mobile health at the clinic

7/29/2019 Mobile Health at the Clinic

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idea to implementation

table of contents 3 Introduction/ Urgent Care Clinics

Employer Clinics7

11 Retail Clinics

Conclusion 15

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MOBIHEALTHNEWS 2012REPORT

INTRODUCTION

Recent years have seen the rise o retail clinics as a convenient, oten less expen-

sive alternative to a trip to the physicians oce. There are more than 1,300 retail

clinics operating in the United States currently, according to market research rm

Merchant Medicine.

A parallel trend o on-site health clinics is on the rise among larger employers.

According to data rom the Kaiser Family Foundation and the Health Research &

Educational Trust, 20 percent o employers with 1,000 employees or more already

had an on-site health clinic or employees as o late 2009. Among those surveyed,

about 79 percent said the clinics provide care or employees beyond treatments

or work-related illness.

These clinics have risen up largely in reaction to the rising cost o healthcare.

Mobile health tools promise similar benets as clinics: lower costs and more con-

venient care. As a result, employer and retail clinics are perhaps the best-posi-

tioned healthcare acilities to drive adoption o mobile health services.

URGENT CARE CLINICS

While the advent o urgent care clinics

in the United States is not recent they

have existed or decades there is still

some opportunity or these clinics to o-

er new and innovative services. Accord-

ing to the Urgent Care Association o

America (UCAOA), there were close to

9,000 urgent care clinics in the US in late

2010, with about 300 new clinics open-

ing annually in the years immediately

preceding the survey.

The UCAOA has created criteria that urgent care clinics must meet. Urgent care

clinics must accept walk-ins at all hours o operation. They must oer on-site di-

agnostic services, including phlebotomy and x-ray. Urgent care clinics must also

treat a broad spectrum o illnesses and injuries. Furthermore, these clinics must

be staed by at least one physician, unlike retail clinics, which oten are staed by

physician assistants or nurse practitioners.

We are looking

at both provider

facing technologies

and patient facing

technologies to

capture data from

biometric devices

and share that

data to support

coordination of

care.

- Steven Kukulka, Director

IT Business and Quality

Services, Take Care Health

Systems, a Walgreens Health

& Wellness Company

3

continued on next page


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Given urgent care clinics mandate

to accept walk-ins at all times that

they are open, potential patients

and the clinic sta would both ben-

et rom a scheduling system that

provides patients with expected

wait times beore they arrive at the

clinic. Mobile applications like Aet-

nas iTriage app have relationships

with emergency room departments

to display wait times. They also pro-

vide wait times or ambulances insome locations. A similar oering

rom urgent care clinics could help

patients make a decision to drive a

little arther to visit an urgent care

clinic that may be arther away

rom them but has a shorter wait

time. A location-enabled mobile

app like iTriage can guide patients

to other locations in their area.

Like ZocDoc, iTriage is also an ap-

pointment-booking app. While wait

times may not be as useul to pa-

tients with appointments at physicians oces or employer clinics, with millions

o downloads these apps can help drive new patients to these other clinics, too.

Arkansas-based Sherwood Urgent Care is one

o the ew urgent care clinic operators that has

developed its own native iPhone app. Sher-

woods clinics are walk-in and boast extended

hours and weekend hours. The app aims to

help patients locate the closest Sherwood clinic

(there are six) and it provides one-click dialing

to call the clinic and inquire about wait times,

according to the apps description. The appalso includes a puzzle game that can entertain

or hours, according to its description in Apples

AppStore.

Dallas, Texas-based CareNow also oers an iPhone app, called CareNow Web

Check-In App, which helps users nd the nearest CareNow location, register as

a patient, and check-in or an appointment directly rom the app. The CareNow

app also promises to call the user when the doctor is ready to see them. The clinic

operator uses the app to emphasize its value: Talk about convenience! the app

description concludes.

Apart rom marketing and scheduling apps, urgent care clinics do have a ew

other mobile health opportunities.

