Tactical innovation


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?


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.


6
Jul 10

Health Care as Information Care: View From The Street

Sure, plenty of articles, news blurbs, tweets, and other stuff has been issued about personal health records (I’m blazing a new trail: The Term Doesn’t Need Capitalizing Anymore. You read it here first), but few really acknowledge the primacy of information care in the realm of routine primary care the way this recent Chicago Sun-Times article does:

Health Records In A Snap (7/3/10, immediate access – no registration/subscription required).

We’re not sure reporter Sandra Guy identifies the potential alternative futures perfectly, but she does a more than respectable job:

One key question is how electronic records from these kinds of centers will talk to other electronic records being generated by a growing number of retail clinics and health-screening kiosks, as well as at hospitals, emergency rooms and primary-care doctors offices.

Will the system end up like the United States’ cellular-phone system, with a variety of underlying network standards that are able to talk with one another, albeit with expensive roaming fees? Or will a single standard be mandated?

There’s plenty of room for alternatives between these rather stark choices, and we would have liked to see some of those referenced in this general interest piece. But that’s exactly what enthuses us about this article – it’s a general interest piece that frames the connection between “better” primary care and “better” means of communicating about that care more lucidly than most of its kind.


11
May 10

Bayer Diabetes Care Sponsors Free A1c Tests At MinuteClinics Thru June 12

As they say in the retail business, “while supplies last”….

Free A1c Tests Available at MinuteClinic to Help Diabetes Patients Monitor Blood Sugar Levels


10
May 10

Retail Clinics and Mobile Health

Without any extant models that we know of to point to, we’re nonetheless convinced that there is a useful nexus of retail clinics/convenient care and mobile health out there somewhere.

We are quite sure that Solantic’s 5/7/10 announcement of its mobile phones application is not it – but on a slow news day, an example is an example….


5
May 10

Thinking Outside – and Inside, and All About – The Box

Yes, we know this initiative is not specifically about retail clinics, or US-style convenient care, but we just think that it’s incredibleness quotient is off the chain:

Containers Into Clinics


4
May 10

Where Do Doctors Learn The Price of Care?

Turns out more than a handful have become well-acquainted with the role of cost in clinical decisions at the East Harlem Health Outreach Partnership, which is a free (for patients) clinic run by students of Mount Sinai School of Medicine, according to this 5/3/10 New York Times story: Teaching Physicians The Price of Care (5/3/10.

Medical students evaluate patients, choose which drugs are prescribed, arrange care for patients who need to see a surgeon or other specialist and collaborate with a social worker to help those who need social services or assistance paying for medicine. They also sit on the steering committee and are in charge of researching and updating the clinic’s formulary, a stock of inexpensive, cost-effective drugs that are purchased from the hospital pharmacy.

Surely similar models might emerge for providing teaching hospitals’ students about real world health costs via immersion in hospital-supported clinic operations…?


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


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.


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)