02
Sep 10

Green Shoots, The Sequel (vol 3)

Clinic operators continue to shift their mix of locations, closing here, opening there, changing operating hours elsewhere. Target’s announcement of plans to open five new Chicago-area clinics (Chicago Breaking Business, 9/2/10; immediate access) is just the latest sign of retail clinics’ continued evolution.

UPDATE: WalMart has also recently opened a new clinic in Palmyra, ME – it’s 100th retail clinic, according to available news stories.

Target has made few changes in its clinics mix in the past few years. The five new Chicago clinics will bring their total to 36 – a large move percentagewise, but not one that will vault Target into the ranks of the leading clinic operators, CVS (MinuteClinic), Walgreens (Take Care Health), Kroger (The Little Clinic), or WalMart.


30
Aug 10

Thinking Flu Shot? Schedule It

We’ve never been clear why retail clinics have not done more experimenting with scheduling. Like MinuteClinics’ new flu scheduler initiative:

Flu Shots Your Way

Or Target’s since-discontinued online clinic visit scheduler.

My sense is that Target took down its online scheduling application due to lack of use – but why not make it available, even if it’s seldom used? Its very availability suggests that Target has its would-be clinic visitors’ ease & convenience in mind. I suppose it raises issues for onsite juggling of onsite walk-in customers – who may be unaware of clinic scheduling options – and those in the know who HAVE scheduled visits.

Management of customer perceptions of ‘privilege’ is not insignificant, but may be enough, combine with low use, to make mothballing scheduling the right move.

Can anyone help clarify this for me?


25
Aug 10

Take Care Health Congratulates Itself For Engaging Its Clientele

On the other hand, what else are press releases for, anyway?

Exceptional Patient Experience Delivered at Take Care Clinics at Select Walgreens

Take Care Clinic strongly engages more than 3-out-of-every-4. The typical company in Gallup’s database strongly engages less than 1-in-5 of their customers.

“In today’s consumer-driven healthcare environment, engaging patients is far more powerful than simply satisfying a patient. Not only is satisfaction a poor indicator of future behavior, but more importantly engagement may be predictive of a patient’s willingness to make changes necessary to improve their health,” said John Fleming, Gallup principal and chief scientist customer engagement….

“Take Care Clinic believes that an engaged patient leads to better adherence,” said [ Sandra F. Ryan, RN, MSN, CPNP, FAANP and Chief Nurse Practitioner Officer for Take Care Health Systems]. “If a patient believes in the provider who is giving the advice, they are more likely to follow the treatment protocol that has been put together. This includes taking medication as prescribed, seeking follow-up care or making a lifestyle change. The patient is also more likely to return to a Take Care Clinic because of the great experience and care received.”

Before we continue – who knew you could grow up to be a customer engagement scientist? Sounds cool.

We understand Take Care Health’s and Gallup’s enthusiasm for the kind of customer engagement Take Care clinics are generating. What we don’t understand is this: given retail clinics’ focus on episodic care, and their explicit public commitment to supporting customers’ development and/or maintenance of relationships with primary care physicians, shouldn’t ‘scoring’ engagement success based on actual customer return visits be viewed as ambiguous at best? (We can set aside that, as a practical matter, Take Care will have a tough job gathering objective evidence that customers have in fact followed through on care recommendations from their Take Care visits).


24
Aug 10

Echoes From Rand’s Retail Clinics Report

Summaries are trickling in:

The Role of Retail Clinics Post-Health Reform (HealthPopuli, 8/22/10)

More Research Needed on Role of Retail Clinics: Study (Healthcare Financial News, Healthcare Financial Management Association, 8/23/10)

and they’re as devoid of surprise as the report itself. Which is probably par for the course for any report released in mid-August.

They’re also prone to substitute their own implications for the frankly cautious implications identified in the report itself. Again, little surprise there.