Patient education apps like, or example, Blausen Human

Atlas and Orca Healths EyeDecide, could prove useul to

healthcare providers working in urgent care clinics. These

apps are typically best viewed on the providers iPad, which

can be turned to share with the patient. These apps can

help explain an illness or a surgery to patients during the

oce visit. Instead o pointing to an anatomy poster on the

wall, providers can share dynamic apps oering animations

or videos that help illustrate the patients issues. While these

types o patient education apps have ound early adopters

among childrens hospitals looking to engage their young

patient population with iPad apps that help explain com-

plicated surgeries, the same apps could be used at urgent

care clinics, too.

URGENT CARE CLINICS CONTINUED...


MOBIHEALTHNEWS 2012REPORT4

Blausen Human Atlas HD (or iPad)


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Another mobile health service ur-

gent care clinics might consider:

mobile treatment plans. Many pa-

tients have trouble recalling every-

thing their physician said during

oce visits. A number o mobile

health companies are working to

create apps that record everything

that was said during a visit or apps

that provide treatment plans tai-

lored by providers or individual pa-

tients.

Silicon Valley-based Ji oers its Ji-

Pad iPad app to physicians look-

ing to solve this problem. The app

enables providers to record short

videos that include voice notes,

requently asked questions and an-

swers, images, and animations, all

with annotations that physicians

can record right into the videos.

The idea is that patients can review

these physician created presenta-

tions ater their oce visit as many

times as needed until they under-

JiPad

Pipette

stand their treatment plan. Providers can send the JiTalks to patients via email.

Urgent care clinics could have a number o these JiTalks prepped or the most

common injuries and illnesses that they treat at their acilities and provide pa-

tients with these videos when they leave the clinic.

Pipette, a startup that recently completed the Rock Health incubator program

or digital health companies, also oers apps that providers can equip patients

with when they are being discharged rom the hospital. Pipette works to enable

hospitals and care teams to monitor and educate patients during recovery with

an aim to reduce complications and lower the cost o care by enabling early

intervention o high-risk patients, according to the company. Urgent care clinicsare in a position to adopt similar services or their patient populations.

While the requisite reimbursement and workfow systems are not yet in place to

support it, remote virtual consultations, whether real-time or asynchronous, are

another opportunity or urgent care clinics in the uture. In 2010 one emergency

room physician at George Washington University Medical Center began evaluat-

ing how accurately physicians were able to diagnose patients wounds i given a

picture taken by the patient with their mobile phone.

Dr. Neal Sikka asked patients who arrived at the ER with cuts, skin inections, rashes,

and other wounds to take pictures o their wounds with their own mobile phone.The patients were instructed to email those images to a secure email account,

which physicians accessed on-site to make a remote diagnosis. Since the pa-

tients were in the waiting room, soon ater physicians saw them in-person to con-

rm the diagnosis. Sikka said about 90 percent o the remote diagnoses were

correct.

URGENT CARE CLINICS CONTINUED...




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User Experience research and design

dramatically improves the success rate for

healthcare productsby focusing on who will

ultimately decide its relevance:the end users.

investin yourusers experience

URGENT

CARE CLINICS

CONTINUED...


Patients told Sikka that remote consultations would save time, reduce costs, and

improve communication between patients and providers. Sikka said that the

technology would be o most benet to patients in rural areas who would rathernot travel to an urgent care clinic or emergency room to get a diagnosis o a

supercial injury.

Given the transience o patients visiting urgent care clinics, it is unlikely that pro-

viders at these clinics will be motivated to adopt the mobile health services noted

above. Under the ee-or-service paradigm, it is better or business i patients show

up in-person to receive care and ollow-up care. With the exception o working

with location-enabled acility nder apps, wait time apps, and scheduling apps

like ZocDoc and iTriage, urgent care clinics are unlikely to adopt many o the

patient-acing mobile health tools currently available or under development.

Employer clinics and retail clinics, however, have other motivations.

