The operating chain
The fragmented infusion nursing workflow.
Eight steps, usually spread across fax, spreadsheets, text messages, paper notes and a portal or two. Here is the chain as an agency actually lives it, where it breaks, and what changes when it is one record.
The chain
One operational event, seen eight ways.
- ReferralThe pharmacy’s request arrives
- Patient and governing orderWho needs care, and what care is authorized
- Pharmacy relationshipThe requirements, rates and submission rules that apply
- StaffingAn eligible, credentialed clinician within reach
- Schedule and visitThe appointment, and the care delivered
- Documentation and reviewThe record, checked against what was required
- Pharmacy communicationWhat the pharmacy must get back
- Invoice and reconciliationWhat the visit is worth, billed and paid
Where it breaks
Every handoff is a place where work is lost.
| Between | What goes wrong by hand | What Paloma keeps |
|---|---|---|
| Referral and order | The packet is typed again, and the dose in the schedule is not the dose the prescriber signed. | AI reads the packet and proposes the patient, drug, dose, route, frequency and prescriber; staff confirm. The source document stays with the record. |
| Order and visit | The order is revised and the nurse arrives with last month’s instructions. | A revised order is a new order, never an edit. The order that governs today is known, and the nurse charts against it. |
| Need and nurse | The referral lands where the agency has no nurse, or the assigned nurse’s license lapsed last week. | License and competency status is shown before assignment; Find Staff searches the agency’s own eligible staff, then Paloma Talent. |
| Visit and note | The note comes back days later, incomplete. | A guided note on the nurse’s phone, saved as the nurse works; a dose that does not match the order is flagged before signing. |
| Note and review | Nobody reviews it until the pharmacy asks. | Every submitted note reaches the Director of Nursing’s queue, to be approved or returned for correction. |
| Agency and pharmacy | The pharmacy wants its own form, and learns what happened by email. | Per-pharmacy documentation requirements, and a portal where authorized pharmacy users access role-appropriate information for their pharmacy. |
| Visit and invoice | A completed visit never reaches an invoice, or reaches it at the wrong rate. | Only reviewed, signed visits become invoice lines, at that pharmacy’s contract rate; every completed visit not yet invoiced is shown, with the reason. |
| Invoice and payment | A correction overwrites the record, and what was booked no longer matches what the pharmacy was told. | Payments are recorded as events; a correction preserves the original. |
Why these should not be separate systems
Consider one visit. The nurse who made it needs the order. The reviewer needs the note and the order together. The pharmacy needs the reviewed note. The biller needs to know the visit was reviewed and which contract prices it. The administrator, months later, needs to show a surveyor that the nurse was licensed that day.
In separate systems, each of those people is handed a copy. In one record, each of them is looking at the same visit from where they stand. That is the difference Paloma is built on, and it is why the pillars of the platform are not separate products.
Paloma Cares
See the current Paloma workflow
The demo agency is a working Paloma Cares with synthetic patients, pharmacies, orders, visits and invoices. No sign-up and no card.
From Paloma Cares
What Paloma Cares supports today
This list is published by Paloma Cares and was last verified on 2026-10-10. palomacares.com is the source for what the product does now.
- Referral intake with AI document readingLiveSee it in Paloma Cares →
- Orders and the governing orderLiveSee it in Paloma Cares →
- Find Staff from the patient chartLiveSee it in Paloma Cares →The staffing need is worked out when Find Staff is opened from a chart, referral or visit.
- Infusion visit documentation on the nurse's phoneLiveSee it in Paloma Cares →
- Clinical review before billingLiveSee it in Paloma Cares →
- Pharmacy portal for pharmacy partnersLiveSee it in Paloma Cares →Read-only governed access for pharmacist, case-manager and billing-contact roles. Sending orders, messaging and downloads are under development.
- Pharmacy invoices, statements and paymentsLiveSee it in Paloma Cares →
The products
The software doing it.
Use either independently. Use them together when you want patient demand and workforce supply to work from the same context.