Many people know the problem: Once again, working from morning until night, with an increasingly scratchy throat, no visit to the doctor however due to lack of time. Then a fever arrives too, on Friday afternoon – of course. For people affected, the only option left has been a trip to the emergency clinic. For a long time now medical office hours have no longer matched our life patterns – a market niche, in other industrialised nations as well.
Yes, we are open!
In the U.S.for that reason for years there have been retail clinics in supermarkets and pharmacies. Specially trained nurses or doctors’ assistants treat mild, acute disease, from the ENT area to skin and eyes as well as gastrointestinal and urogenital tract problems. Politicians have a very ambivalent relationship with the relevant service providers: they are happy to see the medical benefits – available inexpensively, seven days a week. In fact, studies show that such a consultation for an earache in retail clinics costs 59 U.S. dollars for a booking, while a visit to the doctor’s surgery will cost $US 95. For on-call service it’s 135 US dollars, and in clinical emergency facilities as much as 184 US dollars.
Cheap – but also good?
Many wonder, however, whether the quality of walk-in clinics corresponds to standards of doctors’ offices – a criticism that is not necessarily based on fact: Andrew J. Sussman, President and Chief Operating Officer of the Minute Clinic, cites an earlier study from the Annals of Internal Medicine. According to the research, treatments in retail clinics were able to be compared to doctors’ offices for quality criteria, but were significantly better than those in emergency departments. “Numerous international publications have proven their high quality”, says Ron Liebkind, Chief Marketing Officer of Finnish clinic chain Laastari. A recent study by Christine K. Cassel, of the American Board of Internal Medicine, points to several benefits of retail clinics, in terms of access, cost, quality, coordination, care, patient follow-up and communication. Liebkind: “I think that facts are more important than speculation”. Who gets treated in retail clinics though?
Female and affluent
As part of the RAND Study scientists put respective target groups under the microscope. The result: women visit retail clinics more frequently than men. They often belong to middle and high income groups, tend to have no chronic diseases and are mostly found in the age class 18 to 44: aspiring professionals, for whom the opening times, seven days per week, often from morning until late at night, are appealing. The successful model from ‘the states’ has now spread to Europe.
Well provided in the far north
Laastari (meaning in English “patch”), a health service provider in Finland, has specialised in the treatment of common acute illnesses. A clear win-win situation: retail clinics promise “quick and easy access to health services for busy, modern people”, says Liebkind. “The health system then becomes more effective and can focus on future challenges such as the growing number of chronic diseases”. Small cases make fewer demands on the resources of physicians or hospitals. Customers also receive quick and personal assistance with simple illnesses.
Appointment frustration – no thanks
A gap in the market, which established practices currently only partially cover: In the United States patients complain that they would get no appointments at short notice and then, despite previously made appointment, would have to take into account long waiting times. Not at retail clinics: these are usually found in easily accessible locations such as shopping centres or pharmacies, parking included. Patients do not need a date, but can be treated from Monday to Sunday, the clinics are usually available ten to twelve hours per day. In addition, prices are transparent: any consultation takes a flat rate of 45 € per booking, vaccinations cost 25 €. The close proximity to pharmacies guarantee that prescriptions can be redeemed immediately – particularly important for acute pains.
Using iPad and SMS in therapy
Retail clinics like Laastari rely on sophisticated workflows and advanced technology: on-site nurses take the patients and clarify in an approximate 15-minute interview symptoms or pre-existing conditions. All digital data travels via iPad for review to a physician. If drugs should be prescribed, the physician sends an electronic prescription online to the nearest pharmacy. The patient receives an SMS message with additional information. “We place high value on the communication between all members of the healthcare team,” says Liebkind. “This means using top technology and developing recording systems for our patients, so that all information can be retrieved accurately and quickly”. Employees of the retail clinics are enthusiastic: “Our system is just great. I had never used an iPad before”, says Anne Kantola, a nurse at Laastari. “But right from the start, everything was very intuitive in its use”.
Challenge for programmers
For creating the iPad application, a lot of brainpower was needed: it was to be user friendly, able to be employed quickly and easily, with privacy and other matters such as reliability being further factors. Developers interviewed doctors and nurses at Laastari, in order to better understand their needs in everyday practice. The result was an app that displays essential processes such as check-in, diagnosis and medication, including any warnings. In addition to trained personnel, technology is therefore an essential backbone for Laastari. Equipped in this way, the chain has now also expanded to Sweden.
The network grows
Perspectives for Germany? “We can work with any clinic”, says Ron Liebkind. Nevertheless, individual needs of each country have to be taken into account – a question of mindset. In some countries, retail clinics are more widely accepted, while others prefer family doctors. Liebkind has plans: “We are building an international hospital chain, which can be implemented everywhere” – provided that there exists an acceptance.