Episode 72: How to Modernize Home Infusion Through Seamless Coordination with Kaila Raimondo

Amanda Brummitt:  WeInfuse Podcast Episode number 72. Welcome to the WeInfuse Podcast, where we explore the business of infusion therapy and bring you insights from the people shaping the future of care delivery. I’m Amanda Brummitt, and today we’re diving into the world of home infusion and specialty pharmacy with Kaila Raimondo, head of U.S. Markets for AlayaCare.

AlayaCare is transforming how care is delivered outside the traditional four walls of a clinic or hospital, and Kaila brings a unique perspective, not just as an industry leader, but also as a former infusion patient. We talk about everything, from solving complex logistical challenges with software to improving the patient experience to why nurses are the true face of your brand.

All right, Kaila, thank you so much for joining us today. Can you start by just telling our listeners who you are? 

Kaila Raimondo: Absolutely. And thank you guys so much for having me. So my name’s Kaila. I’ve been with AlayaCare since the early days of 2019. And over the years, I’ve held quite a few different roles at the organization.

So I’ve been with the company for about seven years and we’re a 10-year-old organization. So that kind of tells you where I fall within the pecking order here. Yeah, they have been here for a while, seeing our growth and evolution as an organization. I started in our Client Success division and I used to implement our clients. So early in the days when we initially started in the infusion market, I was helping to get clients onboarded to the AlayaCare solution.

I then moved over to our Solutions Engineering team, where I would help to come up with custom solutions for our customers, provide tailored and comprehensive demos to them so that they could understand all of the different pieces of the AlayaCare equation, and also help prospective customers make the decision if AlayaCare would be a good potential fit for them, before I transitioned to lead our U.S. markets at the organization. So not only our infusion and skilled nursing realms, but also our U.S. personal care divisions. AlayaCare is a multifaceted organization with infusion being a piece of the puzzle, a large piece of that. But we do have other markets that we serve today.

I came into this role after completing my Master’s in healthcare administration, and what really drew me to the work was to help modernize how care is delivered, especially in home and community-based settings. My mother is a nurse by trade but she would help to coordinate and manage a lot of community care services in Canada.

AlayaCare is a Canadian-based organization, but we work predominantly with U.S.-based organizations. So I’ve been seeing home and community care from a really young age. I’ve always been motivated by the challenge to improve those systems after looking at what my mom went through when she was looking to coordinate care or as a home care nurse, the types of experiences that she would tell us about when coming home after a day on the job. So it’s been entrenched for a long time in getting involved with this particular area of the space. 

Amanda Brummitt: Incredible. I love that you bring an international perspective to the space. I’m sure that comes in quite useful. 

 Kaila Raimondo: Definitely. We see a lot of nuances between the multiple different markets that we service.

Obviously, the Canadian and U.S.-based healthcare systems are vastly different from one to another, so it’s very interesting to see those differences and how they ultimately play into the care that patients receive and the experience that patients have with the systems at play. 

Amanda Brummitt: Yeah, definitely. Tell us a little bit about AlayaCare for people that aren’t familiar with the organization.

Kaila Raimondo: Yeah, absolutely. So AlayaCare is an end-to-end software platform. We were purpose-built really for delivering care outside of four walls of a hospital or a clinic. Our mission is rooted in a powerful belief that everyone deserves to receive the best possible care in the place that they call home.

Obviously, as we know, our population is aging rapidly in North America and around the world, so home care is going to be continuously more and more required for that segment of the population. Everything we build is really in service of that particular idea, making it easier for providers to coordinate, deliver high-quality care, be efficient and compliant in the ways that they need, but also putting the patient and their family’s experience at the forefront.

That can be huge in the home infusion and the home care spaces as a whole. Again, ensuring that the patient feels comfortable and confident with the nurse or the care provider that’s coming into their home and their families being engaged in the care. Even more so than, again, in clinic or hospital-based settings, say.

We work with a wide range of organizations across the US and Canada, like you mentioned, home infusion and specialty pharmacy providers being a big portion of that. And really, the platform supports clinical documentation, scheduling care planning, mobile tools for nurses, and compliance workflow. So, helping you to modernize the whole continuum of care in the home care setting.

Amanda Brummitt: Fabulous. Okay. So as I hear you talking through all this, a lot of it sounds very familiar. It sounds like you’re very much aligned with the way WeInfuse handles their business, but it also sounds like you could be competitors on the surface. So what made the two organizations decide to work together? 