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According to David Chase, CEO o

patient relationship sotware ven-

dor Avado, larger employers are

aggressively pursuing onsite clin-

ics because o the annual get less

or more story they get rom their

health plans. Chase says compa-

nies like Concentra and CareHere,

which setup workplace clinics or

large employers, are seeing 100

percent growth year-over-year.

While the overall trend is certainly

motivated by cost pressures, onsite

workplace clinics are also conve-

nient.

As Chase wrote in a recent column

or The Hungton Post:

Not only is the clinic nearby, but

the need to even go to the clinic

is reduced. In the fawed ee-or-

service model, a doctor can only be paid i you visit their clinic. Not surprisingly,

many doctors will optimize or the patient to come to their oce as requently

as possible as it allows or more billing events. In contrast, [direct primary care]

and onsite primary care physicians share the act that as much as [two-thirds]

o clinic visits dont require a ace-to-ace encounter. Rather, phone or electronic

communication is sucient. For example, one doctor shared how he hasnt seen

a patient with Shingles in ve years. These patients simply take a photo with their

camera phone, email it to him and he can easily tell it is Shingles. He can then call

in a prescription, saving everyone time and money.

Employers and employees both benet rom reduced absenteeism at the work-

place and ewer trips to the clinic. Qualcomm has long touted the benet o

reduced absenteeism as one o the reasons it has an onsite work clinic.

Qualcomms onsite clinic uses Myca Healths Hello Health platorm to maintain

or increase employee productivity and activity. Qualcomms workorce is highly

educated and, thereore, very expensive: 77 percent o the companys employees

have PhDs and Masters, which means i they have to leave their desks to go home,

get their car and go to the doctors oce, it can be extraordinarily expensive or

the company. The cost o productivity drove Qualcomm to the Myca platorm.

Care can be conveniently provided to the employees, who on some occasions

can check-in with their doctor via email or even video chats.


EMPLOYER CLINICS


HealthSpot Care4 Station (exterior shown let; interior shown right)


8/15

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While Myca Health does not publicly discuss its other major employer customer, Apple,

the iPhone and iPad maker, does use Mycas health practice sotware onsite at its work-

place clinic, Apple Wellness. According to Mycas website: Myca is supporting South

Bay Sports and Preventive Medicine on-site and online services at Apples corporate

campus in Cupertino.

Apple Wellness Dr. Martin Yee conducts virtual visits including live video chat and in-

stant messaging with his patients via Mycas platorm. Yee wrote that these may not

be appropriate in some situations and are only or established patients, in his bio on

Mycas website. An in-oce visit is typically required or initial vis its with Yee. He also ex-

plains that emails should only be used or routine communications and should not be

used or urgent matters and questions that require prompt medical attention.

Still, its clear that Mycas platorm has helped cut down on some unnecessary or rou-

tine visits to the doctor or Apple employees.

While platorms like Mycas help improve online and mobile communications between

patients and providers, the next step is equipping patients with apps and health de-

vices that help them manage their own care. Few employers are doing this today, but

employer clinics are likely to be one o the rst places to drive adoption o these mobile

health services.

Large employers with businesses that are already working in mobile health are begin-

ning to adopt the technologies as part o employee wellness initiatives. Qualcomms

health division, Qualcomm Lie, recently conducted tness and wellness challenges

using BodyMedias connected tness devices and other connected devices like WiFi-

enabled weight scales. Employees at Sprint have participated in similar challenges

between work colleagues. While neither company has publicly announced leveraging

similar health-ocused devices as part o a care program overseen by their companys

onsite clinic, it seems likely such programs will begin to nd their way into these clinics

soon.

Another large employer that is actively working in the mobile health space, AT&T, was

one o the rst to make available WellDocs mobile health program, DiabetesManager,

a mobile and Web-enabled virtual coaching program that has been clinically proven

to reduce A1c levels. AT&T said that while some o its employees are using the program

today, it does not have an employer clinic on-site, so those employees are using the

program with their own o-site primary care providers. Now that programs like Diabe-

tesManager are FDA-cleared and available, it is likely that employer clinics will begin

adopting and oering them to patients soon.

