Monthly Archives: February 2011

Driving forces / MinuteClinic / Tactical innovation — Comments Off
28
Feb 11

Check-In Tech: Doctors Borrow From Airlines (and MinuteClinic)

Curious that the article credits self-service check-in tech at airlines as inspiring “early-adopting” doctors, but does not mention MinuteClinic – and probably other retail clinic and other convenient care clinic operators too – who employ the same kind of technologies.

Patient Check-In Technologies Cut Cost, Wait Times

Physician practices are adopting touchscreen tablets, kiosks, or patient portals that automate the check-in process, resulting in shorter wait times, reduced errors, and lower labor costs.

Driving forces / Fierce Healthcare / Health care venues / Opinion/commentary/analysis — Comments Off
28
Feb 11

Emerging Convenient Care Models: Good for ‘Individual Us’, Not As Good for ‘Institutional Us’

The perceptive Sandra Yin published her last editorial for FierceHealthcare last Friday. Her parting observations, titled How Boundary-Breaking Disruptive Healthcare Gets It Right (Sandra Yin, FierceHealthcare, 2/25/11) focused on signs of disruptive innovation in health care – and specifically on the convenient care models of that specific type of innovation.

She summarized her remarks thus:

What I like about these three examples is that at least one element of each disrupts the traditional models of healthcare, which assume hospitals and physician practices are the main means of delivering care. We seem to be evolving beyond that for certain kinds of conditions where the diagnosis and treatment are clear cut.

In each case, walls have fallen and traditional rivals find themselves on the same side. Lines in the sand are erased. Instead of fearing competition from urgent care, a hospital runs an urgent care facility. An ER passes along patients to a nearby urgent care facility. A retail clinic benefits from formal ties to health systems.

Health care venues / Scheduling treatment visits / Tactical innovation — Comments Off
23
Feb 11

Wait, Wait, Just Pay Me: Cash Back for ED Waits

Ingalls Family Care Center locations offer cash back to any patients who use their new InQuicker ED reservation service and wind up waiting to be seen, according to this Chicago Sun-Times story: Service Ensures You’ll See a Doctor On Time, Or Your Money Back (Monifa Thomas, Chicago Sun Times, 2/22/11).

(we knew we’ve referenced InQuicker in previous posts, but we did NOT know we had done so as many as 4 times. But it’s a fact – you could look it up.)

We’re not sure what they do if a scheduled-but-waiting patient hasn’t yet given them money, as would often seem likely to be the case – but we quibble.

The novelty of timely health treatment – the kind available at retail clinics, and treatment facilities that take, and keep, appointments – makes news. That’s what we know.

Clinics in pictures / Driving forces / Health care practitioners / Lisa Loscalzo / MinuteClinic / National/regional/local TV coverage / Public policy / Retail clinics — Comments Off
22
Feb 11

Retail clinics in New York: The Road Ahead?

This Benita Zahn, News 13, Albany, NY, 2/17/11:

Sprang from this:

EASY ACCESS, QUALITY CARE: The Role for Retail Health Clinics in New York (Paul Howard PhD, Senior Fellow, Manhattan Institute for Policy Research, 2/2011).

Congratulations to Paul for producing a thoroughly examined analysis and recommendations for pragmatic policy development regarding retail clinics in New York State. Also for generating such a rapt turnout for his presentation on a frigid morning in the State’s Capital.

Retail clinics are scarce in New York State, for what amateur summarizers of public policy (like ourselves) refer to as “a complex of factors”. Dr. Howard’s report sorts those factors out, and suggests ways in which New York State’s policymakers might most effectively address them.

What’s that you ask? What was our role in the report’s production? Well, now that you bring it up, we did supply Paul with data on clinics penetration, which he used judiciously. Deftly, even.

Driving forces / Strategic initiatives — Comments Off
16
Feb 11

Will It Take A Village (Without a Doctor)?

