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Elevate Health Technologies recently conducted in-depth interviews with the clinical staff at Dr. Luis Diaz’s Neurology practice in Las Vegas, NV, where nurses and other clinicians are on the front lines, tirelessly advocating for patient care day in and out. What emerged from these conversations was powerful testimony supporting why site of care isn't just a matter of convenience, but a critical factor in patient safety, treatment efficacy, and overall healthcare quality.
The following insights come directly from frontline clinicians at Dr. Luis Diaz’s clinic, who manage infusion therapy every day for patients with multiple sclerosis, myasthenia gravis, and other neurologic conditions requiring specialized IV medications to slow disease progression, help manage symptoms and improve their quality of life.
For patients requiring regular infusion therapy, IV medications for conditions like multiple sclerosis, myasthenia gravis, or autoimmune disorders, where they receive treatment can profoundly affect care quality and outcomes. While insurers increasingly push patients toward standalone infusion centers or home health services to cut costs, a growing body of evidence suggests that keeping these treatments within the physician’s office delivers superior results, while decreasing costs.
In our interview with Tanya Pellegrini, RN at Dr. Diaz’s clinic, we explored her personal experience in advocating for patients while navigating complex insurance approvals to ensure medications are administered in the most appropriate setting for optimal outcomes.
When asked about physician-based treatments versus sending patients to outside infusion centers, Tanya’s response was unequivocal: “There are a hundred reasons why they need to be here with the doctor if the opportunity exists.”
The advantages of physician-site care extend far beyond convenience. Tanya described how comprehensive observation begins the moment patients enter the office: “When the patient receives the infusion here, we escort them back to the infusion center, I’m looking at you, I’m talking to you, I’m seeing what’s going on.”
This continuous observation enables rapid recognition of changes: “I can see how you’ve changed, either for the better or for the worse, from three weeks ago or four months ago. We’re observing patients from the moment they walk in…” Tanya explained.
Proximity to the physician is invaluable when issues arise: “If something comes up, it’s easy to say, “This is a problem. We need to let you see Dr. Diaz today. He’s right here, let me get him.”
When patients are sent to outside infusion centers, the result can be a “ring-around” of fragmented care. Tanya detailed the cascade of communication failures: “The infusion centers are over there; they’re being infused. They call us if the patient is experiencing symptoms or reactions, then they want us to evaluate when there’s no patient in front of me… Now we’re making an appointment for the patient to come back to the office because the patient has a flare-up. The patient has to come back and be evaluated at the office where they would have already been in the first place. Now I need to speak to the other office, then to the patient, to get to their schedule.”
The administrative burden multiplies with each handoff: “Did you get the labs for the patient? Now I need to send you the lab order… Now the patient has a question about the labs, and now you need to call me back again… I could have done all of that right here, while the patient was here.”
Published research mirrors these observations. A quality-improvement study in BMC Health Services Research notes that breaking continuity of care by sending patients to outside facilities contributes to suboptimal outcomes by diminishing close contact with primary providers and by preventing centralized documentation in the health system’s EHR. The same study found prior authorizations can create the largest bottlenecks, with insurer responses taking up to two weeks at times (Choudhary et al., 2023).
Tanya also described lapses in oversight when infusions occur elsewhere. “We have a patient who went elsewhere for his or her Ocrevus infusion. I don’t know how the patient got infused, as we never sent an order. How does the other infusion site know that patient even needs that medication...”
In that case, the patient was infused a week early relative to the 26-week interval, raising serious concerns about quality control and coverage. Fragmented care outside the physician’s office creates opportunities for medication errors, inappropriate dosing, and missed adverse reactions, issues that can be addressed immediately in an integrated setting.
Tanya shared another case that illustrates this problem: “We had a patient who wasn’t even our patient yet, transferring from a retiring neurologist, and the infusion center wanted us to give them an authorization to infuse when Dr. Diaz hadn’t even consulted to make sure the patient was being cared for correctly.”
Drawing on her insurance background, Tanya highlighted the shortsightedness of policies that push care elsewhere. “A patient missed his care and is experiencing setbacks. The insurance company does not care if he goes to the emergency room (ER) instead of receiving treatment on time to prevent the ER issues. Instead, the insurance company gets a humongous bill, and they don't care that it will cost more in the long run?”
