retail clinci project rreport

8/7/2019 RETAIL CLINCI PROJECT RREPORT

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What is a Retail-based Clinic (RBC)?

Various vendors have developed limited scope, primary care clinics

that are housed at retail sites (Target, Wal-Mart, Walgreens, CVS

Pharmacy). In most cases these are staffed by nurse practitioners

providing basic primary care and treatment for minor conditions suchas strep throat, ear infections, bronchitis, sore throat, andimmunizations. No appointments are necessary and posted fees

generally are less than at a physician’s office. They are also referred to

as “store-based clinics,” “retail health clinics,” and “convenient careclinics.”

The chart below lists the major retail based clinics. In addition, insome areas, local hospitals and physician groups are developing clinics

with local retailers or providing staff for these clinics.

Retail-Based Clinics Currently in Operation



Vendor Size and

Location

Future

Goals

Web site

Aurora QuickCare

13 sites inEasternWisconsin

Consideringadditionallocations

www.aurorahealthcare.org/services/quickcare/index.asp

Curaquick 5 sites inNebraskaand Iowa

Plan to add upto 9 additionalsites

www.curaquick.com

The Little Clinic 8 sites inIllinois,Kentucky andIndiana

Signed anagreement withPublix to add upto 50 clinics,including sites inFlorida.

www.thelittleclinic.com

MediWin 1 site inArizona

Plan to add 2more sites

www.mediminute.com

MedPointExpress

2 sites inIndiana

www.medpointexpress.com

MEDspot/HEALTHspot

2 sites inIndiana

Also providesconsultingservices tophysicians toopen their ownretail clinic.

www.medspot.net

www.healthspotclinics.com

www.cliniciansconsulting.com

Minute Clinic 81 clinics in:FL, GA, MD,IN, MN, NC,OH, TN, WA

Recentlypurchased byCVS Pharmacy

www.minuteclinic.com

Quick Clinic 3 sites inOhio

Plans for additional clinics in Ohio

www.quickclinic.com

RediClinic 11 sites inAR, NY, OK,and TX

Plans to open75 clinics in2006. Onlyprovidesservices topatients over 2years of age

www.rediclinic.com

www.revolutionhealth.com

Solantic 12 sites inFlorida

Are staffed withboard certifiedphysicians.Also, has awebsite just for kids toencourageparticipation byoffering

membershipcards anddiscounts to

www.solantic.com

http://www.aurorahealthcare.org/services/quickcare/index.asp


http://www.curaquick.com/

http://www.thelittleclinic.com/

http://www.mediminute.com/

http://www.medpointexpress.com/

http://www.medspot.net/

http://www.healthspotclinics.com/

http://www.cliniciansconsulting.com/

http://www.minuteclinic.com/

http://www.quickclinic.com/


http://www.rediclinic.com/

http://www.revolutionhealth.com/

http://www.solantic.com/

http://www.curaquick.com/

http://www.thelittleclinic.com/

http://www.mediminute.com/

http://www.medpointexpress.com/

http://www.medspot.net/

http://www.healthspotclinics.com/

http://www.cliniciansconsulting.com/

http://www.minuteclinic.com/



http://www.rediclinic.com/

http://www.revolutionhealth.com/

http://www.solantic.com/





http://www.takecarehealth.com/

http://www.wellnessexpressclinic.com/



CURA QUICK

Services :Curaquick's Health Care Providers will authorize prescription

medications as needed.

Curaquick offers treatment for the following:

Curaquick can also provide corporate wellness services including rapid cholesterol screening.Our cholesterol checks can be completed with results in less than 15 minutes at a cost of just$28.

Allergies Athlete's Foot

Bladder Infections Bronchitis Cold Sores

Cough Diarrhea

Dizziness/LightHeaded

Ear Pain/Itch Flu Headache Heart Burn Impetigo

Insect Bites Joint Pain Laryngitis

Minor Back Pain Vaccine (Additional fee applies)

Td (Tetanus,Diptheria)

Minor Burns & Rashes Minor Skin Infections

Minor Sunburn Nasal Congestion Nausea/Vomiting

Pink Eye & Styes Rash/Itch

Ring Worm Sinus Infections Skin Infections Stomach Pain Strep Throat Swimmer's Ear Swimmer's Itch Upset Stomach

Testing (Additional fees apply)Urinary Tract Infection Strep Infection TB Influenza A & B

FEES :

Curaquick's basic visit fee is $59 with no co-pays or deductibles to meet.Additional charges apply for laboratory tests and vaccinations.



