Retail clinics: field reports

Driving forces / Opinion/commentary/analysis / Retail clinics: field reports / Take Care Health — No Comments
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).

Clinic openings and closings / Driving forces / Retail clinics: field reports — No Comments
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.

Clinics in pictures / HealthMart / Opinion/commentary/analysis / Retail clinics: field reports — No Comments
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:


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6
Jul 10

MA ER: Up

And the increase in ER patients is not due to the advent of universal coverage in Massachusetts, according to this Boston Globe article: Emergency Room Visits Grow in Mass. (7/4/2010)

These observations do not surprise us:

David Morales, commissioner of the division [of Health Care Finance and Policy], said several national and statewide studies have shown that expanding insurance coverage does not reduce emergency room visits. This is because the uninsured “are not really responsible for significant ER use’’ he said.

The growth in emergency room use predates the health insurance law and mirrors national trends, according to Nancy Turnbull, a senior lecturer at the Harvard School of Public Health.

“I don’t think the increase has anything to do with health care reform,’’ she said. “It’s much more reflective of [primary care] access problems.’’

But we feel these two surmises are on shakier ground:

  • “Morales said the state needs “to change our payment system to encourage the use of primary care.’’ Better payment for primary care physicians would encourage more doctors to enter the field, he said.”
  • Andrew Dreyfuss, EVP health care services at MA Blue Cross, the state’s largest insurer, suggests that the slight decrease in ER use among MA BC subscribers “could be related to growing use of limited-service clinics, such as CVS MinuteClinics.”

Changing payments is one part of changing health care usage, but simply raising pay presumes that what primary care is, is what it should be. Do we really know that?

And there are roughly a dozen MinuteClinics in all of Massachusetts. We’re pretty sure they alone did not account for BC MA’s contrasting ER usage trend.

Driving forces / Opinion/commentary/analysis / Physicians' perspective / Retail clinics: field reports / Strategic initiatives — No Comments
19
May 10

Docs Embracing The Convenient Care Concept

Judging, that is, from two items freshly available on the internet.

First this from a May 18 posting in Postgraduate Medicine: Embracing The Convenient Care Concept.

The five Drexel clinicians (three are physicians, at least one is a registered nurse) who authored this piece address the controversial status of retail clinics among physicians this way:

This new trend in delivering health care has been mostly, if not totally, ignored by the medical school practice plans, with the exception of the Mayo Clinic in Minnesota, which has developed several “express care” clinics as stand-alone facilities. As a medical school practice plan and a division of general internal medicine, we could continue to keep a blind eye toward this new trend in primary care medicine or embrace the concept. We aim to develop a new convenient care model integrating our College of Medicine practice plan in partnership with our College of Nursing graduate nursing program to form a stand-alone clinic within a bustling business district in downtown Philadelphia….

….Although organizations such as the American Medical Association and the American Academy of Pediatrics initially voiced concerns over quality of care and disruption to the continuity of care, … retail clinics have exceeded expectations and proved that they can perform well, both in terms of patient satisfaction and in quality measures….

The second is a Washington Post guest editorial written by San Francisco-based emergency room physician Jennifer Brokaw:

Keeping routine medical care out of hospital emergency rooms (5/18/10; free registration may be required).

….[N]on-emergency care delivered in the ER costs almost five times more than in a doctor’s office or clinic.

There are four ways we can steer minor emergencies away from the ER.

First, establish more offices and clinics that are not based in hospitals (and do not carry hospital overhead). The recent trend toward low-cost, retail- and pharmacy-based clinics has been a relative success for what these facilities offer: quick evaluation and treatment for simple problems. They have been found to cost less than one-fifth of what an ER costs for the same complaint….

Clinics in pictures / Driving forces / Employers and retail clinics / Health care practitioners / Public policy / Retail clinics: field reports / Strategic initiatives / Tactical innovation — 1 Comment
29
Apr 10

Community Health Centers and Retail Clinics: Are You Thinking What I’m Thinking?

I mean, when I look at the map of community health center locations provided in this New England Journal of Medicine article: (Health Care Reform and Primary Care — The Growing Importance of the Community Health Center, 4/28/10), I say to myself “imagine if that many locations were served by retail clinics”.

And then I occasionally reply to myself, “well, why couldn’t the retail clinic operators do for some – and maybe many – community health centers what they have begun to do for employer-sponsored onsite clinics?” which is namely to supply operating expertise with special attention to the particular needs of the location’s clientele.

