Rite Aid Drugstores Roll Out Telemedicine; New Model for Walk-in Clinics

I have closely tracked the evolution of walk-in clinics in big-box stores and retail drug store chains for several years in this blog. Various business models have been tried, the most successful of which have been the nurse-staffed facility and the training of pharmacists to administer flu shots (see: More than 30,000 Pharmacists Now Administering Flu Shots in Neighborhood Drug Stores). I am sure that the executives of the retail pharmacy chains are going to continue to tweak this model until they get it right. It increases traffic and places the local drugstore as a key link in the broader healthcare delivery market. The latest version of this theme is to connect customers to physicians or nurses via an on-line webcam located in the store. Mr. HIStalk first alerted me to this trend (see: Online doctors are just a click away). Below is his note:

Nine Rite Aid drugstores in Michigan roll out OptumHealth’s NowClinic, which allows people to conduct a 10-minute IM or webcam-based chat with a doctor 24 hours a day for $45, the outcome of which can be a prescription filled by Rite Aid.

Here's the original newspaper article:

Michiganians who have an urgent medical question, lack insurance or just want access to a doctor and prescription after hours can increasingly reach for their phones or computers for an instant chat or webcam conversation with a physician or nurse....But the trend is drawing attention from some physician groups and state medical boards, including Michigan's, that are uneasy about the quality of online physician diagnoses and prescriptions. Companies such as MDLiveCare and Consult A Doctor offer consumers the convenience of online health care 24 hours a day, and employers are showing more interest in offering the service to employees to rein in health care costs....[N]ine Southeast Michigan Rite Aid stores will debut OptumHealth's NowClinic, which allows consumers to talk to a nurse for free or use a credit card and pay $45 for a private appointment with a doctor licensed to practice in Michigan — anytime the store is open and online 24 hours a day. Doctors can diagnose patients and, when appropriate, write them a prescription, which can be filled at Rite Aid stores. NowClinic gives Rite Aid a similar service to rival CVS's MinuteClinic, a walk-in clinic inside select stores, including several in Metro Detroit....While telemedicine is legal in Michigan, the Bureau of Health Professions, or the state's medical board, does not support physicians prescribing medication after using an Internet questionnaire or without having an existing doctor-patient relationship, said Steve Creamer, manager of the professional practice section for the state bureau. Doctors doing so are providing substandard care, which would lead to an investigation that would likely lead to a fine and/or license suspension or revocation, Creamer said, adding the state is considering changes to its laws to clearly define what is improper.

From a business perspective, the NowClinic model makes perfect sense. The Rite Aid chain takes advantage of a pre-existing, web-enabled physician/nurse consultation service. This approach avoids the cost of building an expensive walk-in clinic in the stores. However and given the details in the article above, I suspect that it's unlikely that Michigan or many other states will approve "physicians prescribing medication after using an Internet questionnaire or without having an existing doctor-patient relationship."

Getting into the walk-in clinic business is not that simple. The drug stores want the increased customer traffic and growth of their prescription business. What they don't want is to run a first-aid dispensary and emergency room. My prediction is that this NowClinic telemedicine model is not going to work out for Rite Aid. They are a little late to the party and many of their customers will not be comfortable with the telemedicine approach.

Comments

[Electronic Medical Records]

There can be a lot of problems with this. I also do not trust every cashier in a drug store to be able to perform a flu shot. They work behind a register and do not alwyas have the best training. There can always be mistakes.

[Brian Sabb]

Dear Readers,

For minor treatments, this model is not a whole lot different than the current in office model.

How much time does your doctor spend with you in the office? How much time does he or she examine you?

I am not saying that this is an ideal model, but at 2 AM would you rather wait in the ER for 6 hours or see a doctor in 10 minutes for your sinus congestion or sore throat?

Dr. Friedman, please keep these excellent blogs coming.

Sincerely,

Brian Sabb

[sallyhealthcaretech]

Wow, how awesome is that! Being able to talk to a doctor from the comfort of your home and then go get your precription... the only issue I see with this is someone "pretending" to be you or lying about their symptoms to get a certain prescription.