Aurora QuickCare

Services :

At Aurora QuickCare clinics, our $65 visit fee includes exam, diagnosis and treatment of manynon-emergency conditions, including:

o Bronchitis

o Ear Infection

o Ear Wax Removal

o Female Bladder Infection

o Influenza

o Insect Stings

o

Minor Rasheso Mononucleosis

o Motion Sickness

o Pink Eye

o Poison Ivy

o Ringworm

o Seasonal Allergies

o Sinus Infection

o Sore Throat

o Wart Removal (common, plantar, flat)

Patients must be six months or older to be treated.

Our nurse practitioners and physician assistants also can provide a prescription if needed.However, for long-term care and prescriptions for chronic conditions such as high cholesterol andhigh blood pressure you will be referred to your provider's office.

If we determine that your condition is too serious, we'll refer you to your provider's office, anurgent care facility or emergency department.

Aurora QuickCare clinics accept cash, credit card and most insurance plans. Please have your insurance card with you at the time of your visit.

Because your busy schedule doesn't always match your provider's office hours, Aurora

QuickCare offers immediate access to the following health screenings:

o Camp and sport physicals for patients nine years and older - our providers can perform

the appropriate exam and complete the forms needed for your child's participation.o Lipid profile (cholesterol) - for long-term care and prescriptions related to chronic

conditions-such as high cholesterol and high blood pressure - you will be referred to your

personal provider. Find a provider .o Pregnancy testing - accurate results in a private, respectful setting

o TB testing - includes required test result reading 48-72 hours after the test

http://www.aurora.org/doctors

http://www.aurora.org/doctors



Vaccines are available for:

o Seasonal flu

o Meningitis

o Pneumoniao Travel vaccines (coming soon)

o Well tetanus

FEES : $65

Flu shot Pneumonia shot

Cash Discount: $30.00 Cash Discount: $55.00

Insurance: $46.00 Insurance: $70.00

RediClinic

SERVICES :

1. Minor Illness & Injury

Respir ato

ryConditions

Bronchitis

Colds

Coughs

Flu

Sinus Infections

Sore Throats

Strep Throat

Head, Ear, and Eye

Skin, Hair, and Nail

Acne

Insect Bites

Lice

Minor Skin Infections and Rashes

Poison Ivy

Sunburn

Wart Removal

Digestive and Urinary

Bladder Infection

Diarrhea

Nausea

Urinary Tract Infection

Vomiting

http://www.rediclinic.com/services/services.php

http://www.rediclinic.com/services/illness.php


http://www.rediclinic.com/services/services.php




Earaches

Ear Infections

Fluorescein Eye Stain

Pink Eye

Styes

2. Physicals

Includes measurement and evaluation of height, weight, blood pressure, vision, eyes, ears, nose,

throat, neck, chest, heart, abdomen pulses, lymph nodes, skin, joints, spine, and muscles.

Sports $59

Camp $59

Basic $59

College $59

DOT Examination $75

3. VaccinesDTaP $79

Hepatitis A, Hepatitis B - Adult $169

Hepatitis A - Adult $129

Hepatitis A - Child $79

Hepatitis B - Adult $129

Hepatitis B - Child $75

HPV Human Papilloma Virus

(Gardasil)$189

Influenza (FluMist®) $49 (Limited Supply)

Influenza Flu Shot (Fluvirin

®

) $25Japanese Encephalitis - Child $159

Japanese Encephalitis - Adult $289

Measles, Mumps, Rubella (MMR) $99

Meningococcal - Menomune $149

Meningococcal- Menactra $159

Pneumococcal Vaccine $79

Poliovirus vaccine $79

Rabies - Prophylaxis $299

Tdap (Diphtheria, Tetanus, and

Pertussis)$69

Tetanus $59

Tetanus Pedi dT $74

Tetanus & diphtheria (Td) $75

Typhoid - Oral $84

Typhoid - Vaccine $99

Varicella $169

Yellow Fever $139

http://www.rediclinic.com/services/physicals.php





Zoster (Shingles) vaccine $259

4. Mens / Womens Screenings

Choice package : for healty individuals , routine check up 69$

Tests Included

Lipid Profile

Glucose

Blood Pressure

Body Mass Index (BMI)