And then I frequently go “hmmmm….”

For the time-pressed, here is the map in question – though I strongly urge anyone following retail clinics to check out the entire article:

Nationwide Distribution of Community Health Center Sites, 2008.</p> <p>Data are from the 2008 Uniform Data System, prepared by the Robert Graham Center, April 2010

Nationwide Distribution of Community Health Center Sites, 2008.
Data are from the 2008 Uniform Data System, prepared by the Robert Graham Center, April 2010.

The accompanying map of the share of each state’s population that frequents CHCs is also information-rich:

Percentage of the Population of Each State Served by Community Health Centers, 2008

Percentage of the Population of Each State Served by Community Health Centers, 2008

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28
Apr 10

Initiatives to Reduce Avoidable ER Visits Dept.

No, we don’t have “departments”, a la old-timey print periodicals, but we’ll probably strive to keep an eye out for stories similar to this unprepossessing notice that appeared in the 4/28/10 Chillicothe Gazette:

New Initiative Designed to Reduce ER Visits

A kickoff meeting for IMPROVE (Implementing Medicaid Programs for the Reduction of Avoidable Visits to the Emergency Department) is scheduled for this morning in Columbus….

According to the very brief article, the program will

  • redirect ER visits to more appropriate treatment venues
  • increase communication quality among care providers and health care systems
  • promote ER visit alternatives “consistent with the medical home concept”

to accomplish its mission.

Big goals, short article, no publicly available details we know of, yet. Looking forward to learning more about it.

Driving forces / Opinion/commentary/analysis / Retail clinics / Retail clinics: field reports / Strategic initiatives / Tactical innovation — 1 Comment
26
Apr 10

Q&A With MinuteClinic’s Sussman on Providing Chronic Care

Just when we were all set to mope about the shortage of new retail clinics stuff to kibitz about, along comes Drew Weilage’s Our Own System blog with a sharp note regarding the Minneapolis Star Tribune’s Q&A with MinuteClinic CEO Andrew Sussman on MinuteClinic’s new chronic condition monitoring services (Minneapolis Star-Tribune, 4/18/10). The Star-Tribune’s Chen May Yee is atop her formidable reportorial game with this question (though the reply is not particularly revealing):

Q I’m intrigued by the lineup of MinuteClinic CEOs so far. You had Michael Howe, who came from the fast-food world, followed by Chip Phillips, who came from the pharmacy world, and now you, a doctor who comes squarely from the traditional health care world. What does this say about MinuteClinic’s ambitions?

A I come with great excitement for delivering health care services in new ways that meet patients’ needs, that’s accessible, affordable. Right now, that’s what our country needs.

We like both Weilage’s reference to the Star-Tribune’s article (how do we miss so many of these gems ourself? All those geeky alert and monitor code thingamabobs, for naught!), and also Weilage’s blog, from its minimalist design to its optimalist content. Good stuff, that.

PS: here’s another terrif piece, introduced to us in the same Our Own System article, on nurse-centric programs crafted to manage hospital readmissions more effectively (or, more accurately, to avoid them)

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20
Apr 10

New Clinics Locator – And Clinic Treatment Is (Often) Free!

Or at least this is what the Partnership for Prescription Assistance says at their web pages for the Partnership for Prescription Assistance’s new Blackberry and iPhone clinic locator apps:

With this application, patients can scroll through the medicines offered by PPA member programs or locate one of 10,000 free health care clinics across the United States…..Many patients will get their medications at no cost or at discounted prices….The Partnership for Prescription Assistance can help you find free or low-cost health clinics near your home.

Here’s a link to the online version of the locator itself: Partnership for Prescription Assistance Low-Cost Health Clinic Finder.

Hat tip to MedGadget for posting this info.

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13
Apr 10

Growing Pains In The Birthplace of Retail Clinics

A fine 3-page article in Monday’s Minneapolis Star Tribune captures the current state of uncertainties about retail clinics’ future (HCMC is Late Entry in Retail Clinic Race, April 12,2010, immediate access.)

The article focuses more on the clinical than the financial aspect of the challenges clinics face, asserting that the seasonal nature of the conditions clinics treat most – colds & flu – most confounds efforts to make retail clinics sustainable.

The article reminds us that we would love to see data on the spectrum of conditions that clinics address, to see both the #s of reported incidents of those conditions in representative regional populations and the frequency with which treatment is sought for those conditions. Does anyone know where this kind of data might be found?

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