In a recent blog note (see: A Visit with a MinuteClinic Nurse Practitioner; My Observations and Conclusions), I discussed how IT was being deployed to make a visit to a MinuteClinic more convenient for patients and efficient for the NP caregiver. There was nothing earthshaking about the IT from my perspective -- making an on-line appointment, displaying wait time for patents in the waiting area, and news about the availability of a vaccine in short supply on the web. I immediately thought about how Uber and other ride-sharing apps have shaken up the previously stable taxi industry using IT. Many people now prefer Uber over taxis because you can summon a ride from any location in a city, you are messaged with the arrival time and shown the location of the Uber driver, you know the name of the driver, you can input your assessment of the driver, and your credit card number is kept on file so that payment is simplified. In the face of these conveniences, It has never occurred to me to take into consideration the skill of the Uber driver, assuming, that the skill of a random Uber driver was roughly equivalent to that of a random taxi driver.
Let's now talk about a primary healthcare visit. For most visits, I believe that the skill level of an NP is equivalent to that of PCP. For certain unusual cases, the diagnostic acumen of a physician will obviously be superior. However, the NP can be supplied with computer-based algorithms that can provide alerts when a case needs to be turfed to a physician. Their own training, obviously, comes into play here and personal warmth also goes a long way. In other words, operational efficiencies, as in the case of Uber, often override any possible doubts about the skill level of the healthcare provider.
Theoretically, then, the patient experience during a MinuteClinic visit can be viewed as analogous to a ride with Uber. It can perhaps be enhanced to a level superior to a physician office visit using IT. The goal of CVS/MinuteClinic executives then, like the Uber executives, will undoubtedly be to consider a list of the items that irritate/satisfy patients regarding a visit to their primary care physician and try to ameliorate them with IT. Here is my first crack at such a list:
- Inability to make an appointment with little wait time.
- Parking and convenient access to the clinic.
- Wait time in the office.
- Skill set and professionalism of the healthcare professionals.
- Attentiveness/friendliness of the healthcare professionals.
- Cost of the visit, particularly if uninsured.
- Inability to solve the problem that prompted the visit.
- Inadequate follow-up, particularly if the health problem persists.
I am not sure how many of these challenges can be "improved" with IT by MinuteClinic executives but it would be a good list to start with. I would welcome comments about how IT can be used to attend to the issues in this list.
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