We think it may take a few such communities for people to begin to re-imagine what health care might be in the US. We’re inspired by this Valentine’s Day opinion piece in the NY Times: Villages Without Doctors (Tina Rosenberg, New York Times, 2/14/11)

The strategy is to move beyond doctors — to take the work of health care and shift down from doctors and nurses to lay people, peers and family. 

The premise is simple, effective and will be employed in the US, as Ms. Rosenberg’s essay suggests, though her focus is on its application in rural India.

We must note that while many reader comments are enthusiastic, several of the critical entries (#s 2, 3, 5, 8, 16, 19, 29) – at least a few from physicians, who should know better, and who are scolded by some of the other posters – are especially instructive.

These range, mostly, from incredulity to sarcasm, and most evidence a startling lack of understanding about the nature of population health needs. Does everyone – even the worldly, wise readers of the New York freakin’ Times – imagine that health care in real life is like an episode of House?

Clinics and location-based services / Driving forces / Employers and retail clinics / Health care venues / Opinion/commentary/analysis — Comments Off
14
Feb 11

Retail Clinics: New by Re-Assembling Old

We feel Bizmology reporter Anne Law did a terrific job describing her personal experience with a RediCare clinic visit in Grocery-store health clinics: passing trend or shift in care? (Anne Law, Bizmology, 2/10/11)

We also feel her analysis demonstrates how innovations like retail clinics perform best when facets of the innovation’s ‘feature set’ (clinic wait times, convenience of location, etc) mesh with facets of the health care value chain – in the case of her story, health benefit plan incentives to use clinics rather than emergency rooms:

Another driving factor for me, which led me to accept the awkwardness of hanging out in a grocery store for several hours, was the fact that I was able to pay my regular office visit co-pay, as opposed to the ER co-pay I would have had to provide at the urgent care clinic down the road. I would think this would be a bonus to other clinic patrons, especially those who feel that an ER visit should be for an emergency only.

Driving forces / Health care venues — Comments Off
14
Feb 11

Hospital Innovations Making News: The Roundup

Several local-news stories about marked shifts in hospital operations, which seem to focus on hospitals “de-hospitalizing”, morphing into unusual, if not outright new, configurations for defined types of health treatment:

Great Bend Hospital to Eliminate 130 Jobs (KTKA News 49, Topeka KS 2/13/11)

The Central Kansas Medical Center in Great Bend has notified 130 employees that they will lose their jobs May 1, when the hospital becomes a same-day surgery center….the hospital’s name will change to St. Rose Ambulatory & Surgery Center on May 1.

New Emergency Room Stands Apart (Sharon Salyer, Everett (WA) Daily Herald, 2/13/11)

A 2010 study by the federal Centers for Disease Control and Prevention found that only about 16 percent of patients treated in hospital emergency rooms are actually admitted to hospitals. “….60 percent…need emergency-room service but don’t need to go to the hospital,” [Swedish Health Service ER supervising physician Dr. John] Milne said. “That’s really the target market we’re looking at, that gap in the middle.”

Swedish Health Service is based in Seattle WA.

The companion story in the Herald,Emergency Rooms Compete For Customers, (Sharon Salyer, 2/13/11) notes

Swedish/Mill Creek is the third satellite emergency room it has opened since 2005, and the first outside King County…..Based on the experience at its Issaquah satellite emergency room, which opened in 2005, only about 7 percent of patients need to be transferred to hospitals….

Meanwhile, nearby Providence Regional Medical Center’s ads for its new ER focus on its attachment to the hospital:

Providence, opening a new $460 million medical tower in June, and an emergency room that will take up its entire first floor, isn’t waiting to publicize what it sees as its advantages.

Its ads promote its award-winning emergency room service and ask: “If you need an emergency room, wouldn’t you rather there be a hospital attached?”

Emergency Room Stands on its own in Chaska (Tom Meersman, Minneapolis Star-Tribune, 2/12/11)

A new medical center with ER, urgent care and specialty clinics but no hospital is a move toward alternative care venues….

