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Would You Like an A1c Test with That?

Created Oct 21 2015, 08:00 PM by Lippincott Solutions
  • MinuteClinic
  • patient care
  • Retail-based clinics
  • EHR
  • telehealth

Thursday, October 22, 2015
A look at the pros and cons of retail health clinics.

Since CVS Health acquired MinuteClinic nearly a decade ago, the retail-based clinics have flourished. More than 800 MinuteClinics now operate inside CVS pharmacy stores across the country, providing on-the-spot care for customers’ minor illnesses and injuries.

Recently, the chain made news when it announced talks with three different telehealth vendors to expand its direct-to-consumer telehealth services.

“CVS Health is piloting several different telehealth opportunities, including making telehealth physician care accessible through CVS Health digital properties,” states an August 26 company news release.  “CVS Health will also explore enabling MinuteClinic providers to consult with telehealth physicians to expand the scope of care offered at MinuteClinic.  In addition, MinuteClinic will continue to provide telehealth care to patients in CVS retail stores and will explore serving as a site for in-person exams to facilitate telehealth medical visits.”

As the rise of retail-based clinics—and their disruption of the traditional U.S. healthcare model—continues, a parallel debate over their worth persists, too. Here’s a look at some of the pros of obtaining a rapid strep test at the same site where you can also pick up a pack of cough drops and a jug of orange juice, and a few reasons why critics say it might not be the best decision a patient can make.

Retail-based Clinics are Accessible

Retailed-based health clinics are no longer an anomaly. For many, on-the-spot healthcare is as accessible as their nearest Wal-Mart, Walgreens, Target, CVS, Rite Aid, or Kroger. At the start of this year, some 1,866 retail clinics were open and ready to serve patients, according to a Huffington Post report. What’s more, the majority offer evening and weekend hours, which makes obtaining care and juggling one’s daily routine that much easier.

Retail-based Clinics are Quick

Forget the need for an appointment. To have a healthcare provider take a listen to your cough or a look at a twisted ankle at a retail-based health center, all you need to do is show up. Contrast that with a call to a primary care provider, who may or may not have an opening available that day—or even the next. While emergency departments don’t require appointments either, a visit there can last hours.

“I have to say,” writes a patient in Forbes about his first visit to a retail-based clinic, “the experience was quite pleasant and efficient, even if I had to wait 40 minutes because there were others ahead of me because it was July 5, the morning after a holiday when the clinic was closed.”

In and out in under an hour? That’s a deal-maker for many a patient.

Retail-based Clinics are Affordable

The cost to obtain minor care at a retail-based clinic is much less than at an emergency department. MinuteClinic lists its prices online (how’s that for transparency?), letting cost-conscious patients know ahead of time that a shingles visit will cost them between $79 and $99, while a mono test runs just under $25. With emergency department copays and deductibles often much higher than that, retail clinics offer cost significant cost-savings to many patients.

Retail-based Care May Obscure the Big Picture

“The problem is that good medical care is more than sick visits,” muses a pediatrician in a Daily Beast column. “It’s about knowing your patients and following their health over time.”

The American Academy of Pediatrics even has a policy statement against them, partly because of the fragmented care they may encourage. Without the seamless care of a primary provider or group, special needs or chronic conditions run the risk of being erroneously dismissed as a flash-in-the-pan minor issue.

“Parents may not be aware of the implications of a seemingly minor illness, and a provider at a retail clinic is only concerned with the complaint that brought the family through the door,” the pediatrician continues. “Even if the presenting symptoms look like a clear-cut diagnosis, if a pattern over time emerges to indicate something in need of further investigation, it’s part of the care I provide to have such things in mind.”

Retail-based Care May Leave Holes

When a patient receives care from a retail-based clinic, her regular provider may—or may not—ever find out. While CVS integrates prescription and visit information from its MinuteClinics to the electronic health records (EHR) of some hospitals and health networks, that’s not the case with all.

“I got a printed clinical summary to take with me from Minute Clinic’s home-grown EHR, which I perused while waiting for the pharmacy to fill my prescriptions,” explains the Forbes contributor. “But I was not given the option to have the records sent electronically to my primary care physician or to download a copy via a portal.”

Retail-based Care May Present a Conflict of Interest

Drug stores prescribing—and also selling—medications make some onlookers uncomfortable. Furthermore, adding extensive telehealth services to the mix doesn’t help.

"Who is watching the cookie jar on all the telehealth providers now?" asks an Oklahoma-based hospital VP/CIO in a FierceHealthIT report. "As the world's largest pill popping society, [and getting worse each year], will this venture by CVS lead to more prescriptions that can be conveniently filled at your local CVS? Will that lead to better quality care for our patients or hurt us in the long run?”

"Don't get me wrong, I think telehealth has a major role to play in the way we deliver and receive care," he adds. "I'm just a little more skeptical."

What’s your take on the growth of retail-based health clinics? Do they help or do they hinder patient care? Leave us a comment below with your thoughts.