Premium Pacakge :Individuals who may be at an increased risk for heart disease or

diabetes due to family history, smoking, obesity, etc. 107$

Tests Included

Lipid Profile

Glucose

Kidney function

Liver function

Complete Blood Count (CBC)

Blood Pressure

Body Mass Index (BMI)

7 Vital Tests Package: Individuals who want a comprehensive package of tests and

screenings that will provide an overall assessment of their health. 136$

Tests Included

Lipid Profile

Glucose

Kidney function

Liver function

Electrolytes

Complete Blood Count (CBC)

TSH

Blood Pressure and Body Mass Index

5. Individual Tests (Venipuncture*)

CBC (Complete Blood Count) w/ $29

http://www.rediclinic.com/services/menswomens.php





DIFF

Comprehensive Metabolic Panel

(CMP)$39

C-Reactive Protein (CRP) $35

Glucose $30

Hemoglobin A1c $25

Homocysteine $35

Lipid Panel $29

Pregnancy Test - Blood $39

PSA - Total $45

Sedimentation Rate $29

Testosterone (Free & Total) $69

Testosterone (Total) $49

Thyroid Stimulating Hormone $29

Thyroid Panel w/ TSH $49

T4 Free $16VAP Cholesterol Test $69

Individual Tests (Non-Venipuncture)

TB Skin Testing $29

Urinalysis, Complete $35

Urine Culture/Colony Count $35

Wound Culture $39

Titers (Venipuncture*)

Hepatitis A Antibody $59

Hepatitis B Surface Antibody,

Quantitative$59

Hepatitis B Surface Antigen with

Reflex$59

Hepatitis C Antibody $59

Titer, MMR $89

Titer, Measles $32

Titer, Mumps $32

Titer, Rubella $25

Titer, Varicella Zoster $75

THYROID CHECKUPS : 75$Tests Included:

Thyroid Panel w/ TSH

Free T4



DIABETES CHECKUP :Tests Included:

VAP Cholesterol Profile (extensive cholesterol test)*Glucose

Liver Function

Kidney Function

Hemoglobin A1C

ALERGIES :

RediClinic has allergy testing packages to take the guess work out of which allergens give you

itchy, watery eyes, sniffles, sneezing, or other allergic reactions. The packages identify common

allergens, plus regional environmental and food allergens.

Tests Included:

Weeds

Ragweed

English Plantain

Pigweed/Careless

Lamb's Quarter

Cacklebur

Marsh Elder/Poverty

Dock/Sheep Sorrel

Sage

Saltbush/Scale Mix

Russian Thistle

Kochia/Firebush

Spices

Black Pepper

Garlic

Curry

Jalapeno/Chile Pepper

Mustard

Paprika

Trees

Cottonwood Tree

Maple Tree

Aspen

Alder

Mesquite

Juniper/Cedar

Box Elder

Oak

Elm

Pecan/Hickory

Mulberry

Arizona Cypress

Sycamore

Olive

Grasses

Bermuda Grass

Blue Grass

Rye Grass



Poppy Seed

Rosemary

Sesamie

Seafood

Tuna

Cod

Salmon

Shellfish Mix(b)

Shrimp

Halibut

Dairy

Eggs

Cheese - Soft

Milk - Cow

Yogurt

CaesinCheese - Hard

Cottage Cheese

Goat Cheese

Whey

Vegetable

Carrot

Corn

Tomato

Avocado

Bean Mix(d)

Broccoli

Celery

Lettuce

Mushroom

Peppers

Potato

Asparagus

Eggplant

Onion

PeasSpinach

Squash

Sweet Potato

Fruits

Citrus Mix

Orange

Melon Mix(a)

June

Orchard

Fescue

Redtop

Timothy

Rye

Brome

Grains

Oats

Rice

Soybean

Wheat

Barley

Hops

Rye

Bran MixWheat Gluten

Molds

House/Dust Mites

Smut Mix/Stemphyllium

Candida Albicans

Aspergillus

Alternaria

Helminthosporium

Cladosporum

PenicilliumRhizopus

Meats/Poultry

Beef

Chicken

Pork

Turkey

Lamb

Veal

Other

DogCat

Cane Sugar

Peanut

Baker's Yeast

Cocoa/Chocolate

MSG

Nut Mix(c)