EMPLOYER CLINICS CONTINUED...



PointClear recently published a white paper titled Six

Healthcare Trends and Why User Experience Matters. Two

o those trends relate directly to this MobiHealthNews

report.

Download the full paper here

Trend: Mobile Health Becomes Mainstream

We dont merely adopt mobile devices; we marry them

B.J. Fogg, Stanord Persuasive Technology Lab

Designing or mobile requires a deep understanding

o context: what goals and tasks do your users need to

accomplish on mobile? There may be specic eatures that

are more important on a mobile device and those should

be available and prominent. Users will have some o the

same goals as when using your product in other platorms.

But oten there are unmet needs that can be addressed

and new business opportunities to exploit by leveraging

the unique capabilities o mobile devices, such as the

integrated phone, camera, accelerometer or GPS.

Users have an expectation or mobile apps; they should be

purposeul, useul in context and easy to use otherwise

users will abandon them. You add little value by simply

having a mobile version o your product. The value is

added in the execution. Through usercentered design andresearch, these needs can be uncovered and applications

can be designed or maximum engagement.

You will also need to consider orm actor when deciding on

which platorms to develop. The portability and ubiquity

o a smartphone makes it useul in many situations,

however, datarich or imageheavy apps could benet

rom the greater screen real estate on an iPad or other

tablet, provided a tablet device makes sense in the context

o use. When designing a tablet solution it is best to have

a dierent user interace rom both your smartphone and

desktop web applications. You should design a tablet

interace that is uniquely suited or the combination o the

tablet screen size and touch interace.

Using a design technique called Experience Journey Maps,

you can visualize the entire experience your users have

with your products and services. This technique can be

useul to identiy gaps where youre not serving users well,

and also highlight opportunities or new solutions, such as

in mobile.
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sponsored contentCONTINUED

Trend: The Rise of Retail Health Clinics

The demand or primary care services in the US outmatches

the availability o primary care physicians. At the same

time, there is an exponential increase in healthcare costs

and high percentage o underinsured patients. This

climate has created a demand rom patients or lower cost

care and more convenient access. Retail health clinics are

one solution. Walgreens, CVS and WalMart are the top

three providers, oering clinics in many o their stores.

Retail clinics typically oer basic preventative care services

such as fu shots and treat low severity illnesses such as

colds. These services are short in duration and the patientvolume fuctuates and is unpredictable because patients

can walkin. Technology tools are required that help the

sta manage this type o schedule.

A positive patient experience in the retail clinic is

dependent on accurately setting expectations o wait

times, creating easy to use selservice tools, and creating

an instore experience that supports the retail clinic.

And mobile solutions that allow patients to easily nd a

nearby clinic location and schedule an appointment are

necessary to support the immediacy o these types o

health conditions.

Viewed in isolation, market trends such as the rise o retail

and worksite clinics, the expansion o homebased care,

and the prolieration o inormation and communication

technologies can seem unrelated. However, when viewed

holistically, these trends demonstrate that the landscape

o primary care appears to be undergoing a signicant

transormation. *

* PRIMARY CARE, EVERYWHERE: CONNECTING THE DOTS

ACROSS THE EMERGING HEALTH LANDSCAPE. JANE SARASOHN-

KAHN FOR THE CALI FORNIA HEALTHCARE FOUNDATION (2011).

brought to you by:

Connected health devices, particularly blood pressure cus like the one oered

by iHealth, have begun to nd early adopters among some primary care provid-

ers across the US. These cus are controlled by an iPhone or iPad app that also au-

tomatically logs the reading with a time stamp or trend analysis and later review.

Some primary care providers have recommended devices like this to patients

with high blood pressure to get a more accurate and consistent reading o their

BP. Daily readings can paint a more accurate picture than inrequent readings at

the doctors oce where patients may actually suer rom white coat syndrome,

which is when a patients blood pressure spikes in the presence o doctors.

