{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:54:31Z","timestamp":1781632471304,"version":"3.54.5"},"reference-count":8,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Purpose<\/jats:title>\n To describe development and implementation of a \u201cclear bagging\u201d workflow to improve coordination of vaccinations after hematopoietic stem cell transplantation (HSCT) while maintaining clinic-based administration and reimbursement.<\/jats:p>\n <\/jats:sec>\n \n Summary<\/jats:title>\n Vaccines administered during clinic visits are often billed through medical insurance using a buy-and-bill model, which can result in patient claim denials and subsequent institutional write-offs, particularly for Medicare beneficiaries. To address this, health systems have adopted alternative distribution models such as clear bagging, whereby an internal pharmacy dispenses medication for on-site administration, supporting care coordination and reimbursement retention. At Oregon Health & Science University (OHSU), patients receiving HSCT complete a 24-month posttransplant vaccination protocol at an ambulatory oncology clinic. To address challenges associated with medical billing for these vaccines, a clear bagging workflow for post-HSCT vaccinations was implemented to route vaccine dispensing through an internal outpatient pharmacy while maintaining clinic-based administration. The implementation leveraged an existing post-HSCT vaccination protocol within the electronic health record (EHR) by incorporating electronic prescriptions that are routed by default to an OHSU outpatient pharmacy. A dedicated outpatient pharmacy work queue captured vaccine prescriptions originating from the EHR protocol, ensuring efficient identification and prioritization for dispensing. Implementation established a standardized workflow for vaccine distribution, documentation, and billing. Over the first 10 weeks after workflow implementation, 173 vaccine prescriptions were processed through the clear bagging workflow. Projected increased reimbursement was $1,655 per Medicare patient completing the 24-month post-HSCT vaccination protocol.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This report demonstrates that clear bagging can be an effective model for vaccine delivery in oncology populations, reducing administrative burden while supporting both patient care and institutional protocols.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ajhp\/zxag163","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T11:42:59Z","timestamp":1780746179000},"source":"Crossref","is-referenced-by-count":0,"title":["Clear bagging workflow implementation for post\u2013hematopoietic stem cell transplant vaccinations"],"prefix":"10.1093","author":[{"given":"Blas","family":"Aguero","sequence":"first","affiliation":[{"name":"Oregon Health & Science University , Portland, OR 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