Strawberry

Bananas

Grapes

Apple

Peach

Watermelon

Berry Mix

Coconut

Grapefruit

Mango

Pear

Pineapple

Plum/Prune

Epidermals

Cockroaches

Horse Hair Mixed Feather

Ascorbic Acid

Aspartame

Baking Powder

Carob

Carrageenan

Coffee

Egg - White

Egg - Yolk

Guar

Nitrates

Nut Mix II(e)

Parabens

Sulfites

(a) Cantaloupe, Honeydew

(b) Clam, Crab, Lobster, Oyster, Scallop

(c) Almond, Cashew, Pecan, Walnut

(d) Green, Kidney, Lima, Navy, String

(e) Hazelnut, Pistacio, Macadamia

HEART CHECKUP :

The Premium package includes the five tests that are most important in measuring your risk for heart diseasincluding the VAP Cholesterol test, which measures fifteen cholesterol components and is the most comprehecholesterol test available.

Tests Include:

• VAP Cholesterol

• C-Reactive Protein

• Homocysteine

• Blood Pressure

• BMI

More Services†

B12 Shots $25

Ear Irrigation† $69

Flu Instant Test $20

Injectable Antibiotics Inquire within

Minor Laceration Closure $99

Mono Instant Test $19



Nebulizer Breathing

Treatments

Inquire Within

Pink Eye Instant Test $25

Pregnancy Instant Test $15

Spirometry (Lung Age Test) $39

Steroid Injections $23 to $39

Strep Instant Test $20

Suture/Staple Removal $39

Urinalysis Dipstick $15

Urine Drug Screen $29

PROJECT analysis of RETAIL CLINICS

Retail Clinic / Convenience Clinic Consulting

The retail clinic concept - walk-in service of low acuity illness/injury at a reasonable

cost in a convenient location - has captured significant attention since its introductionin 2001. Frequently referred to as "disruptive innovation" in health care, the retail

clinic model is one of the few innovations bringing true value to the consumer.Clinicians Consulting provides start-up and operational assistance to the retail clinic

industry. As one of the earliest founders and operators of retail clinics, we are themost experienced in the industry. Our industry experience together with our

knowledge of health care brings significant value to your team.

Business Planning

Start-Up Consulting

Operations

Services

Clinicians Consulting offers a complete solution for building, developing, and

operating convenience clinics through their turnkey development system. Thesystem is the most comprehensive non-franchise system in the industry.

Strategic Business Planning

CC offers a strategic planning process which will assist in launching your projectforward. This program can be accomplished in a relatively short period of time. We

will spend several hours together in person or over the phone facilitating your plan.CC will then provide additional material including but not limited to an example

business plan for your convenience clinic operation.

Feasibility Analysis



A feasibility analysis is a preliminary study undertaken before the real work of aproject starts to ascertain the likelihood of the project’s success. Unfortunately, the

success rates for small business are quite low. Depending on which statistics youbelieve, the chances of a new business surviving for 5 years are between 30 and 50

percent. As an entrepreneur, you can greatly increase your chances for success byanalyzing your marketplace before beginning. There are several aspects of a

feasibility analysis we can perform including:

Demographic analysis

The demographic analysis consists of a review of the census, economy, ethnicity,

education, and employment of your prospective market. The information is useful inthe determination of clinic viability. The information also assists in finding an ideal

location for a clinic.Legal feasibility

We will evaluate local laws and regulations on nurse practitioner (NP) and physicianassistant (PA) practice. The regulations placed on NP/PA practice varies among

states which is pivotal on the success of convenience clinics mainly staffed by suchprofessionals.

Economic feasibility

The local economy, insurance market, and personal financial situation are importantindicators for the success of a new convenience clinic. CC will both gather andanalyze this data. CC will also provide a basic example proforma including potential

sales revenues, fixed and variable costs, and break-even figures.Market assessment

The market assessment consists of reviewing existing and potential competitors andperforming an assessment of need for a convenience clinic. The market assessment

is best performed with a visit by CC to your intended market area. Assessing themarket size for a convenience clinic is tricky but a critical part of a feasibility

analysis. For a clinic to work, you must have enough customers willing to spendmoney on your service to provide sales revenues that cover your expenses and,

hopefully, earns you a profit.