O course, it only begins with blood pressure monitoring. Consumer-acing, con-

nected health tools are already on the market (or soon-to-be) or a wide range

o chronic conditions. These devices and related services can help employers cut

down on health costs by helping employer clinic providers spot health issues in

their early stages. Keeping an eye on the trend data fowing rom these mobile

health services will support preventive care.

Heres a short list o example devices and services that employer clinics should

consider adopting:

Cellular-enabled or smartphone-based blood glucose meters are one o the

newest, but long-awaited, health tools to gain FDA-clearance recently. Sanos iB-

GStar, which was developed by AgaMatrix, received FDA clearance at the end o

2011, which made it the rst iPhone medical peripheral to receive the greenlight

rom the agency. Sanos meter is a tiny device that plugs into the bottom o the

iPhone. The device uses AgaMatrix test strips and automatically logs the blood

glucose readings in a companion iPhone app. These data can be emailed to a

care provider with the push o a button.

Another diabetes meter company, Telcare, recently received FDA clearance or

its cellular-enabled blood glucose meter, the Telcare BGM. This device has em-bedded wireless connectivity so no companion mobile phone is necessary to

send data to the cloud where providers can keep track o readings in real-time.

However, Telcare has developed smartphone apps to help patients and providers

alike keep tabs on readings, diet, and trends.



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Connected weight scales like

iHealths Bluetooth-enabled scaleor Withings WiFi-enabled WiScale

help users track their weight, body

at percentage and body mass

index. The weigh-ins are automati-

cally sent to a web portal that

eeds into iPhone and iPad apps.

Connected weight scales are also

useul or heart patients who oten

show a dramatic spike in weight

just beore a heart episode. With-

out consistent weigh-ins and the

resulting trend line, however, it is di-

cult to discern this telling spike in

weight.

Asthmapolis is bringing to market a

tracking device or asthma patients

that use inhalers. The little device

sits atop the inhaler

cartridge and takes

a time stamp every

instance the inhaler

is used. I the user

has a smartphone,

the device can

communicate with

an app on the users

phone via Bluetooth

and leverage the

phones GPS capa-

bility to take a loca-

tion stamp, too. Theresulting map o inhaler usage can

point to problem areas or asthmat-

ics that can help users change be-

havior. I it seems to correlate with

inhaler usage, stop driving past the

renery on the way to work, or ex-

ample. The device can help providers at clinics

determine how severe a patients asthma hasbeen lately since increased inhaler usage is an

important indication o a worsening condition.

AliveCors iPhone ECG case enables patients

to capture a clinical grade electrocardio-

gram right rom their smartphone. Patients

with chronic heart problems can send provid-

ers an EKG as oten as a provider likes to do

quick scans or arrhythmias and other heart

issues beore they turn into more serious car-

diac events. As o this reports publication, the

iPhone ECG device was not yet FDA-cleared,

however, the clearance is expected soon.

Devices or remotely tracking and managing diabetes, obesity, high blood pres-

sure, asthma, and heart conditions are just the beginning. There are already more

than a dozen connected tness devices available on the market that can help

employer clinics motivate employees to get in shape. New, wrist-worn sensors

can detect the wearers emotional

state, which could help people with

anxiety or stress to track their condi-

tion and pinpoint potential triggers

by keeping a log in an companion

smartphone app. Increasingly, com-

panies like Philips and Azumio are nd-

ing ways to passively measure heart

rate and breath rate rom smartphone

and tablet cameras. Philips iPad 2 app

can airly accurately measure a users

heart and breath rate just by analyz-

ing the fow o blood in the users ace.

Most o these devices will cost aabout $100. Many o the apps are ree. These

rugal innovations, as the West Wireless Health Institutes Vice Chairman Dr. Eric

Topol calls them, can help employer clinics keep employees well, out o the physi-

cians oce, and productive at work. For employers looking to take control o their

health costs, connected health services like those listed out above should soon

nd champions at their clinics.




