If drug store walk-in clinics expect to grow out of their initial "minor ailment" stage, they need to integrate more closely with community hospitals. This integration can take a number of forms such as electronic record sharing, frictionless referrals of patients, and enhanced continuity of care. One step already taken by both the CVS MinuteClinics and the Walgreens Healthcare Clinics has been the deployment of EHR software that potentially could interface with hospital EHRs. Both CVS and Walgreens have announced that they will purchase Epic software which is also commonly used by many hospitals, particularly the larger and more complex ones (see: MinuteClinic taps Epic for EMR; Walgreens Healthcare Clinics to Implement Epic Electronic Health Record Platform).
In its pursuit of hospital integration, Walgreens seems to be testing the model of leasing clinic space to health systems such as Providence Health in Oregon and Washington (see: Walgreens Leases Clinic Space in Oregon and Washington to Providence Health) and recently in Chicago to Advocate Health (see: Advocate Health Care to Operate Walgreens Healthcare Clinics in Chicagoland Area). If this model is successful and more widely deployed, many of the Walgreens walk-in clinics will be converted to ambulatory care centers of health systems. This solves the hospital integration problem. Getting burned by its Theranos deal may have convinced the Walgreens executives that it doesn't want to be in the healthcare delivery business but still wanted on-site clinics to increase walk-in traffic and prescription business (see: Walgreens Scrutinizes Its Theranos Relationship More Closely).
As for CVS, its MinuteClinic business may now be too large and successful to change but the problem of EHR integration remains if it expects to grow the business. A recent clinical affiliation agreement between CVS and the University of Michigan Health System may provide clues about how CVS will pursue this goal (see: U-M Health System announces clinical affiliation with CVS Health). Below is an excerpt from this article:
The University of Michigan Health System has established a new affiliation with CVS Health to continue to improve the health care experience for patients. Through the affiliation, CVS Health will share prescription and MinuteClinic...visit information with U-M Health System providers by enabling communication between their secured electronic medical record systems. For example, with the patient’s consent, a MinuteClinic provider can view the patient’s U-M medical record and will electronically share patient visit summaries with the patient’s U-M Health System provider. In addition, U-M Health System providers will receive data on interventions conducted by CVS pharmacists to improve medication adherence.This enhanced information sharing between the two organizations will improve the coordination of care for U-M patients who use CVS pharmacy and MinuteClinic locations nationwide....The two organizations recently worked together on a pilot project. The project allowed for collaboration between selected CVS pharmacists and U-M Health System providers in Ann Arbor to improve chronic disease management of U-M patients in the local community. Building on the lessons learned from the pilot, the two organizations are exploring other opportunities to engage community pharmacists in direct patient care.
The most interesting point in this article is the emphasis on coordination between "selected CVS pharmacists and U-M Health System providers...to improve chronic disease management of U-M patients in the local community." Pharmacists, both in a hospital and community setting, are becoming extremely important participants in patient care, particularly for patients with chronic diseases. I have neglected to discuss in the past the role of CVS and Walgreens pharmacists as walk-in clinics take on a more important role in our total healthcare delivery system. This article will serve as a reminder to pay more attention to this opportunity presented by walk-in clinics.