Marketplace dynamic changes and next steps
What has significantly changed in the marketplace is the growing presence and acceptance by the healthcare and patient communities that the retail clinic can be a key provider of care to millions of people. Over the past 5-10 years, we have experienced the growing presence of clinics and an expanding portfolio of offered services. What was once a trend for only the largest chains installing these clinics to drive more traffic into their stores, has now become a very common offering by retailers of various sizes as well. There are now 2,100 retail clinics with a forecast of 2,800 locations within the next two years.
What started as a questionable business model is now maturing into a key stakeholder in the healthcare supply chain, as demonstrated by the retail clinic channel’s commitment and accepted responsibility to play a significant role in advancing the quality and scope of patient care at an affordable cost.
Additional drivers on the growing success of retail clinics are:
- Obamacare and the continued “graying of America” creating more patients with fewer physicians to provide the healthcare they need than ever before. Public policy continues to emphasize affordability, accessibility, and coordinated care. Emerging retail clinics combat this trend head on.
- Clinic providers, collaborating with their store pharmacists, expanding their portfolio of core services beyond preventive and urgent care, to providing coordinated care for chronic conditions.
- Greater acceptance by payers and healthcare communities demonstrating greater alignment with the retail clinics, resulting in a higher quality of care delivered at these locations.
- Growing affiliations and partnerships with other healthcare providers to help address reduction of hospital readmission costs and to help achieve STAR rating financial and quality objectives. Visits to retail clinics or urgent care centers lead to a $4.4 billion annual reduction in healthcare spend versus emergency room visits. We know that readmissions of Medicare patients cost over $26 billion annually, nearly all of which could be saved if patients were receiving proper care during and after their first visit to the hospital. Integrated healthcare systems, large clinics like Cleveland Clinic, and other regional clinics are expanding their reach, partnering with retail clinics to provide both immediate and chronic care — like a “hub and spokes.” This continuum of care connects the physician and services to the patient with transparency, using video follow-up consultations.
Expanding use of electronic healthcare records (EHRs) and information systems enables the communication and sharing of clinical data profiles of patients to help address and mitigate “gaps” between hospital, physician offices, labs, and pharmacies. This can also help align health plan goals and protocols and ensure that patients are provided with a continuity of care within these collaborative programs to improve health outcomes.
Development and use of connected diagnostic digital devices continue to grow, enabling the remote clinics to collect standardized data and support chronic management from primary physicians.
Hybrid model of retail clinic with telehealth platform
Telehealth, as an enabling technology platform, seems to make the most sense supporting the business models of the retail clinics. Expanding the portfolio of services of traditional urgent care/preventative care models enables telehealth to communicate between doctor and patient, offering a high level of care and real-time evaluation. Additionally, nurses can use these digital interface consoles to consult in real time with a physician when they encounter urgent care situations they are not trained or licensed to address.
This growing model combining nurse staffing with telehealth consoles extends both the hours and range of care that can be delivered within an existing retail clinic footprint.
To further contribute to the adoption and success of the retail/telehealth clinic model, federal and state governments are recognizing the value of telehealth and implementing favorable rules to provide reimbursement for the growing practice.
Pharmacy should have a ‘seat at the table’ in telemedicine
Being a key stakeholder in healthcare supply chain, pharmacy is strategically positioned to play a very significant role in telemedicine, leveraging the trust, loyalty, expanding role, and physical access to these retail clinics.
New relationships; clarity of practice models, roles, and responsibilities; and subscribing to a platform for interoperable clinical data exchange and documentation still need to be worked out. Pharmacy should be engaged early and stay involved, since this retail clinic/telehealth movement is happening in our stores. Early engagement and involvement will help ensure we have a “seat at the table” as telehealth/telemedicine continues to evolve, grow, and becomes a practice standard.
David J. Fong, PharmD, is president of Dave Fong Rx Consulting, Inc. A former senior retail pharmacy executive for Fortune 100 and Fortune 500 companies, he is recognized as one of the U.S. and Canada’s business and professional healthcare leaders, leveraging his knowledge and experience working with pharmaceutical manufacturers, distributors, retailers, payers, and healthcare technology companies to bring value to the industry and the consumer.
