Because of the nature of attention required for patients receiving long-term intravenous care, patients are increasingly preferring to have treatment administered away from the hospital setting, typically at home or at alternative sites. The home infusion therapy market is expected to reach $28.3 billion by 2024, according to a May 2017 report by Grand View Research, Inc. The shift away from hospital settings has increased the care team members needed to coordinate infusion therapy. What used to be a physician, nurse, and patient team has now expanded to include specialty pharmacy providers, delivery drivers, and family caregivers. Close to 66 million family members currently serve as caregivers for aging, ill, or disabled Americans, according to the Family Caregiver Alliance.

Introducing The Circle Of Communications

In the current circle of care, the members all have different levels of sophistication and knowledge, but one thing is consistent: Communication is typically quick and urgent. Therefore, members of this care team, whether clinical or familial, need to have a centralized platform that allows for confidential, fast-paced, asynchronous collaboration for patient care decisions. For example, an 80-year-old male patient suffering from lung cancer receives infusion therapy at his daughter’s home for total parenteral nutrition (TPN). Because of the temporary effect of radiation on his esophagus, he has been unable to swallow food or anything liquid. To train the daughter and the home health nurse, a skilled infusion nurse would visit the home to teach the specifics of the medications and train them on device setup and cleaning. The pharmacy staff would communicate with the daughter and home health nurse on an ongoing basis to determine which medications and supplies are needed for upcoming rounds of treatment. They would then work with a third-party courier service to deliver medications to the home. These deliveries would occur frequently because many intravenous medications, such as TPN, have a short shelf life once mixed, some lasting just 7 to 10 days. In this example, the doctor, patient, daughter, pharmacy, specialty nurse, home health nurse, and courier driver all comprise the circle of care helping to ensure the well-being of patients.


Historically, email, pagers, and lately even text messaging have been the means of the circle of communications in infusion therapy. Increasingly, as with all health care, texting has increased, as it allows for faster collaboration than do legacy applications. Estimates show that roughly 95% of health care professionals admit to using personal mobile devices for work-related tasks and communications in the workplace. The use of texting, however, puts patient data at risk and a pharmacy’s business in jeopardy. Many members of the modern circle of communications are unfamiliar with protected health information (PHI) regulations, particularly patients, family members, and delivery drivers. Because the Health Insurance Portability and Accountability Act of 1996 enforces stricter compliance requirements for small to midsize health care businesses, specialty pharmacies must adopt alternative and compliant platforms to enable care teams to communicate sensitive patient data. In addition, cyberattacks on US health care organizations have increased by 63% in just the past year, according to an analysis by TrapX Security. As a result, specialty pharmacies need to be confident that the sensitive patient data shared within the circle of care will not be compromised. Although care team members may have antivirus and firewall protection in place that protect PHI sent on their computers, a new trend in ransomware is targeting mobile devices. According to Kaspersky Labs, since 2014, mobile attacks have almost quadrupled and are expected to be even more prevalent in 2017. Without a secure means in which to text, pharmacies and the patient care teams they collaborate with will remain vulnerable to advances in “smishing” (SMS phishing) and other mobile cyberattacks.

Protecting The Circle Of Communications

Fortunately, pharmacies have the opportunity to leverage enterprise-strength messaging platforms that function in a way that care team members are accustomed to. These modern secure messaging platforms offer secure chat and collaboration while also providing sender control, image and screenshot security, and ephemerality—features particularly beneficial to providers of home infusion therapy. Secure messaging platforms also offer control over information being shared. Unlike SMS text messaging, an advanced secure messaging platform gives senders complete control of the communications, images, and documents they deliver. Specifically, this means recipients cannot copy, forward, or share information, which denies unintended propagation of sensitive patient data outside the circle of care. As such, the care team can leverage the efficiency and features of SMS texting, such as group text, without opening up the conversation to risks, vulnerabilities, or outside sources. Some secure messaging platforms available today can prevent images from being captured in a screenshot and stored on a device camera roll. These apps also provide the ability to expire messages from devices and message servers, key to security and compliance, while maintaining a copy of the communication with the patient record in the electronic health record (EHR). These capabilities not only protect the patient and their personal data, such as test results and medication information that remains on a device, but also ensure critical information is immediately and confidentially accessible to the care team via the EHR. As the infusion therapy market continues to grow at a 9% compound annual growth rate, according to Global Market Insights, security and compliance risks are scaling in tandem. By investing in secure messaging technology, specialty pharmacies will be able to facilitate higher volumes of communications, protect critical information, realize more revenue by efficiently serving more patients, and ultimately improve quality of care.

About the Author


GALINA DATSKOVSKY, CRM, FAI, and a serial entrepreneur, is an internationally recognized privacy, compliance, and security expert. Datskovsky is the CEO of Vaporstream, a leading provider of secure, ephemeral, and compliant messaging.

(Article originally published in Specialty Pharmacy Times January 29, 2018 by Galina Datskovsky, CRM, FAI)