Fortunately, convenience clinics bring true value to the healthcare arena previously

not seen and this increases their competitive advantage when compared to existingservices. In performing a feasibility assessment it is our intention to assist you in

making an informed choice about whether or not a convenience clinic is stillattractive and practical for you.

Complete Design and Lay-out

CC provides complete design and layout of each clinic to maximize the efficiencies of the concept. This includes developing a floor plan, complete rendering package and

color boards for all finishes selected. CC provides a list of necessary medical andoffice supplies and will provide quote from several vendors.

Roll-Out

The CC development program is designed to brand and rollout the concept on a

multi-unit level. To accomplish this we will use coordinated efforts with our Sales,Real Estate, Project Management, Construction, Marketing, Training, Operations and

Public Relations Departments. The expansion program includes market penetrationand saturation through public relations, web site advertising, and real estate

development.



Recruitment Program

CC has developed a nationwide placement firm dedicated to advancing the quality of

healthcare within the United States by providing convenience clinic systems withsuperior customer service. We emphasize a strategic fit between client and candidate

by instilling a high level of integrity into every relationship and transaction.Searching for an addition to your staff or looking to expand your line of products andservices can be stressful. We understand the commitment you have made to ensure

the quality of life for your patients and the responsibilities therein to your

community.

We offer services to NP/PA candidates and employers who are looking for the "rightfit." Finding time to search and having access to the technology needed to locate

candidates and career choices is sometimes nearly impossible. We have pooled thenecessary resources needed to match candidates with clients. We, at CC, use the

latest techniques in healthcare recruitment and placement available leaving you todo what you do best, treat patients.

Training Program

The CC Management Training Program covers the business and operational skills

required to efficiently manage the operations while ensuring premium quality serviceaccording to our exacting standards. The complete two-phased training program is

highly interactive, and trainees are monitored closely to ensure optimaleffectiveness.

The first-phase of the program is the New Client Training Program. This phase is

designed to be conducted via teleconferences and web conferences. The program isinteractive and complete to give a new location manager a working knowledge of

every aspect of running their business, as well as, understanding the development of

their rollout program. The program is geared to be comprehensive and informative,to maximize the skills and abilities of any new manager.

The second-phase of the program is our Road Training Team. These trainers arrive

on-site at least 3 days prior to a new location opening. Their function is to help setupand prepare the new location for opening. The opening team has a specific schedule

and agenda for its time at the new location. The team will frequently remain on-site

during the opening and during the first several days of operation to aid and assistthe staff. The opening team will continue to provide a measure of off-site supervision

until it can be demonstrated that the resident management team can consistentlymeet the concept’s operational standards.

In addition to the two-phased training program, the manager will have access to

operational documents to reinforce their training and share the experience withemployees.

Operations

To implement the corporate growth of your program, CC can provide a support and

staffing structure that will grow in step with the expansion of the concept. Certainfunctions may be outsourced (marketing and public relations).



CC provides a fully trained and functional operations department ready to begin thetask of building the CC concept into a multi-unit brand. The operations department

will work with your location management and new clinics to insure your success. Thisincludes, but is not limited to, a 24 hour a day phone and e-mail support, operations

support, and on-going training.

This only provides a summary of what we can do . The fact is each of our projectshave been completely different and we can develop a program aimed to meet yourspecific needs. Just give us a call. Our consulting program can be tailored to the

executive, so we can design an approach that produces quick results. We're looking

forward to working with you..

"CC's timeless effort and creativity proved to be instrumental in implementing thebusiness plan and subsequent expansion of our clinics. Under their guidance and

leadership, we have evolved from an innovative and unique healthcare concept intothree successful prompt care clinics. Due to the vast and immediate success of these

clinics, we are currently exploring other venues in the area for further expansion."

Disruptive Innovation

The retail clinic concept is the ideal service for our increasingly convenience andhealth oriented society: high quality medical care with no appointment needed,

convenient locations, in and out exams in 15 minutes, inexpensive, and time saving.We help bring these elements together with creative retail medical care in a high

quality, professional manner to service the needs of our society. Retail clinics are notonly fulfilling existing demand - they are creating a new one - pioneering a whole

new branch of the medical industry, accessible medical care at low-cost.