Kaila Raimondo: Yeah, that’s a great question. We’ve been long admirers of the work that the WeInfuse team has done. I think we’ve connected for the last five to six years at many different conferences, always waiting for a perfect opportunity to partner together.

As I mentioned, AlayaCare does handle a lot of the clinical documentation and nursing management components. They are required for home and clinic-based infusions, but we don’t manage any of the pharmacy management components that a solution like WeInfuse does. So any of the dispensing and inventory management.

Again, we partner with solutions similar to WeInfuse in the space so that we can obtain the patient information and coordinate & manage the visits. But that’s really the differentiating factor between our two different organizations. 

Amanda Brummitt: Okay, so Kaila, at what point did you, Bryan, and Reece decide, okay, we should actually work together instead of just hanging out and sharing ideas at conferences?

Kaila Raimondo: Absolutely. So again, it was a long time coming. Like I mentioned, we’ve been meeting with the WeInfuse team for five to six years, but the impetus was really an organization called Palmetto Infusion Services. They are a current partner of WeInfuse and have been integral in building out some of the dispensing portions of the product that are newer to the WeInfuse umbrella.

We had met with them over the years. The time was finally right where their home infusion business had grown to a level where they felt like a tool like AlayaCare would be helpful as they continued to grow and scale. They were mentioning challenges as it relates to coordination and management, getting the right nurses in the right locations, but also coordinating care across different nursing agencies.

So this is very important. One piece of the home infusion umbrella is that most specialty pharmacies don’t have their own home infusion nurses. And if they do, they still will rely on subcontracted nursing agencies to provide a lot of that infusion care. And Palmetto does that almost exclusively today.

So there’s a care application that we refer to as a marketplace. Home infusion & specialty pharmacies with subcontracted nursing agencies to actually provide that nursing care. And so that was the impetus of us starting the conversation with Palmetto and them ultimately letting us know that they were making the transition to WeInfuse for all of the pharmacy benefit management components of their business.

And we were really excited to hear that again, finally having a mutual fit customer we could work together with to build the integration. But that marketplace component, again, was a key driver in that equation. Knowing that our organizations working between the two companies, AlayaCare and WeInfuse again, not only relied on us, but also external parties to be able to coordinate and manage that nursing care.

Amanda Brummitt: How cool to see three giants in the industry come together and figure out how to play in the same sandbox. I love it. 

Kaila Raimondo: Yeah, for sure. It’s been awesome to, again, work with their team and the Palmetto team. They’ve been nothing but a pleasure thus far. So we’re really excited to continue to evolve and work together in the long term.

Amanda Brummitt: That’s always exciting to hear and I can’t wait to see what you guys do together. Switching gears just a little bit, tell us about what you all do for specialty pharmacy. 

Kaila Raimondo: So we do work with multiple different specialty pharmacy providers in managing any of the dispensing and then delivery of the medications, and then coordinating and managing the nursing care.

So a lot of the time we’ll see that. The cadence of care for specialty drugs versus home infusion drugs can be slightly different. And the needs of the patients are often not the same in both of those realms. So having the application be configurable and based in those different roles of an organization can be key to ensuring that the coordination and management is done effectively.

Amanda Brummitt: Awesome. And then you guys are strictly home infusion, right? 

Kaila Raimondo: That’s correct. Yeah. We generally will coordinate and manage for home infusion organizations. We do have a few providers that do run an ambulatory infusion center or an infusion suite-based clinics, but we do like to play in the space where there is a home and a IC-based component versus the solely AIC-based orgs.

Amanda Brummitt: Okay. Yeah, that totally makes sense. All right, so shifting towards what you’ve seen in all your experience, what would you say is the biggest challenge and challenge that you see providers face in infusion? 

Kaila Raimondo: So this is a bit of a personal question for me, but because before I ever worked in this space, I was an infusion patient myself.

Amanda Brummitt: No way. 

Kaila Raimondo: So yeah, I had been really ill for quite a few years and I was finally diagnosed with Lyme disease after seeing probably 30 different doctors within the space. And that diagnosis completely changed the trajectory for me. I went through months of different treatment that involved both home and in clinic-based infusions.

