. So as I had left Optum and was scratching around for the technology space that I really uncovered the opportunity with these infusion centers and so began putting together the plan and raising the funds to get it done. It was that piece that brought me into it, the piece of not only being a viable business, but a viable business where it seems to have profound opportunity to make a difference.

Dylan McCabe: That’s great and Callie, how about you, what’s been your background at this point and how did you agree to all of this with Aaron?

Callie Turk: I’m a gambler.

Dylan McCabe: Persistent, yeah, very, very, very persistent.

Callie Turk: Well, I’m a nurse by background, so I’ve actually been in the specialty pharmacy space for 10 years. I was a PRN infusion nurse for one of the specialty pharmacies. So I went out into the home and did infusions and then I quickly started coming in and doing more operational stuff. So I had kind of the field experience and then also kind of the operational experience. So for the past 10 years I’ve been in specialty pharmacy, which is a little bit different, but we did have infusion suites and infusion centers that I helped stand up that were linked to specialty pharmacy. So I had that background, our model, it’s basically a physician group that is a little bit different than when you’re attached to a specialty pharmacy. But like Aaron mentioned, we worked on outcomes together and really for the specialty drugs, trying to expand into other specialty drugs as well. But that process in a very large company is daunting and trying to get those approved. So that’s really when Aaron talked to me about it and I thought, why not? That’d be awesome, it’s a good experience and I love doing it. That’s kind of really how it started. I mean, it’s pretty simple. I said yes, pretty quickly, right?

Aaron Smith: Yeah. She has not admitted to regretting that decision more than 10 or 15 times in the last six months.

Dylan McCabe: Well, that’s interesting. So coming from a background where you had infusion centers that were pharmacy based, what would you say has been the biggest difference for you going from the pharmacy based model to a physician based model? The reason I’m asking that is because I run into sometimes specialty pharmacies that have a higher volume of infusion patients and we get into conversations of the difference in your formulary, your drug cost, reimbursement, your payer mix and all this stuff and there’s just a lot of unknowns out there for a pharmacy based infusion center. What would you say to that?

Callie Turk: For me? I think it’s been regulatory. So a lot of my background has been compliance and the regulatory touches everything. It touches pharmacy, drugs, storage, clinical, I mean, it touches everything, but there’s no accreditation like a physician group standalone office versus in specialty pharmacy there are so many regulations. So that actually is easier from my standpoint coming into this situation. But also at the same time, I thought there has to be more, there must be more to it and I think it was just digging and trying to find what is it that we need to do from a regulatory standpoint in terms of, I know the pair contracts has been and I never wasn’t involved from a start-up perspective with the specialty pharmacy, so everything was already in place. So that definitely is something that’s a little bit different, obviously going under Medicare part B versus part D and that’s still kind of a learning curve that I think I’m approaching, but I know that’s a big one. I’m trying to think of other things that, I think the model also having nurse practitioners obviously because we can do part B is very beneficial because I think you reached the Medicare Medicaid population versus all of the specialty pharmacies that had infusion centers that I worked with and we couldn’t take those patients. We could take them if we couldn’t find anybody else to take them, we could take them, but we wouldn’t get paid for the nursing, we basically eat those costs. So I guess those would be kind of the top three that I think of right away. I also think that when you have pharmacy and nursing services, so you’ve got your specialty pharmacy and you’ve got your infusion services, there’s a little bit of a disconnect. There’s always this path of communication that the more people that you have to go through to communicate something there’s always a chance for error or something that isn’t communicated correctly. So I like the fact that it’s more all in house with us versus having to; and obviously we can go to a specialty pharmacy and get drugs for certain therapies that we may not do at the standalone clinic. But I think in general, I found that this was much easier in terms of communication and having it be all in house to where we’re all talking together, we don’t have to go through the specialty pharmacy and pharmacists speak a different language than the clinical team or nursing team. So which is good and bad. I think it’s good to have their feedback too. But I think with the advanced practitioner model, it is a lot easier to kind of get all of that just keeping it in house kind of a consistent, efficient, succinct.

Dylan McCabe: Yeah. Those are some good points and so that kind of leads me to ask what is the difference, I guess, with you guys, you’ve got FlexCare, you’re just getting started here and it’s been a process to get here and you’ve had your grand opening, you’re live, you’re seeing patients tell people about FlexCare, I mean, what is it like to have a standalone infusion center and specifically in your market what makes FlexCare a little different?

