For pharmacies
Keep your pharmacy system. Connect the nursing operation.
A pharmacy that sends nurses to patients runs two operations. One is the pharmacy: the prescription, the drug, the inventory, the shipment and the claim. The other is nursing: who goes to which home, when, what they did there and what comes back. Most pharmacies have good software for the first and paper, fax and telephone for the second. This page is about the second.
- Patient and referral
- Order
- Nursing need
- Nurse coverage
- Schedule
- Visit
- Nursing documentation
- Supplies
- Delivery to the pharmacy
- Billing evidence
- Audit trail
The half of the operation the pharmacy system does not hold
Pharmacy software is organized around the medication, and it should be. It knows the prescription, the compound, the lot, the delivery and the payer. What it usually knows about nursing is a line that says a nurse is needed.
Everything after that line happens somewhere else. An intake coordinator telephones nurses or agencies. A visit is agreed by text message. The nurse writes a note on paper, or in a form the pharmacy emailed, and sends it back by fax when there is time. A supply request arrives as a photograph. Someone at the pharmacy keys the visit into a spreadsheet so that it can be billed, and someone else keeps a list of which notes are still missing.
This is true of large specialty pharmacies with national nurse networks and of an independent pharmacy with three nurses and a county to cover. The difference is only how many people it takes to hold the paper together.
What it looks like
A nursing operation run on paper.
None of these is a clinical failure. Each is a place where the work was done and the record of it did not arrive.
Notes that come back late
The infusion happened on Tuesday. The note arrives the following Monday, by fax, missing the stop time. The pharmacy cannot bill the nursing or close its own record until it does.
Patients nobody has confirmed
A patient was due a visit this week. Whether a nurse went is known to the nurse and, eventually, to whoever calls to ask.
A patient with no nurse nearby
The referral is ninety miles from the pharmacy and outside every nurse’s usual area. Coverage is found, or not found, by telephone.
Supplies requested from memory
The nurse tells someone what is running low. What was asked for, what was sent and when are not written down in one place.
The same visit typed three times
Once by the nurse, once for the pharmacy record, once for the invoice. Each copy can disagree with the others.
Nothing to show a surveyor or a payer
The evidence that a competent nurse gave the ordered therapy on the ordered day exists, in a drawer, in several formats.
Two systems, one patient
The proposition is not to replace the pharmacy platform. It is to give the nursing work a system of its own and connect the two.
| The pharmacy system keeps | Paloma connects |
|---|---|
| The prescription, dispensing and compounding | The nursing order that governs each visit, and what changed when it was revised |
| Inventory and shipment of the drug | The supplies the nurse needs at the home, as a recorded request with its delivery state |
| The pharmacy’s claim for the medication | The evidence for the nursing visit: who went, when, what was done, reviewed and signed |
| The pharmacy’s own patient record | The nursing record of the same patient: schedule, visits, notes, open items |
| The pharmacy’s staff and their workflow | The nurses: license, competency, distance, availability and assignment |
How can an infusion pharmacy manage nurses electronically?
In Paloma Cares the referral and order are read into a patient record, and the order that governs care is identified. A nurse is matched to the patient and scheduled, with the nurse’s license and readiness checked against the visit. The nurse documents the infusion on a phone, at the home. A clinical lead reviews the note. Only then does the visit count as finished, for the pharmacy and for billing.
That is how nursing agencies that serve pharmacies run on Paloma now. Each pharmacy the agency serves has its own relationship in the record: its documentation requirements, its rates, its patients.
Can I keep my existing pharmacy software?
Yes, and that is the intent. Paloma does not dispense, hold inventory or bill a drug claim. A pharmacy should not have to change the system its pharmacists work in to get its nursing notes back on time.
A pharmacy reaches the nursing record in one of three ways, and all three read the same record. People use the pharmacy portal. Documents travel by fax where a pharmacy needs paper. Systems connect by API. No channel keeps its own copy.
How do I stop using paper nursing notes?
The paper note exists because the nurse has nothing else in hand at the bedside. In Paloma Cares the nurse’s phone is the form: the patient, the order, vital signs, the access device, start and stop times, the patient’s response, teaching, and what was used. Required fields for that pharmacy and that therapy are asked for before the note can be submitted, so the missing stop time is caught at the home and not the following week.
How do nursing notes get back to the pharmacy?
Paloma gives pharmacy users role-appropriate access to the nursing operation through the pharmacy portal, for their own pharmacy’s patients only. Pharmacists review the shared clinical documents: reviewed nursing notes with their PDFs, and the orders awaiting the pharmacy. Pharmacists and case managers see supply requests, with the PDF of each and its delivery state. Case-management and billing roles otherwise see the information appropriate to their work, and not the clinical notes.
The portal changes what a pharmacy is in this arrangement. It is no longer an organization that waits for documents. It takes part in the nursing operation directly.
We are building the other two channels on the same record: fax through the provider an organization already uses and keeps, and supported API connections into pharmacy systems, added according to the systems our customers run.
How can a rural pharmacy find infusion nurses near patients?