Using Business Intelligence to Achieve

Goals of Retail-Based Clinics

by Scott Wanless

Taken from Business Intelligence Network

The migration of patient point-of-care off the traditional medical campus represents agrowing trend in the United States. Over the next few years, off-campus healthcaredelivery points will experience a steep upward curve as clinics move into retail locations,corporate office locations, schools, community centers and so forth in increasingnumbers. One fast-growing trend that brings both great opportunity as well as significantrisk is the retail-based clinic (RBC). Compared to traditional clinics, RBCs will require agreater diversity of business intelligence applications.



Forces Driving Retail-Based Clinic Growth

The driving forces behind this migration spring from changes in patients themselves. Inthe past, patients viewed healthcare not so much as a product or service that was shoppedfor, but one that was received from large institutions (hospitals, medical practice groups),

paid for by another large institution (insurance company) and purchased on our behalf byyet another large institution (employer).

Patients have had to become savvier consumers of healthcare services. With higher deductibles, more complex health plans and increased responsibility for costs, we are allbecoming better managers of both the cost and the quality of the healthcare services wereceive. In addition, competition among healthcare providers is forcing organizations toprovide healthcare delivery points where the patients are, instead of requiring patients tocome to them. In response to these pressures, retail-based clinics are emerging as apowerful force.

Retail-based clinics are clinics hosted in retail stores, as the name implies. Currently,there are roughly 150 RBCs doing business across the United States, with another 800 to900 in the planning stages. By 2008, the number of running RBCs is projected to be morethan 1,800.

MinuteClinic, which was bought by CVS in July 2006, is currently the largest operator of RBCs. Others include SmartCare, MedPoint Express and RediClinic (which is backed byAOL founder Steve Case's Revolution Health Group). Most of these are independentbusinesses, but some are owned and operated by provider organizations. For instance,near my home are QuickCare (operated by Aurora Health Care) and FastCare (operatedby Bellin Health Systems). Aurora and Bellin are two large, highly respected integrated

delivery networks in my state.

Host stores include many of the largest retailers of pharmacy, grocery and generalmerchandise, such as CVS, Target, Wal-Mart, Kroger, Walgreens, Kerr Drug, FredMeyer, ShopKo and Winn-Dixie. This makes sense because these and other retailers haveset a strong precedent by operating and/or hosting other service businesses includingpharmacies, optical centers, banks and a host of other service businesses. The motivationfor the host store is pretty clear – to generate additional foot traffic in high-marginproduct lines associated with the hosted business.

The primary motivation for starting an RBC is financial as well. As consumerism grows

in healthcare, RBCs know that they can tap into two of the three key drivers for patientsand their families. In healthcare, consumers focus on three C’s: care, convenience andcost.

As mentioned earlier, in the past, care was the primary factor in this mix, without asmuch regard for convenience or cost as there is today. You went to the doctor you trustedmost. He or she was physically located among other doctors on some sort of medical



campus (clinic, hospital, university medical complex, etc.). This kept the economies of scale high and allowed medical professionals to work and learn together as colleagues.

Cost was much less visible to consumers because we had health plans that just took careof the bill for us. The premiums came out of our paychecks, which made the cost less

visible. So, to a consumer, a $400 procedure with a $25 deductible felt like a $25 bill.

This mix of consumer factors is shifting. Care quality is demanded and assumed byconsumers. Cost is more visible. Convenience is now a much stronger consideration.With the proliferation of health reimbursement accounts, health savings accounts, high-deductible plans and a higher potential denial rate for covered services, a $400 procedurenow feels like a $400 bill. Plus, if you are single mom hauling around three kids,convenience has to be a major concern.

RBCs know this mix is shifting and are responding to it. These types of clinics aretypically staffed with nurse practitioners, nurses and certified medical assistants, with a

physician on call. Plus, the scope of services is generally narrower than a traditionalclinic, primarily testing for and treating common illnesses, performing health screenings,and school or employment physicals. This keeps the operational costs lower than thetraditional clinic. Also, by virtue of being in a retail location, the RBC is theoreticallyalready where the consumer would be to shop for other products and services. This keepsthe convenience factor high.

