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Clear bagging workflow implementation for post-hematopoietic stem cell transplant vaccinations.

Blas Aguero¹, YoungYoon Ham¹, Amber Diaz¹

¹Oregon Health & Science University, Portland, OR, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists

|June 8, 2026

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Clear bagging improves vaccine administration coordination for hematopoietic stem cell transplant (HSCT) patients. This workflow enhances reimbursement and reduces administrative burden in oncology clinics.

Area of Science:

Oncology
Pharmacology
Healthcare Administration

Background:

Vaccine administration post-hematopoietic stem cell transplantation (HSCT) presents coordination and reimbursement challenges.
The traditional buy-and-bill model for clinic-administered vaccines can lead to claim denials and financial losses, especially for Medicare beneficiaries.
Alternative distribution models like clear bagging are being adopted to streamline vaccine management.

Purpose of the Study:

To develop and implement a clear bagging workflow for post-HSCT vaccinations.
To improve the coordination of vaccine administration within an ambulatory oncology clinic setting.
To maintain clinic-based administration and optimize reimbursement processes.

Main Methods:

Implemented a clear bagging workflow routing vaccine dispensing through an internal outpatient pharmacy.

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Utilized electronic health record (EHR) integrated electronic prescriptions for the post-HSCT vaccination protocol.

Established a dedicated outpatient pharmacy work queue for efficient identification and dispensing of vaccine prescriptions.

Main Results:

Successfully processed 173 vaccine prescriptions through the clear bagging workflow in the first 10 weeks.
Projected increased reimbursement of $1,655 per Medicare patient completing the 24-month vaccination protocol.
Demonstrated a standardized workflow for vaccine distribution, documentation, and billing.

Conclusions:

Clear bagging is an effective model for vaccine delivery in oncology populations.
The workflow effectively reduces administrative burden associated with vaccine management.
The model supports both patient care coordination and institutional financial protocols.