With quick clinics, online care, providers give convenience another try

When patients need simple health care, they can get impatient about having to wait.

That's prompted more health care systems to stress convenience.

This month, North Memorial Health Care will open two easy-access clinics in new Hy-Vee grocery stores in New Hope and Oakdale, hoping that shoppers might add treatment for warts, fever and other ailments to their grocery lists.

The resurgence of retail health clinics by hospital operators comes as they also pump money into online programs that let patients tap into care through computers and smartphones without leaving home.

Health care groups are playing catch up with the "on-demand" spirit that's reshaped how banks, airlines and entertainment companies deliver products to consumers.

"As patients are shouldering more of the cost burden, they are much more focused on value and convenience and customer services," said Kimberly Tuby, an analyst with Moody's Investors Service. "We do see hospitals responding, especially on the convenience front."

The push to build small clinics in stores was launched about 15 years ago by MinuteClinic, a Minneapolis-based company that pitched walk-in care by nurse practitioners for minor ailments.

CVS acquired MinuteClinic in 2006, and the pharmacy giant now has about 1,000 store-based clinics in 31 states, and expects to add another 500 in the next couple of years.

While pharmacies have been leading the way in retail clinics, hospitals have had fits and starts with efforts to join the trend.

North Memorial, for example, jumped into the business in 2008 by acquiring Now Care Medical Centers, Inc. At one point, the division included 12 retail clinics and seven urgent care centers. But it was a money loser, and North Memorial dropped retail by 2010.

That earlier effort focused in part on occupational medicine, such as pre-employment physicals and drug testing, said Kelly Macken-Marble, president for population health and ambulatory services at North Memorial. Its Hy-Vee clinics will operate more as an extension of North Memorial's network of primary care clinics.

For as little as $79, patients at the clinics will receive treatment for a limited menu of conditions such as urinary tract infections, strep throat and ear infections.

North's retail redux is an example of a resurgence in interest among hospitals in store-based clinics, said Tom Charland, CEO of Shoreview-based Merchant Medicine.

Last month, a Washington state health system rolled out plans for 25 retail clinics inside Walgreens pharmacies, which ranks second to CVS in in-store clinic prowess. In Green Bay, Wis., Bellin Health has worked with health care groups in the Midwest and on the East Coast to open about 15 retail clinics in the past three years. Duluth-based Essentia Health also is considering retail clinics.

Success is not guaranteed, Charland said, because patients can be scarce outside of the cold and flu season.

"The seasonality of this business hasn't really changed," he said.

Even so, hospitals are focusing on patients' desire for on-demand access to care for simple maladies, said Alicia Daugherty of the Advisory Board Company, a Washington D.C.-based consultant. Retail clinics are one way to deliver that, Daugherty said, while online care programs are another.

Efficiency has taken center stage for hospitals as insurance companies and the government move away from basing payments on the number of procedures. Retail clinics and online care might be ways to deliver care more cheaply.

Patients are also focused on price, Daugherty said, because of a growth in high-deductible health plans that means people must dip into their wallets to pay for care.

"We have Netflix, we have Uber, we have more of a 24-hour economy," she said. "We are expecting to be able to get health care services, as well, in a more on-demand fashion."

HealthPartners has three retail clinics, but has seen more growth with Virtuwell, an online care system for help with a limited set of conditions. In the past five years, HealthPartners has treated 160,000 cases through Virtuwell, and saw a 23 percent increase in visits between 2013 and 2014.

Minneapolis-based Fairview Health Services is making a bigger bet on its relationship with Zipnosis, which is a Minneapolis-based online diagnosis and treatment service.

Allina Health System has seen growth since 2011 in "eVisits" for patients seeking an online exchange of data about any of 17 basic conditions.

Sanford Health is putting video kiosks in a regional pharmacy chain to allow patients to conduct virtual visits for nonemergency needs. Earlier this year, the Sioux Falls, S.D.-based health system launched a program for video visits with doctors through a secure connection to patient laptops, tablets or smartphones.

"The better solution, in our mind, is: You'll have access from your home," said Dr. Dan Blue, the president of the clinic division at Sanford Health

At the Mayo Clinic, there have been forays into both retail clinics and online care for several years. Those will continue to grow, said Dr. Robert Stroebel, a primary care physician and vice chair of Rochester-based Mayo's Midwest community clinical practice committee.

But the challenge is to make sure that care in storefronts and online is integrated with traditional care, Stroebel said. Otherwise, bigger health care problems could be missed.

A trip to a traditional doctor's office can seem to drag on, he said, but that's because physicians must tend to preventive care needs plus problems that can surface during a visit — not just problems identified by patients upfront.

"If we can predict, basically, what the visit will consist of — and if we can put boundaries around what the visit is — then we can be as good as other industries are," Stroebel said, adding: "If a patient comes in with headaches or back pain … but pretty soon you find out it's really because they're having stress at work or their marriage is in trouble — then, all of a sudden, that 15-minute visit goes to a 40-minute visit."

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck