Coverage from Patient-Centered Diabetes Care, April 7-8, 2016. Presented by The American Journal of Managed Care and Joslin Diabetes Center.
Retail health clinics are improving access for some populations that have struggled to get care in the past, explained Eileen Myers, MPH, RDN, and Cathleen McKnight, DNP, on the first day of Patient-Centered Diabetes Care, presented April 7-8, 2016, by The American Journal of Managed Care and Joslin Diabetes Center.
During their presentation, Myers and McKnight examined the various steps and implementation of chronic care programs within retail clinics, retail factors that improve patient outcomes as opposed to traditional care, and how retail clinics work with health systems.
Myers began by sharing the history of The Little Clinic, one of many retail clinics whose mission is to provide family care that is convenient, accessible, and affordable. As a community-based site of care, retail clinics offer a unique variety of benefits. “We are in the retail establishments that people trust,” Myers said. “We are available at the times that don’t disrupt work. We utilize an electronic medical record that supports longitudinal tracking. We have health system relationships, and we have the unique opportunity to share data with pharmacy to enhance adherence.”
She then elaborated on a new project of The Little Clinic, which includes dietitians on the care team. Dietitians offer medical nutrition therapy, group counseling, nutrition store tours, and cooking demonstrations, among other services. When a patient has diabetes, The Little Clinic asks the person to complete a form, and the team discusses the patient’s needs and helps the patient find appropriate foods according to his or her culture, economic setting, and preferences.
Myers added that the clinics perform routine screenings, such as employer-based biometric screenings, to identify individuals at risk for diabetes. Retail clinics are able to use acute care services and physicals in order to find undiagnosed diabetes and then refer those individuals for further evaluation.
“We absolutely cannot do it alone…,” she said. “That is absolutely not our case, nor do I think any of our other fellow retail clinics [can do it]. We work with health systems to help manage patients.”
McKnight followed, detailing the responsibilities and characteristics of retail clinics as a whole. She described the aims of retail health as keeping people healthy, increasing engagement and wellness decisions in those that are less connected, and creating meaningful impacts in sustainable lifestyle changes for struggling individuals. Furthermore, retail health seeks not only to treat the symptoms and the diseases, but also the underlying problems of societal health. Retail clinics differ from traditional healthcare in that they provoke a preemptive healthcare model rather than a reactionary one.
“The reach of the retail clinic captures a large, potentially untapped and invisible population. Instead of the patient seeking healthcare, retail clinics are positioned to pursue community,” McKnight said.
Retail health is appealing to many people who struggle with diabetes; many within the clinic’s patient population do not have primary care providers (PCPs) and some who claim that they do may not be in touch with them. When these patients show up due to an acute episodic visit, it is an opportunity to reincorporate the patient back into the healthcare system. For patients with compliance issues relating to cost, convenience, or accessibility, retail clinics may be the solution, McKnight said.
She added that retail health clinics act as an outlet for the rising demand of the chronic care population, can act as economic relief, and can coordinate the appropriate level of care to the appropriate level of expertise. These clinics do have the ability to provide chronic care as they identify needs, assess patient knowledge of those needs, and then offer counseling around acute care complications. They also provide primary and secondary care including immunizations, vaccines, and programs for smoking cessation or weight loss.
McKnight pointed out that clinics unburden a clogged system and increase compliance with medication; a referral system allows PCPs and specialists to collaborate on follow-up visits, lab monitoring, and medication management. Referral partnerships also permit easy movement of patients from one site to another in order to ensure the continuity of care.