4 Conclusions from the survey on retail health clinics and quality

The continued rise of retail health clinics in the United States has greatly increased convenient access to care for vulnerable populations seeking quick fixes to common ailments or wanting a COVID-19 vaccination. But how do they compare with the care provided in primary care practices and in facilities run by hospitals and health systems?

According to the results of the NEJM Catalyst Insight Council member survey published in October, more than 70% of healthcare leaders globally believe that the quality of care in retail environments is inferior to primary care practices. Nearly half of the 767 respondents (including 513 from the US) also expressed concern about the difficulty of tracing patients using retail clinics over time along with the challenges of managing continuity of care.

However, 66% of global respondents say the pandemic has improved patient views on retail clinics.

A wake-up call for convenience and better access

Interviews NEJM Catalyst conducted with respondents provided context on these issues, with Dennis Jolley, vice president of strategy and planning systems at UW Health in Madison, Wisconsin, noting that the pandemic provided a wake-up call for providers on the need to improve patient access and convenience.

Now that the worst of the pandemic appears to be over, patients who have used virtual visits or retail clinics are more comfortable with these options because they have experimented with them, Jolley said.

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

For healthcare systems, the two biggest benefits of owning or partnering in retail care are improving access to healthcare (cited by 52% of respondents) and meeting consumer demand (48%), an indication of the role that retail assistance is playing in satisfying the patient’s unmet needs. Another important finding, respondents say that retail care helps meet the needs of vulnerable populations, with two-thirds (67%) reporting that the use of retail healthcare has increased access for this group. .

The enigma of continuity of care

Providing continuity of care between retail clinics and primary care clinics, hospitals, or health systems is a key concern for about half of US respondents. The two biggest challenges for healthcare systems to own or partner in retail care are the difficulties of tracking patients over time and care transitions, cited by 46% and 50% of US respondents respectively.

Some are concerned that preventative screenings may not be performed when care is episodic and that retail care will erode continuity of care and ultimately increase the total cost of care. David Fairchild, MD, MinuteClinic’s chief medical officer at CVS, challenged the latter notion in an analysis of the survey results.

Fairchild says the quality concerns raised by healthcare leaders aren’t necessarily unique to retail care and are found throughout healthcare delivery. He notes that the camp still doesn’t have a common way to share medical information due to 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 outlets; another 10% say their organization is planning an affiliation within the next three years.

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

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

MORE INFORMATION 1 | Expand access to primary care and new ways of providing treatment.

Statistics show that up to 25% of Americans don’t have a primary care provider. Consider providing an additional access point for consumers who do not have a primary care physician. Be prepared to deal with coordination of care, a potential increase in patients with chronic conditions, and the ability to refer promptly to specialists.

MORE INFORMATION 2 | Uberize assistance with GPS-enabled smartphones and smart navigation to meet immediate demand for assistance coordination.

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

MORE INFORMATION 3 | Consider focusing on home care.

Over 40% of US respondents say home care will reduce the demand for retail care. But as we’ve seen with other retailers involved in health care, a growing number are looking to expand their home care operations. Get ready to differentiate your services.

MORE INFORMATION 4 | Partner and coexist with retail care.

Traditional practices and organizations are often not agile enough to meet urgent same-day care needs for basic acute care such as strep treatment, noted a CMO from a non-profit research facility in the United States. The downside: retail clinics will free up time for primary care physicians to devote to the problems of patients with greater acuity.

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