And it really gave me a front row seat to what the patient experience looks like. There’s the good; there’s the bad. There’s a lot of really tricky moments that patients and providers face together, and so I think that is a core challenge of the industry, right? Providers are always trying to ensure that the patient experience is as seamless as it possibly can be, but it is tricky, right?

Nurses really are the face of your brand in a lot of case scenarios. I think that the nursing and coordination management is critically important. I know when I was a patient, I would have multiple different nurses knocking at my door. And because that was the case, they didn’t have any continuity of care with me.

They didn’t understand the challenges that I’ve had tolerating drugs in the past. They didn’t really understand all of the nuances of my diagnoses, and so that made it really tricky for me as the patient to feel comfortable and confident. Every single time another new provider was coming into my home.

And so having technology enabled solutions really helps that, again, ensuring that it’s not me, a coordinator, a scheduler, Kaila, making any decisions that I want about who’s gonna go into each of the patient’s homes. Again, using more technology-based platforms help to manage and coordinate that care.

I think a big challenge that ultimately providers face is being able to give nurses the autonomy and the tools that they need to be successful within the home. And so I would say that obviously AlayaCare is looking to solve that particular challenge, but nurses really are a lot of the backbone. What ultimately happens with the patients when they start to receive infusion therapies and having solutions to coordinate and manage that as such, are critical.

Amanda Brummitt: Yeah. First of all, I’m sorry you had to learn about the industry that way. That stinks. It is crazy though, how when we are the patient, it makes us so much better at our job. And what you just described with nursing, that’s something you wouldn’t really think about unless you’d literally been in the chair, but every one of those interactions is a trust moment. And when that person’s new and they know you, that’s terrifying. 

Kaila Raimondo: Exactly, and I think what kind of stuck with me now later on working in the industry is that nurses are often just seen as part of the logistics of coordinating and managing care, but they’re not.

They really are the patient experience that is sometimes the only human touchpoint that the patients have with your organization. They’re the face of your brand, as you mentioned before, and so ensuring that they can show up in the best possible light. Provide the patient with the experience that you are hoping to exude as your brand or your organization is critically important in ensuring that, again, the nurses feel supported in what they’re doing.

Amanda Brummitt: Yeah, definitely. You mentioned the clinical notes. Do you guys have a good spot for all the information like ”Kaila is scared of needles or Kaila doesn’t react well to this thing or the other.” 

Kaila Raimondo: Yeah, absolutely. I think all of those pieces of information are key. If I’m the nurse wanting to go into a patient’s home, I would like to know before I knock on the door–if I’m about to hear three dogs barking, as an example.

Or I need to know that the patient is very resistant, like you mentioned to needles. Maybe they’re a very hard stick. Or they have someone who lives in the home with them that might be resistant to this particular type of therapy. And that’s something that I need to be aware of as the nurse going into the equation here. So yeah, keeping that information in AlayaCare is key so that the nurse can see that on a mobile device. Logging into the patient’s care plan to access some of those pieces of information, and again, just allows the nurse to be more effective and efficient at their job. 

Amanda Brummitt: Very cool. Way to use technology to fix a very human issue. All right, what have you experienced as the biggest light bulb moment in the industry? 

Kaila Raimondo: That’s a good question. I think that for me seeing how difficult it has been to,  one, find trained home infusion nurses, and then two, being able to dispatch them to the appropriate places is critically important. That’s a very niche skill in and of itself. Then on top of that, there are drug-specific or therapy-specific skills that nurses need to have coming into these different home infusion or clinic-based infusion therapies. And not having a large pool to pull from is the number one challenge for most of the organizations that we work with.

They’re sending nurses here, there, and everywhere to try to manage care. Sometimes we’re hearing people are booking flights to be able to see patients because there’s not another trained nurse with, let’s say, intrathecal pumps or the particular chemotherapy drug. Anywhere within that patient’s vicinity.

So making sure that they can be seen, obviously important at the cadence that their therapy requires nurses, again, jumping on planes in order to make that happen. So I would say the biggest light bulb moment for me is ensuring that you have a way to continuously coordinate and manage this care. And like we said, treating the nurses obviously with the utmost respect that they deserve in ensuring that they’re doing the hardest job. Seeing your patient, ensuring that they have a great experience with your organization, and again, giving them the tools that they need to be successful in that is critically important. 

