Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

INTRODUCTION:

Chemotherapy and other infusions in the home is rapidly growing area in healthcare service delivery.  However, in Australia, there is no State licensing or mandatory National accreditation of healthcare services delivering this care.  This means there is no State Health Department oversight of the home healthcare industry anywhere in Australia, and accreditation, which is a process that ensures national healthcare standards are in place, is not enforced or monitored.

AIM:

To identify the major safety risks to patients from the under-regulated development of home chemotherapy services.

METHOD:

chemo@home™ is an Australian, multi-award winning, fully-accredited, private health service, specialising in the management and administration of chemotherapy and immunotherapy in patients with cancer and chronic diseases (such as multiple sclerosis (MS), inflammatory bowel disease (IBD) and rheumatoid arthritis), at home.  Started in 2013, chemo@home™ founded the private chemotherapy at home market in Australia and remains the largest and most experienced provider.

The Founders of chemo@home™ were interviewed to document their unique knowledge in quality and safety of home chemotherapy delivery.

OUTCOMES:

Six major areas of risk where identified in the interviews.  These include the lack of:

• Legislation to regulate the home healthcare environment;
• Mandatory accreditation for healthcare services delivering home healthcare;
• National guidelines for home healthcare services and non-adherence to applicable national guidelines on chemotherapy services/safety (e.g. COSA)
• Appropriate health service governance over chemotherapy protocol assessment and management in the home environment;
• Compliance with product information for medications;
• Risk mitigation and adverse event management of high-risk medications (including the availability at the point of care of resuscitation medications and equipment)

CONCLUSION:

Without legislation, regulation, accreditation and implementation of appropriate guidelines, the administration of chemotherapy in the home is reliant on individual service providers standards of practise.    This may place cancer patients treated at home at risk of healthcare misadventure.