4 Findings from a Study on Health Clinics and Retail Quality

The continued growth of retail health clinics in the U.S. has greatly increased convenient access to care for vulnerable populations seeking quick resolution of common ailments or desiring a COVID-19 vaccination. But how do they stack up against care provided in primary care practices and facilities operated by hospitals and health systems?

More than 70 percent of healthcare leaders worldwide believe the quality of care in convenience stores is lower than in primary care practices, according to the results of a survey of NEJM Catalyst Insight Council members released in October. Nearly half of the 767 respondents (including 513 from the US) also expressed concern about the difficulty of tracking patients who use retail clinics over time, along with challenges in managing continuity of care.

However, 66% of survey respondents worldwide say the pandemic has improved patients’ views of retail clinics.

Wake-up call for convenience and better access

NEJM Catalyst interviews with respondents provided context on these questions, with Dennis Jolly, system vice president of strategy and planning at UW Health in Madison, Wis., noting that the pandemic provided a wake-up call for providers about the need to improve patient access and convenience.

Now that the worst of the pandemic appears to be over, patients who used virtual visits or retail clinics are more comfortable with those options because they’ve been through them, Jolly said.

Respondents’ concerns about quality are likely related to differences between episodic and longitudinal strategies of care, Jolley explained. Retail health tends to be episodic, while good primary care is more long-term.

For health systems, the top two benefits of owning or partnering in retail services are improving access to care (cited by 52% of respondents) and meeting consumer demand (48%), indicative of the role that retail services retail play in fulfilling unmet patient needs. Another important finding is that respondents say retail care helps meet the needs of vulnerable populations, with two-thirds (67%) reporting that using retail health care delivery has increased access for this group.

The Continuity of Care Conundrum

Ensuring continuity of care between commercial clinics and primary care practices, hospitals or health systems is a top concern for approximately half of US respondents. The two biggest challenges for health systems in owning or partnering in retail care are difficulty tracking patients over time and transitions of care, cited by 46% and 50% of U.S. respondents, respectively.

Some are concerned that preventive examinations may not be done when care is episodic and that retail care will undermine continuity of care and increase the overall cost of care in the end. David Fairchild, MD, chief medical officer of MinuteClinic at CVS, disputed that latter notion in an analysis of the study results.

Fairchild says the quality concerns raised by healthcare leaders are not necessarily unique to retail care and are found across healthcare delivery. He notes that the field still lacks a common way to share medical information because of interoperability issues and a myriad of different electronic health record systems.

Will suppliers build a retail presence?

Despite the growth of retail health clinics, only 15% of respondents own or have a formal relationship with these sites; another 10% say their organization plans to join in the next three years.

And in terms of what they see as the biggest external competitive threat to traditional healthcare institutions, more than half of respondents (56%) cited direct-to-consumer telemedicine by a wide margin versus 16% for retail clinics and 13% for urgent care clinics. cares.

As for how hospitals and health systems can respond to current retail trends, US healthcare leaders offer four insights.

INSIGHT 1 | Expanding access to primary care and new ways to deliver treatment.

Statistics show that 25% of Americans do not have a primary care provider. Consider providing an additional access point for users who do not have a primary care physician. Be prepared to address care coordination, the potential increase in patients with chronic conditions, and the ability to make timely referrals to specialists.

INSIGHT 2 | Uberize care with smartphones with GPS and smart navigation to meet immediate search and care coordination.

Traditional care delivery systems must rethink access and ways to make it easier for patients to get the care they want, when they want it, and where they want it, noted one executive. Meet patients where they are – on their mobile devices, at home, at work or on the go.

INSIGHT 3 | Consider focusing on home care.

More than 40% of US respondents say home care will reduce demand for retail care. But as we’ve seen with other retailers getting involved in healthcare, a growing number are looking to expand into home care. Be prepared to differentiate your services.

INSIGHT 4 | Partner and co-exist with retail care.

Traditional practices and organizations are often not nimble enough to meet same-day emergency care needs for basic care in an acute situation, such as treating strep throat, noted one CMO of a US nonprofit research center. The downside: Retail clinics will free up time for primary care physicians to spend on more important patient issues.

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