Amanda Brummitt: Yeah, let’s not make their job any harder than it needs to be, and let’s try to make it easier. So potentially it’s a retention tool. 

Kaila Raimondo: Exactly. Yeah, for sure. And I think that a lot of organizations are slowly but surely coming to the realization that investing in their nursing teams is critically important. When we started working with home infusion providers, we noticed that wasn’t necessarily at the core of what they were hoping to invest in with their business.

And that’s often because nursing is a loss leader as it relates to the financials of providing home infusion therapies. And it can be an expensive endeavor, obviously, to continue to provide the dispense alongside the actual administration of the drug, and the dispense is often where you’re making the large portion of your margins.

That being said, a lot of times you won’t get that referral, you won’t get that dispense, if you don’t have a coordinated way to actually administer the drug. So ensuring that you’re investing in your nursing teams, giving them the tools, the training, the time, obviously the recognition that they need has been a big shift that I’ve been noticing over the last six to seven years that we’ve been in the home infusion industry at AlayaCare.

Amanda Brummitt: Yeah, definitely. I’m excited to see healthcare finally recognizing that too.

Kaila Raimondo: Yeah, definitely agreed. It’s exciting to see all of the Nurses’ Weeks and things that they’re putting out to, again, try to engage the general public in the challenges that a lot of nurses have as they continue to manage their careers. 

Amanda Brummitt: Yeah, most definitely. What are you most excited about right now in the industry?

Kaila Raimondo: Yeah, that’s a great question and I think we’re at a bit of an inflection point within the industry. One where care delivery is expanding behind the walls of clinics and hospitals in a really meaningful way. More patients are being safely treated at home, which is awesome. Payers are increasingly open to those alternative sites of care, which has been, again, a big shift that we’ve noticed in the last six to seven years, and providers are starting to design more hybrid models that prioritize the patient’s choice with obviously clinical appropriateness in these case scenarios. So it’s no longer just a clinic or just home. It’s about making both of those settings work in a seamless, patient centered way. And I think the truth is that what’s convenient for the systems right isn’t always what’s best for patients.

And I think more and more providers and payers are starting to see that. And so I’m really energized by that push forward to see more integrated and flexible models of care. I think that technology is being more readily adopted these days. It’s really finally catching up with where it needed to be within this industry. We do see that home care in particular is a very slow moving industry as it relates to technology adoption. And I think the AlayaCare + WeInfuse integration is a great example of where two platforms come together to support the operational complexities and the clinical nuances of infusion care.

So seeing those shifts over this period of time has been awesome to again, look forward in the future and get even more excited about the changes that are gonna happen in the infusion industry over the coming years and decades. 

Amanda Brummitt: So what makes home infusion slower to follow the hospital setting or ambulatory setting?

Kaila Raimondo: I think that home care in general as an industry has been the redheaded stepchild of the healthcare space in a lot of case scenarios, it wasn’t necessarily as readily adopted. Therefore, any innovative shifts came to that portion of the industry later on. So, in this case scenario, I think home infusion is no exception to that particular rule.

We see that in the home infusion arena. We see that with just standard home and personal care based providers. The ideological shift that needs to happen within the industry isn’t always there. You have a lot of organizations that have been running for 25 to 30 years the way that they’ve been running, and therefore it can be very hard for them to come to terms with the fact that they need to modernize, they need to adopt technology to continue to be at the cutting edge of what they were doing at the time. Even having a home care or home infusion-based organization was at the cutting edge. Now, that’s not enough, right? You need to continue to differentiate yourself, and I think technology platforms really allow you to do that.

Again, the ideological shift of that and really the funding sources that go into home and community based care haven’t been there, right? They haven’t been at the level of grants that are provided to clinic or hospital based organizations, and so that catch up is critically important,  ’cause if organizations don’t have the funds necessary to spend on these types of innovations, again, they can’t continue to provide the best possible patient care.

Amanda Brummitt: That makes a lot of sense. Kaila, you have already shared so much good stuff. Do you have one last piece of advice for our listeners? 

Kaila Raimondo: For sure. I think I’d say stop thinking about all of the operations of your organization as just a back office problem, someone, or something that someone has to manage administratively.