Aaron Smith: Well, so we didn’t choose. Oklahoma City was chosen based off of events, access to care and the availability of these centers. It was definitely an area that we thought not only we could go into and provide additional access to care, but it also was an area that we felt like we could go in there and maybe move the market as far as to quality of care as well and so by selecting Oklahoma City we went through and we had done our analytics as far as the actual providers where Oklahoma City was setting the at five peer practices per million people versus other places like Dallas and Houston, where they’re setting up around nine. So there definitely was a market need there. The second, but it’s not just about going into a place with the market need, it’s also going into a place knowing that we can help and we’re actually very confident given our background that we can go in there for a few things. First off, somehow for a guy who started out again in diabetes 20 years ago, I now have more family members with autoimmune disease and on biologics than I have on diabetes medications or managing their diabetes. This is a market that I’m not sure it’s growing because I think the need has been there, but I think it’s being uncovered and I think it’s being uncovered quickly and without fail the three people in my family who have had to have either struggled with access, or they’ve struggled with the quality of place that they’re in, there are lots and lots of opportunities to provide a good product. So the first part is just from the perspective of technology, making sure that we have the information that we’ve made, providing us with the information very easily, and that we are responsive back to the physicians that are referring to us. So they know what’s going on with their patient. If we’re able to serve them, then they’re confident that we’re serving them. If for any reason that we’re not, or if there are any adverse reactions or anything that’s going on, they know that they can count on any referral that comes to us, it isn’t going into a black hole. A lot of that is, it’s funny how in this industry, the topics may change, but the problems may stay the same. That is exactly what our technology was put into place to do 20 years ago for diabetes education centers for these ambulatory clinics. It’s a known problem whenever your physician doesn’t like referring to people who don’t tell you what’s going on and that’s you send the patient home. So the real first differentiator is this is a problem. This was a problem that I know how to solve and very confident on solving and WeInfuse to his credit, makes it a very easy problem for us to stay on top of. The second thing is being a family member of several people who are in it, I’ve got a real passion for figuring out how to make sure that while these people, while these patients, while my family members or other people who I know, or God forbid me or my children someday are sitting in these centers, that it’s not just a medication that they’re going there to get better and remain hopeful about, but it’s also a place that they don’t mind going. In healthcare, especially as we have the opportunity to make it more patient centered. I think one of the things that we have to remember is that patient center doesn’t always mean more medication or trickier therapies or advanced technologies. Sometimes it just means remembering that that’s a patient who is a human, who is probably scared, who is going through something that is complicating their entire life and putting them in a position where you can help them without making any of those other things worse. What do I mean by that? Give them something to pass their time, through entertainment so they don’t hate it. Don’t send them to places where they’re worried about their privacy as they’re having to answer some somewhat invasive assessments on how they’re doing between each of these things. It’s just easy to make them comfortable. If you think of them as a patient who should be comfortable while they’re receiving their therapy, which goes on for three eight hours. So that one’s a big trying to figure out how to make it a comfortable place, where they feel that they can talk freely and privately without being concerned and they can choose to talk or not talk based off of how they feel that day. That’s pretty important to me and then the other part is just the access. I want to, given my background, my experience with technology and with data I want to be closer to where the problems of access are taking place, because I think it not only as a fixable problem through technology and process, but I think it’s an important one to fix because right now patients are being denied care because of problems in that area.

Callie Turk: And don’t know their resources and don’t have help with an advocate to help them navigate that. I mean, there are so many different resources out there that patients don’t even know about, and it’s almost exhausting for them to go look for it, because then they’re like, what do I do? So one of our goals is to make that part of our process that we can take on for the patient. We’ve already kind of looked at resources, kind of gathered all of that, so that we can kind of spearhead that for the patient. We may not be able to do it all at the time, but that’s something we’d like to build upon just to take that burden off the patient. It may not be doable 100% of the time, but I feel like you can always give them and do the research for them. Not necessarily like here’s a number, call them, call for them. You know what I mean, make it easier for them to kind of navigate for them and say, this is what we found. At some point they have to call and reach out right, potentially, or we can connect them. But I think that’s a huge one too.

Aaron Smith: But the key is it’s complicated for us and I am no expert in this industry, but I’ve been all over the place in healthcare, technology, workflows, management and technology and it is amazingly complicated. Callie has been in this specific industry for 10 years, 12 years, and there’s not a week that goes by where she doesn’t talk about something that is exasperatingly complicated in the process, and we’re the experts. You leave a patient in charge of gathering all this information and putting them in charge of getting that approval and you’re rolling the dice on who you referred to, and they’re rolling the dice on whether they get somebody who provides them with the correct information or not.