The doors opened last week at the Two Twelve Medical Center in Chaska.

They’ll never be locked.

The four-story building, along and named after the recently rerouted highway, features the state’s first free-standing urgent care and emergency department.

Like other ERs, it’ll be open 24/7. Unlike other ERs, it’s not connected to a hospital….

….A similar facility called the Urgency Room opened last fall in Woodbury. It also markets itself as an alternative to hospital emergency rooms and offers faster service and cheaper rates, with staffing by ER-trained doctors and nurses. However, it is not open all night and does not accept ambulances….

The Doctor Will See You NOW (Jeff Nemetz, HBG Health, 2/8/11)

This one confuses us a bit, inasmuch as its more about EDs than doctors, and has a sort of “I don’t know if scheduled ER visits make any sense, but it’s new, so gee whiz” vibe to it, but anyway:

In another example of the relentless march towards the “consumerization” of medicine, and a world where doors are not only open, but may not even exist to bar access to healthcare, I point to InQuickER. Southern California hospitals are ahead of the curve with this online appointment system for the ER, which not only gets you in, but assures you’ll be seen….

….Of course, the development raises some concerns. Specifically, what will this do to the convenient care model of CVS MinuteClinic and others, whose primary value is touted as alleviating stress on emergency rooms?

Really? That’s the chief concern scheduled ER visits brings to mind?

Link to one of the recent ‘news’ stories (presso-driven?) on ER reservations:

Restaurants Take Reservations, Now So Do Some ERs(KING 5 Seattle, WA 2/4/11)

Driving forces / Health care practitioners / Health care venues / Opinion/commentary/analysis / Tactical innovation — Comments Off
11
Feb 11

Retail Clinicians Were Top of Top Minds in 2010

Health Affairs recently congratulated themselves, and justly so, for having published 2 of the Top 5 Most Influential Research Articles of 2010 in the eyes of the Robert Wood Johnson Foundation.

We congratulate them for having written one of them about The Role of Nurse Practitioners in Reinventing Primary Care, (Naylor and Kurtzman, Health Affairs, May 2010).

If you are interested in modeling or forecasting US health care’s future, it seems obvious to us that you must examine those phenomena that introduce measurable change in treatment options for the health conditions most likely to effect the greatest number of people who may influence health behaviors. That implies paying attention to care for the most routine sorts of health concerns, and the clinicians who treat them.

Clinics and location-based services / Driving forces / Health care practitioners / Health care venues / Physicians' perspective / Tactical innovation — Comments Off
07
Feb 11

People are Looking for Clinicians Online, and Finding…Confusion

American Medical News reports that over half of respondents to a recent Harris Interactive poll said “it’s hard to find basic information about a doctor online”.

The article (How To Help Prospective Patients Find a Practice Online (Pamela Lewis Dolan, American Medical News, 2/7/11) goes on to quote several marketing authorities who suggest physicians focus on providing searchers pertinent information about them and their practice, such as where they are.

Hmmm….yeah, we can get behind that.

Andrew Sussman / MinuteClinic — Comments Off
07
Feb 11

Retail Clinics 2011: You Really Know You’ve Arrived When….

…Industry observers wonder aloud whether you’re making a comeback, as knowing health industry observer David Whelan does here: CVS Earnings Are Weak: But Are Retail Clinics Making A Comeback? (David Whelan, Forbes, 2/4/11)

One problem that retail clinic operators report is limited utilization during the summer when few people are sick. This year’s flu shot demand was lower than the year before–something that would not have helped generate visits. There’s been quite a bit of excitement about the possibility of clinics to disrupt more expensive doctors offices. But it hasn’t happened yet.

Whelan concludes with a particular observation about the shifting roles of credentialed health practitioners, and one category of practitioners who may ascend faster than the nurses and physician assistants most associated with care delivery in retail clinics.

We know you’re itching to resolve this little mystery for yourself, dear reader; go ahead, click away – that’s what the link’s there for….

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