A pharmacy’s patients do not all live near the pharmacy, and its nursing network should not have to either. The hard referral is the one far from everyone: a patient in a small town, a therapy that needs a particular skill, a first dose due in four days.
Paloma Cares already knows what that patient needs, because the order and the address are in the record. Find Staff turns that into a staffing need. Paloma Talent searches for nurses by license, skill and distance from the patient, and is open to any healthcare organization. The search starts from the clinical requirement instead of from a job description someone has to write.
This is the difference between software that stores nursing documents and a platform that runs a nursing operation. Documents come after a nurse has been found.
Can Paloma work with contract nurses and nursing agencies?
Pharmacies cover their patients in different ways: employed nurses, individual contract nurses, one nursing agency, or several agencies by region. A nursing agency on Paloma Cares runs its whole operation there and gives each pharmacy a governed view of that pharmacy’s patients. The agency’s other pharmacies, its internal notes and its finances stay with the agency.
Paloma is designed so that a pharmacy which runs nurses itself can use the same operation: its nurses, its patients, its schedule and its notes, beside its pharmacy system. One product serves both sides of the network.
How does Paloma track what was sent, and how?
A document sent to a pharmacy should have one history, whichever way it travelled: the document and the exact version, who it went to, by what method, each attempt, the result, and who sent it. The agency and the pharmacy should see the same honest state, including a delivery that failed and needs to be sent again.
Supply requests work this way now: each is a document in the patient’s chart with its route and its delivery state. We are extending the same transmission record to notes, orders and invoices, and to fax and API as those channels are added.
The architecture underneath
The pharmacy is the first example of a broader idea in Paloma: one operational record, with different governed views for the organizations and people involved in the care. The pattern is an outside party, its relationship to the patient and the provider, what it is permitted to see, what was sent to it, what it can do, and an audit of all of it.
The same pattern is intended to serve a physician signing orders, a referral source, a payer or program and, when private pay is built, a family. Each will get rules of its own. A family is not a pharmacy, and permission is never borrowed from one kind of party for another.
Why Paloma is built around the whole chain, from the work that needs to happen to the money earned for doing it, is told in an operator’s account of one agency and four lines of business.
Home infusion nursing → Specialty pharmacy nursing → Interoperability → Revenue cycle →
Paloma Cares
See it in Paloma Cares
Paloma Cares is the product that runs this nursing operation. See its pharmacy workflows, its published price and a demonstration agency in which every patient is synthetic.
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.
- Home infusion nursingLiveSee it in Paloma Cares →
- Specialty pharmacy nursingLiveSee it in Paloma Cares →
- 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 →Governed, role-appropriate access to a pharmacy's own patients. Pharmacists read reviewed nursing notes and the orders awaiting the pharmacy, and open the PDFs. Pharmacists and case managers read supply requests with their PDFs and delivery state. Billing contacts keep billing-specific access. Sending orders and messaging are under development.
- Pharmacy invoices, statements and paymentsLiveSee 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.
- Paloma Talent (for any healthcare organisation)LiveSee it in Paloma Talent →Usable by any healthcare organization, with or without Paloma Clinical.
- Custom integrations with a customer's systemsPlatform direction
Questions
Pharmacies and nursing: common questions
How can an infusion pharmacy manage its nurses electronically?
By running the nursing work in a system built for it, beside the pharmacy system. The patient, the order, the nurse’s assignment, the visit, the note, its review and the supply request live in one nursing record, and the pharmacy’s staff see the result without calling or faxing for it.
Can I keep my existing pharmacy software?
Yes. Paloma does not dispense, manage inventory or bill for the drug. The pharmacy system keeps doing that. Paloma manages the nursing work around the patient and returns the documentation the pharmacy needs.
How do I stop using paper nursing notes?
The nurse documents the visit on a phone at the bedside in Paloma Cares. The note is reviewed by a clinical lead and then becomes readable to the pharmacy’s pharmacists in the pharmacy portal, with a PDF. Nothing is handwritten, scanned or re-keyed.
How can a rural pharmacy find infusion nurses near its patients?
By starting the search from the patient. Paloma Cares works out the nursing need from the order and the address, and Paloma Talent searches for nurses by license, skill and distance from that patient.
How do nursing notes get back to the pharmacy?
Pharmacy users have role-appropriate access in the pharmacy portal. Pharmacists read reviewed nursing notes with the PDF of each; pharmacists and case managers read supply requests with their PDFs and delivery state. We are building delivery by fax through the provider an organization already uses, and supported connections into pharmacy systems.
Can Paloma work with contract nurses and nursing agencies?
Yes. A nursing agency runs its operation in Paloma Cares and gives each pharmacy it serves a governed view of that pharmacy’s own patients. Paloma is designed so a pharmacy that employs or contracts nurses directly can run that nursing operation the same way.
How does Paloma track what was sent by fax, email, portal or API?
The design is one transmission record per delivery: the document and its exact version, the recipient, the method, each attempt, the result and who sent it. Supply requests carry their route and delivery state now. We are extending the same record to every document and channel.
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.