Dylan McCabe: It is, I was talking with, speaking to the complexity of that model, I was talking with a healthcare organization just this morning that I think they own 70 hospitals across the US and they’re going to start building standalone infusion centers, outpatient infusion centers, but they don’t know that model, that business model and this specific workflow. So they’re going to engage us for consulting on that and they’re mostly in the Northeast, but even though they’ve been in the healthcare space, even with hospitals and stuff like that they know that they don’t know this model and we’ve talked with them enough to where they’ve said, hey, look, we know that the patient is going to have to go through a whole lot of steps, what we call our pre-treatment workflow of getting an authorization, getting an order for an infusion, how many treatments, what frequency for how long and then we have to talk to the payer about what all is covered is a special pharmacy required as a referral required. Is there a plan waiting period for it, is there coverage for this particular diagnosis, all these different things and then checking up on the dates and faxing things off to the payer and sending labs and a letter of medical necessity doing all that stuff. Then you get the patients scheduled and you have to make sure you don’t schedule them before the authorization approval date or whatever. Then the nurse charts and has to record inventory and infusion times, it is a very challenging model, which obviously is what WeInfuse is designed to do is dramatically simplify that model but I like what you said, because you mentioned that it’s scary for two people. It’s scary for the patient and it’s scary for the business owner, but for the patient, I think it’s so intimidating because you want to make sure you’re covered and then you have to go to a different setting to get your therapy and you have to get an infusion and that’s why I like what the NICA does with their website infusioncenter.org and they even have a page that’s dedicated to what a patient should consider before they get an infusion. I like how they do that, but it sounds like you guys are really trying to be patient focused and even take an extra step to help them a lot, which you don’t really hear about too much, unless it’s a specialty pharmacy, which is probably where you’re bringing that perspective to it.

Callie Turk: Yeah. I’ve worked for one specialty pharmacy that provided a lot of support and that’s really, I mean, that was actually one of Aaron’s big goals was to have an advocacy program and mine as well. But I think in general, if you think about the average patient who’s sick, who has to be seen for therapy, who has a full time job, they don’t have the time to, and as a patient myself, you can’t call after work at five o’clock places are closed. So when are they supposed to do that?

Aaron Smith: Or if you call them during the day, you leave a message and then they call back but if you’re on the phone you can’t take the call.

Callie Turk: So that’s, I mean, we have the time and the opportunity to do that and we can kind of build around that model too, of providing that care and staff to that.

Aaron Smith: And if we get an unexpected no anywhere along the way we have the experience and the background and the context to understand that that’s correct. Where when a patient or a patient advocate, a family member care support, when you get a no it’s the most infuriating and hopeless feeling that you can get, because it’s the say no, because they don’t know as her to know because they’re being lazy or is it really a no? There’s just no other way and so you have to go back around and that’s an area that I think that we will help, that we are very, very intent because as I said, we have the background, we have the opportunity, we have the expertise and it is within the business interest to do it. So everything’s aligned for us to be in that position to provide.

Dylan McCabe: And that’s so good and that’s why you guys will be able to offer a level of customer service and support that’s way better than a patient could get in a typical hospital setting. We know that all of this stuff that was shared at the NICA conference, just talking about how payers are pushing patients out of the hospital, setting into standalone infusion suites and using reimbursement to force that change and you guys are going to have a nice setting. I mean, I’m looking at a flyer here for your infusion center, a very nice setting where somebody can go, in a place that doesn’t really feel clinical at all. And they can be in a relaxed environment and sit there for a few hours and be well taken care of and the cool thing is, is you guys are going to see these patients repeatedly and really develop a community there. So I think it’s awesome what you guys are doing, but let’s go back to what you said when you hear a no there’s challenges like we discussed in this business model. What would you say have been some of your biggest challenges leading up to this point?

