Retooling Primary Care

For decades, the entry point in healthcare was the primary care physician’s office. That’s changing rapidly as retailers like Walgreens and Walmart ramp up their efforts. The first wave of retail medicine has been described as a “nurse practitioner in a closet.” But in 2015, we’ll be seeing many retail locations that offer everything a traditional PCP does…and often a whole lot more.

This trend is great news for telehealth providers. Most retail medicine operations are just barely beginning to make a profit. They can become more successful by partnering with telehealth companies that don’t have a comparable investment in brick-and-mortar offices and can leverage scalable, cloud-based technologies.

For example, if nurse practitioners at a retail site wants a quick second opinion, they can get one via telehealth without having to send the patient to a nearby primary care doctor. That keeps more money in the system, both for the retail provider and the telehealth partner.

The rapid growth in both retail medicine and telemedicine is fueled by patients’ desire for greater convenience and faster access to care. A recent Advisory Board story highlighted some of the reasons why Americans have so quickly warmed to retail medicine:

Easy online scheduling – The appointment portals at places like CVS and Walgreens are simple to use – and provide far greater convenience than what most urgent care clinics and EDs currently offer.

Extended hours – Unlike most PCPs, the caregivers at retail clinics work evenings and weekends.

Monitoring chronic conditions – Retail clinics are already adept at helping patients manage and monitor ongoing health problems like diabetes and hypertension.

Deep pockets for clinic upgrades – Retail giants have far more cash than your local PCP for things like the newest medical devices and EMR enhancements.

This will be the year when the synergy between retail medicine and telehealth becomes mutually profitable. The public has made it very clear: give us greater access and more convenience beyond the 9-to-5 limitations of traditional medicine.


Awakening To Miracles

One of the joys of the holiday season is that we become more aware of the magic and miracles that surround us 365 days a year.

A century ago, Ashley Graber would have described her encounter with Dr. Jennifer Needle as a visit from an angel. Today, it’s just one of the everyday miracles made possible by telemedicine.

In 2011, Graber’s daughter MaLea was diagnosed with a high fever and virus and sent home for rest. When her condition worsened, a physician at Columbia Memorial Hospital in Astoria, Oregon requested a teleconsultation with Dr. Needles, a pediatric intensivist at Oregon Health & Science University’s Doernbecher Children’s Hospital in Portland.

Needle determined that MaLea had meningococcemia, a life-threatening bacterial infection. Her doctors inserted a breathing tube before airlifting her to the OHSU hospital.

It took 111 days for MaLea to recover. “I think telemedicine is the greatest thing ever invented,” says Graber. “I don’t think she’d be alive if not for that.”

This holiday season, think of all the people like MaLea – including thousands of stroke and cardiac patients – who are home celebrating with their families thanks to telemedicine. Like the angel in It’s A Wonderful Life, telemedicine offers a special gift: a second chance.


Straight A’s for Pediatric Telemedicine

About 20 percent of American kids live in rural communities that often lack the pediatric expertise and equipment found at children’s hospitals in big cities. But recent studies show that they’re able to get topnotch treatment through telemedicine, in a way that benefits both the tertiary center and the rural facility.

Both studies were conducted by researchers at the University of California-Davis pediatric telemedicine department. One study, published in the journal Critical Care Medicine, revealed that rural children treated via telemedicine had significantly higher quality-of-care scores than those whose consultations were done by phone or locally. And a second study published last summer in Telemedicine and e-Health shows that children’s hospitals in metro areas can benefit enormously from rural hospitals that have deployed telemedicine. UC-Davis Children’s Hospital in Sacramento nearly doubled its number of pediatric referrals, which helped build market share, boost hospital revenue and increase professional billing.

When served by telemedicine, parents in rural communities can rest assured that their kids are getting prompt attention from pediatric specialists. In many cases, a perceived emergency can be handled locally so that both parents and kids are spared the time and expense of driving to the city. And it frees up more beds at the children’s hospital for cases requiring transfer.

A number of U.S. cities (like Cleveland, Boston and Los Angeles) already have more than one children’s hospital – and it may soon be commonplace in most metro areas. Encouraged by these new studies, strategic planners at children’s hospitals would be wise to forge more relationships using telemedicine to provide clinical services to  outlying rural and community hospitals. It’s a far more effective way to provide access to specialist care in a large geographic region, builds market share and increases revenue.

Nothing builds brand loyalty better than letting parents quickly know whether their kid’s condition can be treated locally or requires immediate transfer to the children’s hospital. And providing peace of mind is also good for the bottom line.