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One medical device maker that works closely with retail pharmacies and retail

clinics said that retail clinic customers with diabetes who enter the retail location

spend ten times as much as other customers on prescriptions, devices, and other

retail goods every time they enter the store. Oering chronic condition manage-

ment services will likely bring more customers in the door, which means bigger

basket sizes and bigger sales overall.

While overall growth in terms o the number o retail clinics has not lived up to even

the more modest growth projections rom 2009, there are many indicators that

many more clinics could open soon.

In October 2011 Walmart made headlines ater it sent out a request or inorma-

tion (RFI) to vendors that stated the company was seeking help to dramatically... lower the cost o healthcare by becoming the largest provider o primary

healthcare services in the nation. While the news shook up the healthcare in-

dustry, the company quickly backtracked and stated that the RFI was overstating

its intentions. What is now clear, however, is that Walmart is very interested in the

potential o its budding retail clinic business.

The market leaders or retail clinics today, however, are CVS MinuteClinics and

Walgreens Take Care clinics, which are the two largest nationwide clinic chains

in the country. By many accounts, Take Care is the more innovative o the two, but

MinuteClinic has more locations.

CVS Caremark spokesperson Brent Burkhardt conrmed that while MinuteClinic

inormation can be accessed by CVS pharmacy stores mobile app, [MinuteClin-

ic is] not currently using other mobile technology or apps with its patients.

CVS oers an iPhone, Android, and BlackBerry app or smartphone users that

gives them access to a number o dierent eatures related to shopping at CVS,

prescription lling at CVS pharmacies, and services available at CVS MinuteClin-

ics.

RETAIL CLINICS

In 2009 Deloitte noted that retail

clinics had entered into a period

o contraction because o the na-

tionwide economic downturn. De-

loitte predicted that this period was

just a breather prior to retail clin-

ics nding a more rened business

model to drive renewed, but slower,

growth. That prediction proved true:

In mid-2009 there were about 1,100

retail clinics in operation. As noted

above, there are only about 1,300

in operation today, according toMerchant Medicines count.

In 2009, Deloitte expected total re-

tail clinics in the US to number close

to 1,800 by the end o 2012. The

consulting group predicted that

a second wave o rapid growth

would begin in 2012 and last

through 2014 as retail clinics move

into new markets and begin to oer

new services.

In its report, Deloitte wrote that re-

tail clinics operating in retail phar-

macies and grocery stores oer

opportunities or sell-through o

services in addition to prescription

ulllment and over-the-counter

health care products.

These clinics could help increase

the basket size o shoppers at

their retail locations by encourag-

ing consumers to purchase health

devices and services (like those

listed above) that are sold in-house.




12/15

Like CVS, Walgreens mobile app bridges its clinic, pharmacy, and retail businesses, but the clinic-related unctions

are very limited. Walgreens has apps available or iOS, BlackBerry, and Android devices users. The Walgreens apps

enable users to look up the locations o Walgreens Take Care clinics, but the mobile apps do not oer any ap-

pointment scheduling eatures yet. The apps also provide users with a virtual tour o the services the clinics oer.

Walgreens does already oer online appointment booking or its clinics, so it is likely this will move to mobile apps

soon, too.

We are building a series o mobile apps right now or our providers and their associates working at our clinics,

Steven Kukulka Director IT Business and Quality Services, Take Care Health Systems, a Walgreens Health & Wellness

Company said. Our patient portal sends out text message alerts to patients or upcoming appointments and

alerts or when a secure message is waiting or them on their patient portal. We are also looking at both provider

acing technologies and patient acing technologies to capture data rom biometric devices and share that data

to support coordination o care and patient engagement. We are investigating those currently both or biometrics

captured in [retail and employer] clinics and at home.

On the retail pharmacy side Walgreens has led the pack. The company rst launched apps back in 2010 that let its

pharmacy customers rell prescriptions by scanning their medications barcode with their camera phones. The app

quickly became the most popular way that customers relled prescriptions via their mobile phones. More recently

Walgreens added a medication reminder eature to its mobile app as well as the ability to transer a prescription

rom a dierent pharmacy to the users local Walgreens.