Aaron Smith: It’s these process of sequencing all of the contracts that have to be in place before you kind of open that and see a patient, that is a sequence that is very specific and at best slow, but if you get anything out of sequence, it is really slow and nearly impossible to and we were very fortunate due to work that we did with you guys, work that we had done with CSI, Callie’s experience in the industry as a whole to we have done pretty well on the sequence, but my initial assumption, the cocky entrepreneur assumption was when everybody said that it takes eight months for contracting. That really means is it takes four months, but you have to stay on it. Well, what it really means is that it kind of takes eight months and if you screw it up, it will take 16 to 32 or they may not contract it. There was also this assumption that you built a Yukon, there’s a larger opportunity within this area, it’s an under-served area, but under-served doesn’t mean that there aren’t options for these patients and I think that’s the other thing is we expected the payers and contractors to really jump at the benefits that we were bringing. But it’s the contracting process, which they’ve been through many, many more times than we have and it goes at the speed that it goes at and so they certainly weren’t jumping the second. But the thing that I was surprised about was that they didn’t feel that they had to jump because due to exceptions within policy, there are still ways to eventually get these patients to the care they need. Now, is that good? Is it optimal? No way because there are patients who are falling through the crack every time there’s any sort of impediments in getting them in. The longer you take to get the patient in the door, the larger chance that that patient is going to continue to lose health, that they’re not going to be able to recover on one side or that they’re just not going to, that they’re going to become hopeless and fall through on the other side. So it’s not optimal, but it was an overestimation on my part to think that things would be easier then what they are. They’re not, they’re complicated.

Callie Turk: And I think what I’ve learned is that when someone tells you a timeline, oh, we can get it done in this amount of time or if the website says it will be done in this amount of time, triple it, or have a backup, because it really is a case. I mean, even with like the building permit, construction is a whole other learning experience. If you’re building from the ground up, it’s a beast of a project. I mean, it’s like probably one of the bigger projects I’ve ever had to deal with and it’s to the minute details, but it’s huge and it takes a lot of time and I think in general, the expectation you should always expect and plan for things to take more time than even their projected to take, just to give yourself-kind of a buffer of time for literally everything. I swear, there’s just a few things that I can think of that were promised a time or told a time-frame and they take twice as long and when your business opening depends on it, that is very; time is money.

Aaron Smith: Yeah, to be a little bit more specific about the challenges, going back to my answer, the challenges [inaudible] there is this specific order to it and the challenge was to challenge could everybody knew going in, which is that it’s complicated getting it started. But I will say the resources that we had available through NICA, through WeInfuse, through CSI, we were able to put together a plan that got us through and that worked and then met the timeline. That timeline’s a little fuzzy because at the early point, we didn’t know enough to make a timeline, which it was probably good, but those steps were available, the challenge, but when it comes to sequence, it comes to the sequence of you have to have the site and the licenses before you can start your contracting process with your payers, you have to have your contracting process pretty well down the line and nearly in place and close to opening the doors before you can start your processes, your contracting processes with your medication providers, with your group purchasing organizations and all of those things. So the key thing that I really learned, not that it’s complicated, I couldn’t learn that nine months ago had I listened to everybody who’s trying to tell us that. But the key thing that we were that we did take care of, but is important for anybody who is considering this is to take care and manage that cash-flow during that process, because when you finally get to the point of opening the doors, you are opening the doors to another leg of the marathon. You’re not hitting the finish line and I was fortunate in this part to plan it in, but I am very relieved and would advocate for anybody considering starting it to pay very, very close attention to the timelines and to make sure that they account for not just the timelines for getting the doors open, but the margin for error to get those doors open and then once those doors are open to take care of the timeline for growth.

Dylan McCabe: That’s good. That’s good advice. I mean, it’s just like acquiring, you’re starting any business, you better do your due diligence and make sure you’re aligned with the right people and you did market analysis to make sure you’ve got the right market. You’ve got the right model. You’ve got the right team in place. You guys are starting on such a strong foundation and obviously the heart is in the right place too to be patient focused and want to really take care of people. So let’s switch gears, so talking about challenges, tell us now what are a couple of things you guys are most excited about today with your infusion center?

Callie Turk: So I guess for me, I’m excited about almost everything that we’ve done. I mean, this whole process has taken so long. It feels so good to have a space like you mentioned before, it doesn’t look like a healthcare center and that’s what we wanted. I was really glad when you said that, because I thought that was our goal to make it not seem like you’re going to a hospital or a physician’s office, that’s really just boring and not comfortable. So that made me excited to hear you say that because a lot of effort went in from all of our team to make it that way and a lot of effort underwent policies and procedures and so I found protocols for therapies, and I know not everybody’s big on that, but I think it’s huge. I think everybody needs some sort of direction and if anybody needs to, when you open it, you kind of get lost in there. So much stuff moving around. Take it back to, what did we decide? What was our protocol? What was our plan? And I’ve done that myself already. So it helps me kind of navigate that a little bit more and so I’m excited to actually all of the work that we’ve done in the past, gosh, nine months has been so worth it right now and I feel like implementing that, I’m excited about implementing it. I’m excited about the workflows that we’ve done, the communication gaps that we’re trying to fill with processes that we’ve actually done with our patients. So it’s working so far, we have one patient, but it’s exciting that it’s working and I feel like I’m always about improving too. So getting that feedback, I’m excited to get feedback and seeing what the patients actually say and modifying whatever we need to do.