All of these factors make retail-based clinics a wonderful opportunity from a businessviewpoint to bring healthcare delivery closer to patient populations and do it more cost-effectively. There are, however, several challenges that must be addressed if this type of operation is to succeed. Business intelligence is one tool that can help the RBC address

these challenges and achieve its goals.

Business Intelligence Applications Needed for RBC Success

Retail-based clinics share many of the same analytical information needs of traditionalclinics. Both require clinical decision support and clinical guidelines at the point of care,and clinical quality measurement to ensure they are in compliance with regulatory andaccreditation requirements. Both need patient information in the form of registries tokeep track of their patient populations and the clinical activities performed to help themget well and stay well. Of course, both types of organizations require administrativemanagement information to make sure they are getting revenue from claims and patient

payments, as well as being able to pay the bills.

There are, however, a few business intelligence applications that an RBC needs tosurvive and succeed that stem from being closer to street level. A few of the additional or heightened business intelligence needs include:

• Demand Management Analytical Support. As any seasoned retailer will tell you,on the retail floor, demand can spike or drop in an instant. On a medical campus,



a clinic has greater control over the flow of patients. In a retail setting, this couldbecome a real problem in a hurry. For instance, the RBC could easily suffer frominsufficient capacity during an epidemic. Even on the best of days, demand couldeasily overload the waiting area. If, for example, the wait at an RBC becomes 45minutes versus a 20-minute drive plus a 20-minute wait to see a campus-based

doctor, consumers may avoid the non-traditional RBC.• Growth Strategy Information. Are you seeing the demographic profile you

expect? Are your resources aligned with this profile? For instance, there is a tacitassumption that the RBC will see primarily younger people who valueconvenience, whereas the campus-based clinic will see primarily older peoplewho value the traditional, private atmosphere. What if this is not true, and youbegin to see increasing numbers of Medicare-covered patients? Are youMedicare-eligible? Plus, the logistics required to serve older populations mightnot be in place in a rough-and-tumble retail setting. It is essential to watch your demographics to make sure your growth plans are on track.

• Cross-Sell Metrics. Cross-selling with the main store presents both opportunities

as well as risks. The bottom line for the host is that they want lift in their ownsales from hosting the clinic, instead of just receiving the space rental revenue.Retailers are ruthless when it comes to getting return on investment from space.Every product and service must compete daily with other products and servicesfor every square foot. This has a potential dark side as well. Clinic staff may bepressured to write or fill prescriptions in the affiliated pharmacy, recommendfoods from the host’s grocery aisles or over-the-counter supplies and equipmentfrom the health and beauty department. In some cases, this may hamper their professional clinical judgment to the detriment of their patients and to their careers. Maintaining this balance will require continuous measurement in order todemonstrate value to both the clinic as well as the host and, of course, to thepatient.

• Consumer Behavior Information. Consumers are even more ruthless than retailerswhen it comes to the products and services they buy. Most of the time, the onlyindication that something is wrong is that you don’t see the consumer again. Thispresents a problem for the clinic because they don’t know what went wrong withtheir service, and they may have to play catch-up if the consumer comes back. Italso presents a problem for the patient in the form of a loss of continuity in their care. Retail-based clinics are likely to experience greater fragmentation in thiscontinuity due to the way consumers view retail services (episodic) versusprofessional services (continuous). This episodic buying pattern could haveserious effects on people with chronic conditions or special healthcare needs.Furthermore, if consumers find that your RBC is good at diagnosis, but unable tofollow up with full treatment, they will abandon your clinic. In the consumers’view, they might as well go straight to the clinic that can get the whole job doneand cut out the middleman. Analysis of data on consumer buying patterns iscritical for RBCs.

• Service Development and Service Quality Measurement. As more RBCs open, thecompetition will keep upping the ante in terms of services offered and the pricescharged. This will put pressure on existing RBCs to add staff with greater



specialization, to add more equipment and to upgrade facilities to serve a wider variety of patient populations. Ironically, the retail environment could eventuallybecome a healthcare campus. While this could have positive business benefits, itcould have detrimental service quality effects. Fragmentation of care can kill apatient as well as a business. Fragmentation of data and process flow can do the

same. Information to support reasoned product growth and product change, aswell as the effects on product quality, is extremely important if the operation is toaccomplish its goals.