20
Aug 10

Policy May Shape Clinics – and Clinics May Shape Policy

This concise summary of the emerging retail clinics business:

McMedical Care |The rise of health clinics in retail stores could affect both health policy and regulation

http://www.governing.com/topics/health-human-services/McMedical-Care.html

was published in Governing in 2006, so it could not have been informed by the recent white paper on clinics and public policy released by Rand, & written by Dr. Ateev Mehrotra and colleagues which we posted about yesterday. We did not see it in 2006 – a link to the article showed up in our mail just yesterday – so we took heed of the serendipity & decided to reference it here.

At very least it makes a nice complement to that more recent publication, providing a historical point of reference for the early & modest research findings summarized in the Rand paper.


19
Aug 10

Retail clinics and public policy

It’s been a relatively slow summer, newswise, for retail clinics, and our vigilance for news items has undoubtedly flagged a bit. So imagine our delight to have news of this report show up in our mail this morning:

Policy Implications of the Use of Retail Clinics. August 2010. Authors: Robin M. Weinick, Craig Evan Pollack, Michael P. Fisher, Emily M. Gillen, Ateev Mehrotra.

We haven’t yet seen any media releases for it, and thought you’d like to know about it.

Dr. Mehrotra can lay claim to being the most recognizable retail clinics expert among clinicians and academics.

We’re poring over the report as you read this. Watch for our review in the next few days.


17
Aug 10

Do More Retail Clinics Equal Fewer Primary Care Docs?

Ken Terry thinks so.

I don’t believe so, and I don’t think the facts Ken points to in his brief article make his case, but alas – I have not marshalled the countervailing facts that impel me to disbelieve his assertion. I hope to, but it won’t happen today.


17
Aug 10

Two (Or More?) Faces of Mobile Health

We don’t comment primarily on health applications of telecommunications technologies, or on public health initiatives. We’re firstly about health care that features convenience (I like convenience. People like convenience).

We remind you, dear reader, of our principal theme to give you context for our posting the following links to two otherwise apparently unrelated health care topics, both identified by their authors or editors as about “mobile health”:

Mobile Clinics Seen As A Way To Cut US Health Bill (Scott Malone, Reuters, 8/11/10; immediate access)

The [Family Van] — which visits six low-income neighborhoods around Boston weekly — is one of about 2,000 such mobile clinics in the United States. Advocates say the approach can help control the rising cost of health care by helping people with chronic diseases to stay out of the emergency room, often the first recourse for inner-city residents.

Mobile Health and the FDA: What WellDoc’s Approval Means for mHealth (Jane Sarasohn-Kahn, HealthPopuli, 8/10/10; immediate access)

While an “N” of 1 = 1, and WellDoc’s approval is for one product from one company, the approval of DiabetesManager represents a positive sign for the many developers of mobile health applications waiting in the wings for market approval.

We’re confident that your familiarity with Healthcare 311 would equip you to advise those authors & editors that their subjects are also squarely in the realm of “convenient health”.

Because they are.


17
Aug 10

CNBC Loses At Retail Clinics

The Fast Money fast talkers are slow learners when it comes to retail clinics & convenient care. In fact, this clip suggests they have learned nothing whatsoever about the industry – but it didn’t stop them from making collective boobs of themselves. Witness:



10
Aug 10

MinuteClinic Visits Up + Conventional Medical Visits Down <> Trend

Sorry, Johnson/Rockoff/Masters, California Healthcare Foundation, Mark Perry, et al – you are NOT on to any particular thing here, however much you wish it so.

MinuteClinic visits up + conventional visits down DOES equal “it’s the economy, stupid” (and no, you bloggers/commenters/industry observers aren’t stupid, either).

We’ll know we have systemic change worth talking about when data on the use of “physician extender services” (gee whiz, is the vocabulary of health care innovation ever lame) shows people prefer the combination of ease, convenience, and quality they offer to care they have obtained from conventional clinicians in conventional settings, in significant numbers.

The data doesn’t show that yet.

Meanwhile, Dr. Jason Hwang, he of The Innovator’s Prescription (along with Clay Christensen & Dr. Jerome Grossman) points to the way Minnesota-based integrated health system HealthPartners is refashioning its delivery of primary care services through the conscious application of wellness programs, worksite clinics, e-visits, and retail clinics.