The Convenient Care Evolution

Retail to wholesale changed pharmacy, electronics, consumer goods, groceries, and many other industries. It will do the same to medicine.

’s MinuteClinic locations have only been around since 2000, but the in-pharmacy clinics have already seen more than 25 million patients.

From an experiment in four states, MinuteClinic has grown over the last 15 years into a juggernaut in walk-in care, with nearly 1,000 locations in 31 states plus the District of Columbia. CVS expects to open 100 new clinics this year and about 500 more by 2017.

The retail-based clinic phenomenon is growing rapidly, driven by patient needs for convenient, fast, and accessible quality treatment for relatively minor illnesses. However, there are bumps in the road, as you would expect of a model that is transforming Sick Care and disease prevention from retail to wholesale.

As the care ecosystem evolves, retail-based clinics will need to:

1. Achieve EMR integration with other sites both within their own networks, which they are doing, but externally with other care provider networks as well.

2. Include an eCare component, consisting of telemedicine, remote sensing, patient portals and other parts as well.

3. Evolve into population management, particularly targeting "frequent flyers" who use expensive hospitals and emergency rooms inappropriately and disproportionately drive up costs.

4. Become part of a non-traditional point of care system, including health clubs, spas, and salons, where patients get a large number of treatments and tests performed.

5. Educate patients about when it is most appropriate to use retail based clinics instead of urgent care centers, a doctor's office or emergency rooms.

Acute primary care has become a more complex delivery platform. The same will happen to chronic care, chronic complex care and population health. Doctors, as part of those systems driven by other team care participants will assume a more oversight and supervisory role, instead of a direct hands on role, and the regulatory and reimbursement/payer systems will need to create systems that reward and create incentives to drive the outcomes. In addition, medical schools and residency training will need to include these skills as part of their graduates’ competencies.

Retail to wholesale changed pharmacy, electronics, consumer goods, groceries, and many other industries. It will do the same to medicine.