For more than two decades, Integrated Health Professionals Inc., a Spokane Valley-based home-heath venture, has been helping to keep the chronically-ill patients it serves across the Inland Northwest out of long-term medical care facilities and in the comfort of their homes.

The locally-owned medical infusion and private-duty nursing provider opened here in 1990 and since then has grown from three employees to a staff of about 110 people, says company CEO and co-owner Michael Glockling.

Integrated Health Professionals' goal is to keep its patients from having to be placed in hospitals and skilled-nursing facilities, thus saving them money and easing their burden, as well as the burden on their families and other caregivers, Glockling says.

The company provides medical infusion services to patients of all ages, but private-duty nursing care only to pediatric patients, Glockling says. He adds that the latter side of the business generates about half of its overall revenue, which so far this year has increased 25 percent.

To serve the young patients it cares for in that capacity, Integrated Health Professionals employs a total of about 80 registered nurses and licensed practical nurses, he says. The company just completed hiring several more nurses to accommodate recent growth it's experienced in that side of its business, Glockling says.

The business's service territory includes all of Eastern Washington, North Idaho, and Western Montana, he says.

Jason Iltz, Integrated Health Professional's director of clinical pharmacy services, says the infusion side of the business, which involves administering drugs to people intravenously and providing the materials and knowledge to do it themselves, also has seen revenue growth this year but not to the same level as the nursing side.

The company's infusion services are available to patients who require regular intravenous medical treatments, which can be administered either at its office or in a non-clinic setting, such as the patient's home, school, or workplace, Iltz says.

On the pediatric nursing side, Glockling says that some of the children the company works with require hourly bedside care due to their condition, such as an upper-airway disorder causing them to need a ventilator to breath. Other children might have been born with a serious birth defect that requires highly attentive nursing care, he adds.

"Not only can we get them out of the hospital, but parents can also integrate back into their jobs," he says. "If they didn't have (nursing services), they would have to care for the child every day."

He says that more than 20 of Integrated Health Professionals' patients receive nursing services on an hourly basis for 8 to 16 hours a day.

He contends that the main benefit for a patient and family is the cost savings in not having to pay daily hospitalization fees. Integrated Health Professionals' patients typically pay a fraction of the cost of similar care in a hospital setting, Glockling asserts.

He estimates that one of the business's in-home nursing patients could pay between $320 and $640 a day depending on the level of care needed and how many hours of care the nurse provided. Daily hospital care, by comparison, could range between $1,000 and $2,000, he asserts. According to information provided by some Inland Northwest hospitals for the Journal's 2011 list of area hospitals published in February, those figures are congruent.

Iltz adds that the cost for similar care services in a long-term facility could also be more than Integrated Health Professionals' in-home nursing, "especially for a patient that requires as much care as some of these kids."

Glockling says Integrated Health Professionals accepts patients who are privately insured, as well as those who are insured through Medicaid and Medicare, adding that the majority of its patients' needs are paid for by the state.

"The state recognizes the need to keep them out of the hospital," he says.

Taking an approach similar to the skilled-nursing aspect of its business, Integrated Health Professionals' home infusion services also seek to allow patients who have chronic conditions—but who don't require the same acute-level care as its pediatric patients—the ability to live a more "normal" life, Iltz says.

"In general, the goal of infusion is to transition people out of the hospital and get them into a home environment," he says. "For some that means just being home will help them heal, but for some to get them back into life might mean back to school and work."

Advancements in medicine over the last several decades have allowed patients who require regular IV infusions the ability in many cases to self-administer their treatment, Iltz says.

"We provide therapy that traditionally was thought of as it could only be done in the hospital," he says. "When you think about bedside care, you think about a patient being in bed and hooked up to machines. Now you get a backpack out with a pump and medicine that a small child could carry around, and people don't even know they are sick."

Patients who require regular IV infusions typically are fitted with a surgically-implanted port called a PICC line that stays in place throughout the duration of therapy, Iltz says.

Conditions that require regular drug infusion as a form a treatment include diseases such as cystic fibrosis, multiple sclerosis, some major immune deficiencies, or a serious bone infection, he says. The type of drugs they need range from antibiotics to parenteral nutrition, which refers to IV-administered nutrients for patients who can't orally take in food, he says.

Integrated Health Professionals' team of certified infusion nurses—who specifically are trained in the area of infusion-based medicine—and clinical pharmacists begin coordinating with a discharge planner a patient's prescribed treatment plan before the patient leaves the hospital, Iltz says.

He says it's crucial to understand the patient's situation to determine who might be helping them administer treatments so that the education process on how to go about home infusion is tailored to that patient's needs and lifestyle.

The business's clinical infusion team then would prepare the prescribed medications at its on-site lab, and would work with the patient's physician to ensure the drugs don't have any adverse effects on the patient, he says.

In the early stages of treatments, a nurse might visit the patient daily to help administer treatments until the patient and their caregiver are comfortable doing it themselves, Iltz adds. After the patient reaches that level of independence, a nurse might only visit once or twice in a four- to six-week period to assess the patient's health and ensure that the treatment is going as planned.

Should any concern arise, Iltz says at least two members of Integrated Health Professionals' team of specialists, including its nurses and pharmacists—as well as him and Glockling, who both have doctoral degrees in pharmacy—are on call around the clock.

Iltz also is a clinical associate professor of pharmacotherapy for the Washington State University College of Pharmacy, located on the Riverpoint Campus downtown. Integrated Health Professionals serves as a practicum site for the college's doctor of pharmacy students, meaning they track the infusion patient's clinical progress, he says.

Aside from home-based infusion, Iltz says patients also have the option to receive their treatments in one of two on-site infusion suites at the business's Spokane Valley office.

While Integrated Health Professionals is one of several home health-care providers in the area, Glockling asserts that the business is one of the last locally-owned operation of its kind here.

He says that most of its competitors all have been acquired by other health-care companies.

One of those competitors is Spokane's Choice Home Health in north Spokane. Formerly called Option Home Health Care Services Inc., it was acquired earlier this year by a subsidiary of Community Health Systems Inc., the big hospital network operator that owns Deaconess Medical Center, Valley Hospital & Medical Center, and Rockwood Clinic PS.

Glockling and a now-retired business partner, Ruth Seignemartin, who still owns 50 percent of the operation, bought the assets of Integrated Health Professionals in 2001 from then-owner Seattle Children's Hospital.