Aaron Smith: Yeah. It’s going to be exciting to actually hear the patients who come in and see, and as a state, yeah. I consider them a source of endless opportunity because they will be bringing in new experiences, new problems that we may be in the position to help solve. But the one thing I will have to give Callie credit for it too, because she’s been big from day one is we are not applying those. She is open too many infusion centers without policy and procedures and having to do it, try to play catch up as patients come in and I tell you the work that she and Rebecca, our nurse practitioner, has done is pretty amazing. I would challenge anybody up to a game of, do you have that protocol? Because I think we are in pretty good shape.

Dylan McCabe: That’s great. That’s going to protect you long-term. Somebody said it is just a predetermined decision ahead of time. About how you’re going to handle something and that way everybody’s on this. One of our co-founders Reece Norris, who’s also our COO is the most process oriented person I’ve ever worked with and it’s been great because we have standard processes for everything and it makes it so simple for me. I’m not Mr. Process, I’m more like a typical sales person. I like talking, I like asking a lot of questions. I like hanging out with people, but when it gets down to the nitty gritty details like, oh, shoot, I missed that, I’m sorry, I forgot to send that email. So we have processes for that, we’ve got processes for everything and I love it. It enables your brain to relax.

Callie Turk: It keeps everybody on the same page and doing the same thing every time and if they go off of it, it’s easy to say, okay, let’s veer them back this way.

Aaron Smith: Yep and those processes are important for missing emails. They were so much more important for a patient who is about to be given a drug for the first time that they could have an adverse reaction to it.

Dylan McCabe: I think that’s…

Aaron Smith: Knowing how you talked to, how do you make sure that the patient’s and how do you make sure that it’s sufficient.

Callie Turk: Yeah, it’s very detailed, because I feel like clinicians, if you’re not someone who thrives off of when patients starting, if they have an adverse reaction, some don’t do well with that situation, but to have stuff just to refer to black and white, this is what I need to do, have something there in front of you. That’s kind of, policy and procedures only so good because it’s a piece of paper, but when you incorporate it into references for staff and have it there, I feel like you get more response out of your staff and they feel more comfortable and confident or at least I do. I’ve been in that position and I wanted that and I didn’t have it. So I feel like that’s why I feel like it’s so important because I’m not the only person that has felt that way. Like what do I do in this situation?

Dylan McCabe: Yeah. And I think that’s what makes this model where as a business model, so different, is there are so many processes in play that are at different stages to get a patient scheduled and then get your inventory updated and all those things, which is what the whole point of WeInfuse and when we’re on a call with someone doing a discovery call, that’s all we do is ask a ton of questions about their current processes and their current workflow. How do you handle your pre-treatment workflow? How do you handle your scheduling? How many people are involved, what does this stream of communication look like back and forth? And I’m telling you I have heard it all. I’ve heard of showing up in the morning where you got 15 people in a big meeting room and a huge whiteboard and everybody’s chiming in saying, oh, this patient needs to be in that column over there. I’ve heard of folder systems, I’ve heard of sticky, heard and seen sticky notes all over the desk, paper systems where papers falling down behind the desk and I’ve heard people today or heard of a group using a project management platform that’s not even designed for clinical setting, but that’s the best tool they had at this point. So that’s great that you guys are so process focused. I mean, you have to be, we like to talk about how in the infusion center, you really have to have equal parts, clinical training and business acumen. You just have to, because the revenue is so high for biologics, you just can’t afford to make mistakes.

Aaron Smith: One mistake can turn the lights out pretty quickly.

Dylan McCabe: Yeah. Well, you guys clearly have an awesome infusion center. You’re in a great market. You’ve got a great heart and passion to do it. What would one parting piece of advice be for people listening to this podcast that are also thinking about either starting or acquiring an infusion center?

