Expert: Streamlining Infusion Workflows Without Compromising Patient Experience

In an interview with Pharmacy Times at the 2025 American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting & Exhibition, Prateek Bhatia, BPharm, PhD, vice president and general manager of Intrafusion at McKesson, discussed how strategic staffing models can help reduce delays and bottlenecks in infusion centers. Continuing from his previous conversation, Bhatia emphasized the importance of aligning roles with state regulations so nurses can focus on direct patient care while administrative and technical tasks are handled by other qualified staff. He also highlighted the critical role of optimizing patient intake and revenue cycle workflows to reduce time to first infusion. Bhatia noted that improving access, automating front-end processes, and addressing intake inefficiencies can enhance patient experience while supporting timely clinical care.

Pharmacy Times: How can better staffing models help minimize delays and bottlenecks in infusion centers?

Prateek Bhatia, BPharm, PhD: That's a great question and very timely. We've been having many conversations here at ASHP about staffing challenges related to infusion service lines. As we all know, many infusion centers across the country are staffed by nurses, and the nursing shortage is causing significant challenges for health system customers across the board.

Some states have allowed the process of really identifying the optimal staffing for these infusion centers. That means looking at a given infusion service line for a health system and understanding who is involved from the beginning of the infusion workflow. If you look at the patient journey, many health systems might not be optimizing the use of a medical assistant or a scheduler to handle the front end of the revenue cycle management process.

If a nurse, LVN, or LPN is doing administrative tasks, those tasks may be able to be done by somebody else, reserving nursing efforts for the infusion portion of the patient journey. Some states also allow mixing to be done by a pharmacy technician. So it's really about understanding whether that's an option. My main advice is to understand state regulations and figure out who can do what so that nursing time is focused on the infusion portion of the patient journey.

Pharmacy Times: What are the biggest opportunities right now for health systems to improve infusion efficiency without sacrificing patient experience?

Bhatia: I think the number one opportunity for a health system is really optimizing access. When I say access, I mean access to the right therapies. There are many therapeutic areas where multiple therapy options exist, so it's important to understand which drugs a health system has access to based on patient preference and prescriber preference.

From an operational workflow standpoint, it's also critical for health systems to understand bottlenecks related to patient intake. Often, time to first infusion can range from a few days to several weeks when the initial intake portion of the revenue cycle management workflow has not been optimized. That includes completing paperwork and gathering associated medical records needed for prior authorization, such as labs and imaging.

Automating the front end as much as possible allows health systems to obtain prior authorization quickly, schedule patients sooner, and get them infused in days rather than weeks. This is important because delays can lead to a decline in script capture, patients seeking care elsewhere, potential disease progression, and patient frustration. The intake portion is a critical step, because the first few days after a prescription is written are often the most important for a patient’s clinical care.