During my years as an ER nurse, I saw my father in the chronic illness patients who regularly came through our doors. Like them, he spent decades suffering from emergency conditions that could have been prevented with proper and consistent care. But unlike them, his ER visits eventually slowed, then stopped completely. Not because of a miracle cure, but because he had me: a reliable and skilled nurse performing his life-saving infusions in the home — on time, every time.
It became clear to me that if my father’s life could be drastically improved with routine at-home care, so could many others. The solution seemed straightforward, but as I’d soon learn, the road to home infusion is riddled with administrative hurdles, staffing challenges, and communication barriers — solvable issues we’re long overdue to address as an industry.
My father was diagnosed with Common Variable Immune Deficiency (CVID) in 1979 after a harrowing ICU stay that left doctors questioning whether he would survive. Despite being an elite runner and water-skier beforehand, missing infusions meant his immune system would be one-tenth as effective as a normal person’s, tethering his survival to medical facilities and their rotating casts of nurses.
Every six weeks throughout the 1980s, my father and a family member would take a full day off work, drive 30 minutes to a hospital, pay for parking, wait for an available chair, endure the infusion, wait again for discharge paperwork, and finally drive home. My extended family regularly donated plasma for these early infusions, but even after pharmaceutical companies began pooling plasma donations and manufacturing antibody infusions (Ig), these hospital days drained my father’s energy, well-being, and even health.
The quality of care was equally problematic. On numerous occasions, nurses with inadequate technical skills would stick him 6-8 times unsuccessfully, requiring backup nurses and rescheduling, which meant missed treatments, sick days, and increased vulnerability to infections. This pattern continued for years: suboptimal care leading to suboptimal health outcomes.
The turning point came when I, now a Registered Nurse, moved back home. Suddenly, my father had access to something that should have been standard all along: a skilled and dependable RN (albeit his son) who could administer his treatments at home, on schedule, every time.
The transformation was immediate and profound. Rather than receiving treatments every six weeks, he could now get them every other week, which kept his immune levels more stable. The more frequent, smaller doses drastically reduced his post-infusion fatigue. Instead of struggling through 2-3 days of malaise following each mega-dose, he now needed just a brief nap before returning to full energy.
Through my ER career, I accumulated a mounting epiphany: my father’s decade-long pattern of inconsistent care triggering acute episodes wasn’t unique. It’s actually well understood among emergency medicine professionals that the high volume of chronic illness patient visits consume most hospital capacity and makes caring for emergent patients harder—but no one knew how to break the cycle. Now, as a founder of a health tech company, I know that this disconnect illuminates a high-level blind spot in how we approach home infusion and other technical medical services.
The traditional approach has been to take home health nurses, often with a different skill foundation, and have them occasionally perform technical procedures they might only do intermittently. It’s like asking someone who typically operates a big rig to operate a commercial airplane once a month and expecting the same level of proficiency as a full-time pilot.
The better approach, which altered the course of my father’s life, inverts this model: bringing highly skilled hospital nurses with thousands of hours of technical experience into the home setting. These practitioners have developed the “10,000 hours” level of mastery that Malcolm Gladwell famously described — they’ve placed countless IVs, monitored complex medications, and handled unexpected complications as part of their daily work.
There’s another critical element here: the landscape of available medications is constantly evolving. New drugs, monitoring guidelines, and side effect profiles emerge regularly. Clinicians who specialize in infusion therapy are more likely to stay current with these changes, providing an additional layer of safety and efficacy.
The nurses who struggled to administer my father’s treatments weren’t uncaring; they simply lacked the specialized experience needed for consistent success with technically demanding procedures. When treatments are administered by specialists who perform these tasks daily, the patient experience improves dramatically, and health outcomes follow.
The future of chronic illness care must recognize this fundamental truth: not all nursing skills are interchangeable. Home health and home infusion require different specialties and should be treated as such. You can bring a hospital nurse into a home setting and achieve excellent results, but taking a home health nurse whose primary focus has been on safety assessments and general care, and expecting technical proficiency with complex infusions, often leads to suboptimal outcomes.
This realization is part of a broader unbundling of hospital services that’s beginning to transform healthcare. As we develop better systems for deploying specialized clinical talent into home settings, we can move increasingly complex care out of facilities and into people’s homes, where treatment is often more comfortable, convenient, and cost-effective.
Technology will accelerate this transformation. With robust data and well-defined use cases, AI can help identify patterns, predict complications, optimize scheduling, and perform other support functions that make home-based care more efficient and effective.
As we navigate these changes, we must remember my father’s experience and the experiences of millions like him. The next frontier in healthcare isn’t just about new medications or diagnostic tools; it’s about reimagining how and where we deploy our existing clinical expertise. For patients with chronic illnesses, this distinction is the difference between thriving and merely surviving.
Author bio:
Ryan Johnson is the CEO and co-founder of Float, a health tech company that reduces operational costs for pharmacies, connects nurses with home infusion work opportunities, and provides quality care to chronic illness patients.
Photo: boonchai wedmakawand, Getty Images