I think the systems that you build, how you schedule, how you communicate, how you document, and how you follow up are the crux of patient care. They’ll either empower your teams or they’ll continue to hold them back and not be innovative–not being at the bleeding edge of what’s going on within the industry. And they either give patients a smooth, trustworthy experience or they don’t. And so you don’t have to rip and replace everything overnight, but you do have to start with small incremental changes. Choosing one part of your workflow that creates friction for you, whether it’s onboarding patients, routing nurses, or getting documentation to where it needs to go can be a great place to start.

I know the AI buzzword is being thrown out here, there, and everywhere, and we haven’t really touched on it today. But again, trying to figure out how you can leverage new tools like artificial intelligence to again, continue to adopt these things with your patients–continue to be on the cutting edge.

Fixing even one piece of the equation here can help to free up time for you guys. Reduce burnout, create momentum for even bigger changes. So bringing yourself and your team along for the ride is critically important. I would say that your nurses, your coordinators, and your pharmacists–they know where the cracks are within your organization.

They can understand where changes need to be made, and the organizations that we see making the best and most innovative shifts are the ones that listen closely and act early with those team members because they can understand where the issues are. They don’t get to the tipping point and they don’t get to the crisis mode before they ultimately make those changes, and I think that’s key.

I think we’re seeing a lot of that geopolitically these days, right? We’re always at the tipping point of something before we ultimately make the change. Ensuring that you don’t repeat those types of patterns with your organization is critically important. 

Amanda Brummitt: That’s really good leadership advice across all industries. You mentioned AI. Is that something that AlayaCare has built into it currently? 

Kaila Raimondo: Definitely. So we do have quite a few artificial intelligence modules in the application. Some that are pertinent to the home infusion space. One of them is an AI scribe for clinical documentation. So, allowing the nurses to speak into their device and say, “Hey, I saw a patient, Peter Globulin today, 10 o’clock to 12 o’clock, he had an adverse event. These were the reactions that he experienced. Here are the details around the progress that he’s had over the last six months. Note that his blood pressure was 127 over 82, that his heart rate was 93,” so on and so forth. As you go through the infusion and allowing that detail to auto-fill in your clinical documentation is huge.

Saves you a ton of time. As the nurse, you don’t need to continuously go back into that documentation. We’re looking to take that a step further with ambient listening. Allowing your phone to be there during that infusion appointment and pick up all of the nuances that are discussed with the patient is huge.

We do also have a virtual assistant in the application called Layla. Layla will help you to coordinate and manage your schedule. Layla can give you summaries of patient care over a long continuum. Layla can provide you with clinical based details that you might need saying, “Hey, my patient is experiencing X, Y, and Z adverse event. What would you suggest are the best clinical outcomes for me to report back to, let’s say my pharmacy or my drug manufacturer in that vein.” So Layla’s been awesome for a lot of our providers to start to use with their nurses. They’re noticing that it’s eliminating a lot of phone calls back to the pharmacy, back to back office, because Layla’s able to search multiple medical journals, look for the best possible pieces of information.

You’re not just getting info from one source of truth, you’re getting it from multiple different sources of truth. One other piece that I’ll mention here is around a tool that allows us to optimize and manage visits and caseloads for nurses. So like we were talking about, sending nurses into the home with a patient that has six dogs when they’re allergic to dogs, right?

Probably not gonna be the best possible fit. Or sending a nurse to drive 120 miles in one day to go to multiple different patients isn’t key. So ensuring that you are optimizing for these types of parameters is huge. And it also allows your nurses to see more patients in a given day while doing less windshield or drive time throughout that period.

So the Visit Optimizer tool in the application is huge. Definitely something that we use to coordinate and manage with the different home infusion providers that we work with today. 

Amanda Brummitt: Fantastic. Kaila, thank you so much for your time, for sharing your personal experience and then putting all your passion into ultimately making infusions better and safer for patients.

Kaila Raimondo: We really appreciate you having us, and again, we’re really looking forward to the continuation of our integration and working with more mutual providers together. 

Amanda Brummitt: That’s a wrap on today’s conversation with Kaila Raimondo from AlayaCare. We covered a lot from the power of technology to improve home care to the critical role nurses play in shaping patient experience and how thoughtful coordination can actually improve patient outcomes and efficiency.

If your organization’s looking to elevate your infusion operations, I encourage you to schedule a test drive of the WeInfuse software and RxToolKit’s web-based resources. Thanks for tuning in. We’ll catch you next time on the WeInfuse Podcast.