Retail healthcare options are steadily increasing throughout the country and in our Pacific Northwest in particular. Most of this is seen in the major metropolitan and suburban areas of Seattle and Portland. There are multiple companies located in our more rural areas that already have active retail healthcare businesses in the larger communities, including: Walgreens, Rite Aid, Target, Wal-Mart, and Fred Meyer. Other companies are offering telemedicine services which are available to patients across the state.
Current retail healthcare models arose due to multiple factors, but the largest appears to be consumerism. Savvy healthcare consumers are increasing demand for value as defined by access, price, and convenience when selecting their healthcare provider. This has resulted in part from the high deductible health insurance plans and changing consumer technologies such as mobile phone apps and telecommunication services. Patients are no longer satisfied with the traditional primary care model that often has restricted access and inconvenient times with little transparency in cost.
Retail healthcare options include straight fee for service models and membership models located inside retail pharmacy chains, grocery store chains and the large discount stores like Wal-Mart. The fee for service models offer a menu of different options with fixed pricing. Many include prices for ancillary services like labs and radiology as well. Membership models charge monthly fees for unlimited access to covered services with some additional costs for elective services. Telemedicine services allow you to call in from anywhere, at any time and receive service without physically being seen.
We already deal with lack of connection between Health Systems due to EMRs that don’t talk to each other. As more of these services pop up we will see more splintering of the patient record and thus my concern is that overall health quality will be affected in a negative way. In Primary Care the long term relationship is vital. The continuity required to diagnose and control illness and chronic disease will be diluted. I have concerns about over prescribing in these little outlets to please patients and meet customer expectations and not stick to evidence based guidelines.
My question is how do we avoid this fracturing of the primary care relationship and meet the ever increasing consumer demands, yet not compromise standards of care and quality?