How EDs Can Embrace The Minute Clinic Model

I try to avoid thinking too hard about problems. I have found that not thinking, when done properly, creates a pleasant numbing sensation in the brain. There are those who will tell you that not thinking is one of my best attributes.

So this is how I’ve organized this anthill.

A healthcare provider’s opportunity to succeed at consumerism is approaching the eleventh hour. The bad thing about the eleventh hour is that you never know when it is a quarter to; you only know when it’s five after, and counting. Regarding healthcare consumerism, could a bag of red Twizzlers be the biggest material difference between your consumerism efforts failing and succeeding at your health system?

Are you out of your mind, Paul?

When I evaluate the CVS healthcare retail healthcare model as represented by the Minute Clinic, three things stand out:

• CVS has customers (prospective patients), not patients
• Their customers do not have appointments, they simply show up
• Their customers become patients, are evaluated, and receive care

Healthcare provider executives are asking, “How can we imitate the CVS consumerism model?” My response to them is, “You already are, you just aren’t doing it very well.”

Hospitals imitate the CVS retail healthcare model 365 days a year, 24 hours a day. It is called the Emergency Department.

• Customers and patients come in.
• Neither the customers or the patients have appointments, they simply show up.
• The customers become patients, are evaluated, and receive care.

The health system ED has evolved into a dual-care model: emergency medicine and retail medicine. The evolution has resulted in more and more customers using the ED like a Minute Clinic.

The evolution to a dual-care system has placed tremendous burdens on emergency care. That evolution accounts for why many EDs are constantly reengineering themselves, posting wait times, and spending a fortune implementing six-sigma projects. And to what end? The more efficient your ED becomes, the more retail customers flock to it.

You and I know there is no point asking me to reengineer your ED. At least that is what I thought before I started writing this piece. But the more I thought about it, the more it occurred to me that I could make a suggestion that would benefit the ED, benefit the real ED patients, benefit your customers — people who don’t have an emergency who just want to be seen by a medical professional, and the people in your health system who are tasked with acquiring new patients — marketing. If I am correct, your time reading this will have been well spent. If I am wrong, I am sure I will hear from you.

Every provider already has a steady stream of non-ED patients who only require the level of treatment provided by a Minute Clinic. Wouldn’t it make sense for providers to set aside a few hundred square feet of space and direct those customers who don’t require emergency care to another area so they can be seen by a clinician? Wouldn’t that enable the ED to be more effective? And if it was determined that the clinic patients needed urgent care services, you have a doozy right around the corner.

And what about all of your other facilities? Could some of them adapt to this model? Probably.

The ED of one of my clients was seeing around 100 asthmatic patients every day. The vast majority of those patients did not need emergency care. Some needed refills, some needed instruction on how to use a nebulizer. We recommended they set up an asthma clinic right next to the ED. And it worked.

What are the benefits of co-locating a Minute Clinic concept next to the ED?

• It frees up the ED for those who require emergency care.
• It converts clinic customers into new patients in your health system.
• And it does so at a very low Customer Exertion Score.

How, you ask?

• Customers do not have to wait until their PCP can see them.
• Customers do not have to call.
• Customers do not have to make an appointment.
• Customers have immediate access to care.
• Customers pay only a copay, not ED rates.

It makes sense to me. But then again it should since it’s my idea. Decide amongst yourselves if this idea is worth exploring — if the decision is close, you may wish to reach a conclusion based on style points. Maybe that deafening noise I am hearing is the sound of all of the pieces falling into place. And if you want to give your clinic more of a CVS feeling, consider adding a candy aisle.

[This piece was originally published on Paul Roemer’s blog, Disrupting Patient Access & Experience. To follow him on Twitter, click here.]