Aaron Smith: That the opportunity is there. I mean, it really is a target rich opportunity as far as have you went through several piece of it, wherever you have that many processes or you have that many processes that need to be paid attention to operation wise and it’s really the merging of two different current domains, which is the independent infusion center or the physician, which provides infusions inside this clinic and you’re merging the ambulatory infusion center from specialty pharmacy. You’re pulling them together. So you’ve got a lot of common ground as far as open areas where processes are currently, they’re not standardized. So a lot of areas where you can come in and make a difference, you have opportunities as far as expansion. Finding places in need of this model is not difficult. You were talking about the one hospital or a healthcare system that’s going to be rolling out 70 of these places. That number alone tells you when one, hospital’s looking at that number that they’re rolling out, there’s opportunity, there’s opportunity and improving, not only the access to care, but also at the quality of care, that’s at these places, improving the centers so that they have a certain standard of privacy and comfort and trust. There’s also at some point there’s going to be a opportunity and the outcomes of these patients, because these medications are way too expensive and the payers are currently paying for it on the assumption that the patient’s going to get better, but there’s not a lot of formal tracking of the outcomes and so that’s going to make a difference, they’re doing it in population health. They’re doing it in diabetes, they’re doing a hip replacement. It will move its way into specialty medications here pretty soon. So there’s opportunities to make a difference in that. So there’s this entire landscape of opportunities, but the one key piece of advice that I would follow that up with is know why you’re doing it because it’s not, as I said earlier, it’s not build it and they will come. You need to figure out why you’re doing it and know that you’re improving something, if you’re going out there, how are you going to help these patients help these physicians improve this patient’s care?

Callie Turk: I guess I would say something that I think you said a little bit earlier, balancing clinical operations with operations, there’s a huge balance and I think you can get caught in drug down into the weeds on clinical operations and it’s really good to have early good clinical operating system in place and protocols and all of that stuff. But there’s also the aspect operationally of what drugs are you going to choose to go with? How is the reimbursement for those drugs? Is reimbursement good for those? I mean, do you just choose them because you want to provide access to everybody and I don’t even know that we know some of those from a payor aspect, you don’t have all of our payer contracts in place, but I think that’s something to think about and knowing that you might have to change some of the therapies that you provide later on. Maybe it’s not as good of a choice, I don’t want to save for patients, but from a business perspective to be viable, you have to look at that. So I think there’s a balance and I struggle sometimes with, okay, when all this clinical stuff in place, because I’m a nurse by background, but I also have to take a step back sometimes like, it’s good enough. We have a good process in place. This is, we have bigger fish to fry here. So I think I think a balance of that is really important, I guess, in my mind. So that’s what I would just say, make sure you’re not too heavy on one side versus the other.

Dylan McCabe: That’s good advice. Well, we could go on and on and talking about this stuff, but just to try to keep it concise for our listeners and people can stay tuned and hear more, but I’m looking forward to updates and if I’m ever in the Oklahoma City area, I’ll definitely stop by and see your place in person.

Aaron Smith: Yeah, we would really love to see you or any of your listeners.

Dylan McCabe: Yeah, you’ve already given me some swag with your foot scare and fees and so I want to be drinking out of this tomorrow. Well guys, thanks a lot for being on the show.

Callie Turk: Thank you very much.

Aaron Smith: Thank you for having us.

Dylan McCabe: Alright, that completes the interview with Aaron and Callie. I hope you got a lot out of that and if you’d like to learn more, you can connect with both of them of course, on LinkedIn, you can also head over to our website weinfuse.com, check out our blog for the latest insights in the infusion practice. Also, if you’re with an infusion practice now, and you want the latest technology to streamline your processes and simplify your business, definitely head over to weinfuse.com and request a demo today and either myself or one of our other account executives, we’ll set up a discovery call with you to dive deeper into your workflow and hopefully take it to the next level. This is Dylan McCabe with the WeInfuse Podcasts. Thank you for listening and I will catch you in the next episode.

Guest Speakers: Aaron Smith and Callie Turk are the Co-Founders of Flexcare Infusion Center. Aaron received his BS in Biology from Southwestern Oklahoma State University and his Masters in Software Engineering from Southern Methodist University. As a former president, VP, and director of numerous companies, Aaron is experienced with healthcare systems, and currently focuses on infusion therapy. Callie received her MS in Health Care Administration from MidAmerica Nazarene University. She has over 10 years of experience in the healthcare industry, holding positions such as Director of Clinical Informatics & Education, Manager of Clinical Education & Outcomes, and Clinical Training & Design Specialist.