• Operational Analysis. The environment that RBCs inhabit is made up of severaldifferent organizational cultures, and not all of these are conducive to attractingand keeping clinical staff. On the one hand, the staff comes in contact with ahighly diverse group of providers. On the other hand, that same staff may actuallyfeel isolated from their peers who are on campus. RBCs are not expected to bestaffed by specialists (e.g., peds, women’s health, geriatric health) because of thegeneral nature of the scope of their services. This could result in abnormally lowstaff satisfaction and consequently high turnover. Monitoring for staffing patterns

and trends in satisfaction rates is necessary.• Public Health Analysis and Reporting. RBCs need to be concerned about disease

and infection control – not only for the clinic, but the main store as well. There issome benefit to having patients go to the medical campus instead of potentiallyinviting public health problems into commercial retail environments. Campus-based clinics have to be concerned about contagions in their environments andmust track these issues for regulatory purposes, and this monitoring need isheightened in the more open world of the RBC.

Next Steps

Retail-based clinics represent a tremendous opportunity for providers as well asindependent operators to bring healthcare closer to the market and to do it in a cost-effective manner. There are several potential difficulties that must be proactivelyaddressed if this type of clinic is going to survive and prosper. Businesses in any industrysucceed when they use the data they already own to make smarter, evidence-baseddecisions. In other words: when they actively use their business intelligence. Healthcareorganizations that ignore this fact fail. Whether your organization is in the retail-basedclinic business, is hosting a retail-based clinic or has chosen to pursue a campus-basedclinic approach, it pays to make the best use of your data for clinical, business andfinancial success. The applications described in this article should provide your organization with ideas for doing just that.

Mark Perry provides an interesting inference from two news stories: a WSJ article thatsuggests consumers are using less health care and another that reports a big jump inMinuteClinic volumes.

http://online.wsj.com/article/SB10001424052748703940904575395603432726626.html?mod=djemITP_h

http://www.dailymarkets.com/economy/2010/07/29/americans-cut-back-on-visits-to-the-doctor-but-increase-visits-to-retail-health-clinics-by-36/

http://online.wsj.com/article/SB10001424052748703940904575395603432726626.html?mod=djemITP_h

http://www.dailymarkets.com/economy/2010/07/29/americans-cut-back-on-visits-to-the-doctor-but-increase-visits-to-retail-health-clinics-by-36/



Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather,they are shifting their demand for health care away from expensive, conventionalphysician offices with limited hours to affordable and convenient retail clinics.Especially when consumers are spending their own out-of-pocket money for health careand they have a choice, they prefer market-driven, consumer-driven options like

affordable, convenient retail clinics over conventional physician offices.

I think Perry is on to something. It’s hard to get people out of their established habits.They have a relationship with their own doctor, they accept the long wait for appointments and even treat it as a proxy for high quality (if my doc is so busy he mustbe great), and just suck it up when it comes to co-pay’s and deductibles. They wantaccess to high tech exams and the latest drugs.

But all these things change over time. MinuteClinic and its ilk are well-positioned to takeadvantage of these trends in the long run. To take them in turn:

•

Relationships aren’t what they once were. Your doctor may or may not remember you. If you have something routine (or even if not) you may be shunted off to seea “physician extender, ” such as a nurse practitioner. At least when you go toMinuteClinic that’s who you expect to see

• Wait times for appointment can be lengthy. Under health reform they are likely toget worse, especially since open access scheduling is slow to catch on

• We’ve now reached the breaking point for co-pay’s and deductibles. Even insuredpeople are nervous about going in for treatment and want to save money. Theyrealize it’s only going to get worse

• High tech exams (like MRIs) and drugs have lost some of their allure. Cost is partof it, but the continued news stories of safety problems with drugs are taking a

toll, too. I think Americans are finally realizing that when it comes to health careless is often more

Finally, especially for routine issues, MinuteClinics do as well or better for quality. Thereason is pretty simple: nurse practitioners are more likely to follow protocols thandoctors, and the standardized MinuteClinic model represents a more disciplined approachto operations than the typical physician office.

It will be interesting to see if the substitution of MinuteClinic for the physician office is atrend that ho

retail clinci project rreport

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