The downstream costs of emergency department visits, hospitalizations, and treatment failures that stem from fragmented care make the case for keeping infusions within physician practices.
Patient preference often favors in-office infusions. Tanya described patients facing insurance pressure to go elsewhere: “We, the doctor's office, push back to the insurance companies. We fight tooth and nail to advocate for the patient. The patients state they are not going to go elsewhere- they want to go where their doctor is. The patients should have a choice on where to go.”
The patients and practices know that relationships matter: “Patients become family, whether they know it or not,” she said. “When they come here, they’re monitored. We know what they need, what they don’t need, what’s changed, and they have access to the doctor. You’re going to have the same nurse taking care of you every time. You’re not a number.”
That same story shows up in the patient infusion chair. David, a myasthenia gravis patient who has been visiting the Las Vegas Neurology Center in Las Vegas, NV for the past 6 years, has received infusions across multiple sites of care. After his first in-office infusion at the Las Vegas Neurology Center, he called the experience “far superior.” He praised the nursing expertise for painless access, on-time bottle changes, and clear communication through a five-hour session.
Small details mattered: the team re-arranged seating for comfort, varied the television programming, and sent professional text reminders for his standing appointment every fourth Wednesday at 9:00 AM. He reported no delays, the best comfort he’s ever had, and, most tellingly, no dread leading up to treatment day.
Knowing he’ll see the same nursing team and that his physician is just steps away gives him a confidence he never felt at external infusion centers. This is exactly the enhanced experience which Elevate Health Technologies’ OnePulse Connect enables: clear communication, consistent care, on-site physician support, and added comforts to allow patients to get the most out of treatments. In fact, communication starts well before the patient’s first treatment- with appointment reminders and tips to stay comfortable.
Our patient satisfaction surveys echo David’s experience. Patients thank our nurses stating that they have “made the experience so much better.” They also highlight what matters most: “ease of access” and a “convenient and nice experience.”
Evidence from frontline experience at Dr. Diaz’s clinic and published research shows that physician-based infusion care offers superior outcomes through continuous observation, immediate intervention, streamlined communication, and comprehensive coordination. As Tanya put it: “It’s a lot more work for Dr. Diaz, and a lot less continuity of care for the patient, when infusions occur outside the physician’s office.” Not to mention the long-term cost of reduced outcomes and potential hospitalizations from delayed or missed treatments.
Through Elevate Health Technologies’ OnePulse Connect-Infusion solution, healthcare practices can enable patients to receive their important treatments in a trusted, optimal setting- their physician’s office. The challenge now is aligning insurance policies with clinical realities. Until then, practices will keep fighting to provide the integrated care their patients need and deserve, proving daily that site of care isn’t a convenience; it is a critical determinant of outcomes.
For healthcare practices interested in establishing their own in-office infusion programs, Elevate Health Technologies’ OnePulse Connect provides comprehensive, turnkey solutions that handle everything from setup through implementation and beyond. By keeping infusion therapy within the physician's office, we can deliver on the promise of better care, better outcomes, and ultimately, a better healthcare system for all.
Schedule a consultative meeting with Elevate Health Technologies to learn how OnePulse Connect- Infusion can transform your practice and provide the best-in-class Infusion experience patients deserve. Click here to schedule a consultative meeting!
Learn More about your turnkey In-Office Infusion program here
About Elevate Health Technologies:
Elevate Health Technologies is committed to making healthcare better for everyone. We collaborate with healthcare providers, patients, pharmaceutical manufacturers, and payors to deliver innovative technologies that truly make a difference. OnePulse Connect empowers healthcare practices by optimizing efficiency and streamlining care, whether through buy-and-bill management, inventory tracking, medically integrated dispensing, or in-office infusion services. Our tailored approach delivers deep data insights, advanced analytics, and dynamic patient engagement platforms. Together, we move as One Pulse, driving smarter, faster, and more connected health technologies for improved outcomes and better patient experiences.
Visit www.elevateht.com to learn more.
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