Retail clinics in vogue

July 17, 2018 0 By CH Unnikrishnan

Big corporations are exploring the concept of retail clinic chains to deliver primary care, marking a new medical age

Retail clinics and urgent care centres are fast catching up in the US. Hosted by strip malls or shopping centres, retail clinics are usually run by healthcare professionals like nurse practitioners or physician assistants. People in the U.S. are flocking to these clinics because they offer a cheaper alternative to a doctor’s office for simple health needs.

Currently, there are around 12,000 such centres across the US, according to Merchant Medicine, a consulting firm.

Even as the popularity of retail clinics has gone up steadily, office visits to primary care doctors has declined by 18 percent from 2012 to 2016, according to an analysis of insurance data by the Health Care Cost Institute.

Reports indicate that more and more big corporations are swarming in, forging new deals to tap a lucrative opportunity in the retail clinics space. Walmart, which already offers pharmacy services for older people, is reportedly in talks with Humana for a potential partnership on using the retailer’s stores for opening clinics and expanding the insurer’s 19 existing clinics for one-stop medical care.

Similarly, CVS Health and Aetna, the insurance major, are planning to expand their base through a proposed merger. CVS Health operates 1,100 MinuteClinics.

Another insurance major, UnitedHealth Group, runs one of the country’s largest urgent-care chains, MedExpress, with more than 30,000 physicians. UnitedHealth is also experimenting with putting its MedExpress urgent care clinics into stores run by Walgreens, a prominent retailer.

Besides these, Amazon, JP Morgan and Berkshire Hathaway are holding discussions to join forces to develop an in-house health care strategy for their employees.

Figures provided by Merchant Medicine shows that HCA Healthcare, the for-profit hospital chain, doubled its number of urgent care centres last year to about 100. Similarly, GoHealth Urgent Care has joined forces with major health systems like Northwell Health in New York and Dignity Health in San Francisco, to open up about 80 centres, according a New York Times report.

As the frustration with the current state of health care grows, big companies are expressing their desire to tackle complex care for people.

One Medical, a venture-backed practice that is one of the largest independent retail clinic chains in US, employs 400 doctors and health staff in eight major cities. With sophisticated computer systems, One Medical allows its physicians to spend half-an-hour with every patient.

However, even as patients feel satisfied with the ease of access and shorter timelines offered by retail clinics, many doctors emphasize the importance of continuity of care, which, they claim, a patient can never get at a retail clinic.

One-stop-medicare: An Indian model

Kolkata-based Glocal Healthcare Systems launched an innovative digital dispensary, dubbed “PHC in a Box”, to provide primary healthcare (PHC) services, in September last year.

PHC in a Box or digital dispensary aims to be a one-stop-shop providing a complete primary care solution such as consultation, confirmatory tests, and a medicines service at the place of residence of the patient.

The digital dispensary achieves this through video consultation with qualified doctors from across the country, quick medical tests and the dispensing of generic drugs at a digital kiosk.

Exploring the possibilities of the internet of things (IoT) and artificial intelligence (AI), it integrates a telemedicine suite connecting doctors on video, an AI-aided tool for the doctor to make error-free diagnosis and prescription according to evidence-based protocols with drug safety check. The digital dispensary involves an IoT device that enables all vitals and investigations within 15 minutes. The digital kiosk automatically dispenses the prescribed medicines without any human intervention.

Digital PHCs can significantly reduce the waiting time to as short as 30 minutes per patient. Meanwhile, visits to primary care doctors takes long queues at consultation desk, diagnostic tests, followed by a day-long wait for test results, and finally, the dispensing of drugs.

To aid the physicians to make accurate diagnosis, PHC in a Box uses Litmus Dx technology. It can also create an electronic health record (EHR) of the patient, which can be accessed online from anywhere.

According to Gautam Chowdhury, CEO of Digital Dispensary arm of Glocal Healthcare, these centres can be easily replicated in a short time to cover all the citizens across the country, reducing the out-of-pocket expenditure of patients by half.

These dispensaries would be owned and operated by local entrepreneurs selected by Glocal across semi-urban and rural areas. Each of these dispensaries is expected to cater to 15,000-20,000 people belonging to the surrounding area.