Recommendations will be made as to the need for additional support in situations where the patient or caregiver is unable to participate in administration of the therapy. It is rare that a delivery system cannot be developed which would allow for the safe and effective administration of therapy in the home. Support personnel may be needed in some cases, but on long-term therapies the support requirements will usually decrease through continuedpatient education and increased patient understanding as the therapy progresses. Theincreased patient involvement generally produces a feeling among the patients that they arehelping themselves to recuperate and generates a positive feeling about the therapy. Qualityof care improves as patient involvement increases. AEtown Vital Care professional is alwaysavailable to answer any questions regarding the therapy. 
Referral sources will not be burdened with evaluation of patients as candidates for home infusion therapy. That evaluation will be performed by Etown Vital Care. The need for supportservices will be evaluated by Etown Vital Care resulting in cost savings for all entities. Followingcompletion of the therapy, the patient will be asked to complete an "Evaluation of Services"form. This instrument will be used to "fine-tune" the services provided to patients in the future.

Following the patient evaluation, Etown Vital Care will contact and arrange for ancillary serviceswhen needed. Many Vital Care locations provide other services in addition to infusion therapy.Durable medical equipment and prescription drugs can be coordinated through Etown VitalCare. 
These and other services are available through Etown Vital Care or Vital Care will coordinatethese services as specified. By the utilization of the Vital Care network, referral sources willbecome more efficient by no longer having to contact a separate provider for each service apatient may require. The patient is presented with a coordinated system of care at home.Referral sources have the ability to monitor the onsite care through Etown Vital Care and willbe able to receive current reports on the patient's progress through the prescribed therapyfrom one provider. This coordination of services will aid in becoming more efficient in theprovision of health care services in the home setting.

There should be no differences in the medications provided in an IV bag from one provider tothose of another provider. There is, however, a big difference in the manner in whichmedications are delivered to the patient at home. Patients often have questions regardingtheir therapy and medications when supplies are delivered to their home. When medicationsand supplies are delivered by a common carrier or the postal service, the deliveryman orpostman cannot provide the patient with answers to their questions about the therapy andmedications. Etown Vital Care is different. Medications and supplies are delivered to thepatient's home by a trained Etown Vital Care representative. The initial delivery and set-up aredone by aEtown Vital Care pharmacist. This individual will be able to answer any questionsthat the patient may have regarding their therapy. This will help to alleviate any anxiety thatthe patients may be experiencing.
Because medications are compounded by the local provider, changes in therapy do not causeincreased expenses. Etown Vital Care does not deliver a month's supply of medication andsupplies in order to save on shipping expenses. AEtown Vital Care pharmacist coordinatesmedication preparation and delivery schedules based on the specific needs of the patient.Etown Vital Care provide referral sources with a cost efficient program that minimizes theexpenses they will incur for products prepared and not administered to the patient. Thissavings is not available through a company that utilizes common carriers or the postal servicefor delivery to its patients. When a change in therapy occurs 5 or 10 days after the month'ssupply has been sent, they follow the same process. Medication and supplies are wasted. Thisis not cost effective. Etown Vital Care offer an alternative with its program that is time efficient,cost effective, and patient friendly.

When therapy begins in the home, Etown Vital Care will provide a pharmacist to instruct thepatient and/or caregiver on the safe and effective use of equipment. If referral sourcecontracts nursing services through another provider, Etown Vital Care will provide those nurseswith an inservice on the equipment and supplies to be used in the patient's infusion therapy.These inservice programs will be conducted prior to initiating therapy in the home to ensurethe safe and effective administration of the therapy. 
All health care professionals should be familiar with the operation of equipment and suppliesbefore entering the patient's home. Etown Vital Care emphasizes the use of training programsand inservices rather than using the patient's home as a training site. A trained team ofprofessionals entering the patient's home that quickly and efficiently initiate therapy increasespatient confidence and will reflect quality patient care. If therapy is initiated with the first dosein the home, Etown Vital Care will remain with the patient throughout the time required toadminister this dose. Whenever the first dose of a therapy is administered at the patient'shome, Etown Vital Care deliver an anaphylactic kit for emergency use. 
The patient will be evaluated for administration devices that are the most adaptable for theirsetting. The devices chosen for the patient are selected to insure the safe and effectiveadministration of the drug as well as to insure high-quality patient care. 
Proper selection and training of the patient and/or caregiver will result in an efficient, safe andeffective delivery of therapy to the patient. When the therapy and its delivery to the patientare understood, the number of interventions required by health care professionals will bedecreased with the result of quality health care and cost savings. A point that should beremembered is that the patient will have access to the Etown Vital Care pharmacist twenty-fourhours a day. These pharmacists will conduct periodic visits to the patient's home to review thepatient's/caregiver's administration technique. This review will be done throughout thepatient's course of therapy.

Continued Quality Improvement and Quality Assurance are terms frequently used in healthcare. The true test of any therapy is whether it improves the patient's condition. Vital Care willwork with referral sources to develop programs that evaluate the outcomes of infusion therapyfor your members. Etown Vital Care will be a partner in the total quality assurance program forhome care. Through development of outcome evaluations and the utilization ofinformation from these evaluations, referral sources and payers will realize the cost-savingsoffered by effective home infusion therapy and Etown Vital Care will be able to determine theservice needs of your patients.
Etown Vital Care has identified several important aspects that should be considered in outcomeevaluations. Some of these include Drug Utilization Review, Route of Administration, Durationof Therapy, Venous Access used during therapy, effectiveness of therapy, patient compliance,patient participation in therapy, patient evaluation of home therapy, and physician evaluationof home therapy. Through outcome evaluations, the quality of care for patients is insured.Data collected through these evaluations will aid in the determination of its expense on a pertherapy basis. Identifying diagnoses which result in costly therapies and the frequency of their 
occurrence will aid in projecting their future expenses. Etown Vital Care will work to help keepexpenses at a minimum while insuring that each patient receives quality care.

Patients may not always be able to self-administer their infusion therapy. However, in manycases a family member or caregiver is willing to assist. This individual is provided training by aEtown Vital Care professional at the site where therapy is to be administered. In addition to on-site training, the caregiver is provided with pump manuals and therapy manuals to answerquestions. AEtown Vital Care professional is always available by telephone to answerquestions. These services, in conjunction with a manual, serve as effective reference materialswhen a professional is not in the home. Caregivers will be reviewed to insure their aseptictechnique for medication administration. If additional caregivers become involved with thepatient's therapy, Etown Vital Care will provide the training and review their techniques of medication administration.
Etown Vital Care emphasizes a complete understanding of the therapy and importance ofaseptic technique to all caregivers. Through caregiver training and periodic review of administration technique, quality patient care is achieved. Proper education, training, andmonitoring promotes safe and effective therapy with the desired therapeutic outcome forpatients in the home setting.

Patient data and therapy information will aid in forecasting of future costs and expenses as wellas cost savings with home infusion therapy. Accurate databases to retrieve information, such asthe names and types of antibiotics used in therapy, diagnosis of patients receiving hometherapy, average duration of home therapy, cost analysis, as well as outcome evaluations, willbe made available through Etown Vital Care. In cases in which referral sources seek specificinformation on patients and therapies, Etown Vital Care will assist by providing the data needed.
The location of Vital Care providers in rural areas allows patients access to these types oftherapy that are not always available through other providers. There are many researchcompanies that offer for sale, at a significant price, projections and forecasts of what the homecare market will represent in one year, three years, five years, etc. This information may notaccurately represent referral sources's members. The participation in patient studies and theexchange of information between Vital Care and it's referral sources will help to plan for thehealth care needs of its members for the future.