(Installment 2, posted April 19, ably recounted the establishment & growth to date of Walgreens’ Take Care Clinics, but failed to mention anything about Take Care’s initiatives in the area of operating on-site clinics for employers – which to be fair is probably in keeping with In-Store Trends editorial charter).

Sean asks this pair of keen questions in installment 3:

Why has the Minute Clinic not made its way into ALL of CVS’ 7,300 stores in the US? Is there a major barrier to entry for retailers considering the introduction of retail clinics?

In answer, Sean identifies five major hurdles for clinics operators generally. We found all basically on point, especially the first:

Awareness – the overall concept and availability regionally has been slow to penetrate consumer awareness beyond for flu shots

We feel Sean may have overlooked the role that the existence of urgent care clinics has played in the gradual introduction of retail clinics. His post does consider the opportunity that long ER wait times and waits for physician appointments present to clinic operators, but it does not take into account the existence of between 7 & 9 thousand urgent care clinics, which serve a market quite similar to that targeted by retail clinics.

Our back-of-the-envelope calculations indicate that if clinics are intelligently sited, there is plenty of demand to go around; for example, considering only visits to emergency rooms that might be more appropriately treated at retail or urgent care clinics, each current clinic would be faced with 40 to 50 patients per day.

But the key word with respect to siting is intelligently. Maybe locating smart is part of what is taking retail clinics so long to grow in numbers.

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• Everyone and their commercial entity has an app nowadays. Don’t you?
• Finding clinics is tricky. Mobile applications can help.
• There are plenty of pharmacy transactions that mobile applications can help a chain’s consumers with, beyond retail clinic-specific stuff.

But with respect to the chain’s MinuteClinics specifically, CVS’s application approach falls short:

• Contrary to CVS’s promise, a user can’t “locate a nearby clinic in a click”. First you have to open the MinuteClinic-specific mobil app, which has its own URL separate from the CVS app. Then you need to identify a state or a zip code – with no option to use your phone’s GPS information to drive identification of nearby clinics. Then you have to click on specific clinic location information links. One click access, it ain’t.
• Hours are indicated but not in relation to the user’s day/time/location.
• There’s no option for users to provide any information about their interaction with any clinics they might actually visit. Obviously CVS isn’t obliged to provide that kind of interactivity, but it kind of comes with the emerging mobile territory.

Naturally our preference is for people to use, to seek out, a clinics locator that provides them access to any nearby clinic location, along with pertinent information and interactivity. Second best would be applications that take advantage of available technologies to surpass “market-available” information and tools. From this perspective, CVS’s approach does not seem to us to rise to second-best status yet.

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From Retail Clinics to Virtual Care, a Natural Evolution in the Patient Access to Care Crisis (Doug Smith, MD, PhysBizTech, 4/11/12)

The development of the retail clinic model was spurred by the inability for patients to access care conveniently and in a timely manner for very common, relatively simple, everyday ailments that required very little infrastructure or elaborate diagnostics to treat….

… I now have colleagues who admit that they recommend that their patients go to a retail clinic if they are calling in to be seen for a simple problem and are not able to be seen in their primary clinic setting. Nonetheless, there are of course still problems with this model….

…I will spend the next several blogs looking at the rise and development of virtual care medical solutions from all perspectives — patients, payer and provider — and discuss the opportunities and pitfalls in all areas.

We hope Dr Smith doesn’t create entirely new separate blogs for each post in his proposed series (/end mandatory tech nerd snark remark), but we DO look forward to reading his perspective on the retail clinic/telephysician nexus.

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Installment #1 is a concise summary of where retail clinics stand today, as one could expect, but we liked this observation concerning a concern frequently expressed about retail clinic firms’ rollout strategy:

Of 982 clinics located in 32 US states in 2010, only 12.5% were located in medically under-served areas. (According to report by RAND Health Research, 2010). Simply stated, this means that retailers believe that the convenience and low-cost nature of the service will drive traffic to the store even when there are primary care practitioners close-by.

Most responses to the Ateev Mehrotra-led RAND study he cites expressed dismay that retail clinics were not sited to serve currently underserved US populations. While those criticisms have some merit, we know of none who simultaneously recognized Sean’s point – that clinics attract patients even in the presence of available conventional primary care. Mehrotra’s research supports this assertion and goes further to note that the retail clinics do not seem to cannibalize conventional primary care clinicians’ practices.

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No, really – what are you doing still here?

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quickly now: which is the 2nd most-cited activity respondents mentioned using their smartphones for?

• People frequently look for health care resources while on the go
• People appreciate help finding health care resources while on the go
• Those health care resources should devote at least some attention to figuring out the best/easiest way for them to help smartphone people to find them

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But we DO obsess about retail clinics of course, so when a Patch correspondent waxes enthusiastic about them, we intend to make our fellow retail clinics fans aware.

So here you go:

About Town: MinuteClinic Rocks Eastchester (Jay Wilson, Bronxville-Eastchester Patch, 3/29/12)

….Sometimes you come across a product, service, or person who exceeds your expectations, and when they do, it’s worthy of mention. And friends concur – one told us she’s a “big fan” while another said she uses them for family flu shots, appreciating the fact that they’ll take the entire brood all at once.

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Making health services more accessible and affordable to more people (Bill Crounse MD, HealthBlog, March 13, 2012)

In fact, this year Microsoft will for the first time open a clinic for its employees at the company’s headquarters in Redmond. The clinic will be operated by TakeCare.

No sign of a grand opening date, but we’ll try to keep an eye out for it.

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Retail chains trying to attract Hispanic shoppers should be encouraged, but they should also be very concerned. They should be encouraged because the concept of walk-in pay for service clinics is a norm in Latin America. So in the U.S., it is very culturally relevant for Hispanics to seek out neighborhood clinics in their communities that provide health services in a similar manner because neighborhood clinics are often a cost-efficient and convenient solution among foreign-born Hispanics, who upon first arriving often do not have jobs where health care coverage is an option for them….

Retail walk-in clinics are a natural fit for Hispanics, but retailers can only maximize this fit when they start expanding access in areas where the market is concentrated and unless they staff and are able to provide quality and culturally relevant care.

Here are six steps you can take immediately to assess your chain’s existing retail clinic coverage and quality delivery in underserved Hispanic communities (Read More)….

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