One device

maker that works

closely with retail

pharmacies said

that customers

with diabetes who

enter the retail

location spend

ten times as much

on prescriptions,

devices, and other

retail goods.

The smartphone apps help users nd the closest CVS locations, rell and transer

prescriptions (including rell by scanning medication barcodes with a smartphone

camera), access prescription history, scan QR codes or coupons, create weekly

shopping lists, schedule a fu shot, check MinuteClinic locations and services as

well as insurance plans accepted at those locations.

While the app still has limited unctionality related to CVS retail clinic, the company

has created a smartphone app that bridges its retail clinic, pharmacy, and store.

Its a promising rst step.

The CVS Pharmacy app does enable users to schedule a MinuteClinic fu shot ap-

pointment, but users cannot schedule any other kind o appointment through the

app. While retail clinics are widely marketed as walk-in clinics, the convenience o

having an appointment and cutting down on wait times is still an opportunity worth

realizing.

RETAIL CLINICS CONTINUED...




13/15

Last year Walgreens made it possible or customers to rell their prescriptions via

text messaging. The retail pharmacy also has a text messaging service that alertscustomers when a prescription is ready or pickup. While analyst rm Asymco

expects that more than 50 percent o people in the United States with mobile

phones will be smartphone users by the end o June 2012, today a majority o

people dont use apps. Oering complementary text message-enabled services

to its customers make Walgreens mobile health services more accessible to the

wider population.

Retail clinics are also likely to be a key

driver o the connected wellness market.

These clinics already provide wellness

and physical exams that include coach-

ing or how patients can keep themselves

well. Since these clinics are attached to

a retail store, the providers are in the best

position to direct patients to an aisle in

the store that sells connected health and

tness devices. As noted above there are

a growing number o consumer health

devices that track activity, sleep, weight,

mood, blood pressure, and much more.

Some stores that have retail clinics on-

site are already stocking some o these

tness and wellness devices. Many more

will in the coming years.



innovation for

healthcare software& services companies

strategy, user experience, technology


Weve driven strong adoption and

customer engagement throughour mobile applications, and these

mobile pharmacy eatures are also

great tools or helping people man-

age their health, said Sona Chaw-

la, Walgreens President o eCom-

merce. This is another way were

extending the access to Walgreens

pharmacy to patients on the go

and helping them stay well.

Medication non-adherence is

one o the biggest hurdles in treat-

ing illness today, responsible or

more than $100 billion each year

in avoidable hospitalizations, said

Walgreens CMO Cheryl Pegus.

Personalized services that can

help patients remain compliant

with their prescription regimens

can be eective in lowering health

care costs and improving patient

care.



Walgreens iPhone app
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14/15

While the patient-provider relation-

ship is generally weaker at retail

clinics, these health tracking devic-

es and apps can help strengthen

it. I a patient who uses an iHealth

blood pressure monitor shows up

at a retail clinic with a ew months

worth o daily blood pressure read-

ings on his iHealth blood pressure

app, that data could prove help-

ul to a nurse practitioner looking

to put the patients current blood

pressure reading in context.

Like many retail clinics CVS Minute-

Clinics already advertise wellness

services that aim to help consum-

ers identiy liestyle changes need-

ed to improve their current and

uture health, including screenings

and monitoring or diabetes, highblood pressure and high cholester-

ol. Mobile health biometric devices

and companion apps can support

and extend such programs to be-

come continuous, daily monitoring

programs.

Dublin, Ohio-based HealthSpot

recently embedded cellular con-

nectivity to its primary and special-

ty care kiosks, called HealthSpot

Care4 Stations, that are designed

or pharmacies, supermarkets, and

workplaces. Patients using the kiosk

can visit with doctors in real-time

via high-denition videoconerenc-



ing running over Sprints 4G network. The kiosks come equipped with digital medi-

cal devices that allow doctors to collect health inormation during the remote visits,

including 3M Littmanns Electronic Stethoscope Model 3200, which enable clini-

cians to listen in real-time to critical body sounds during remote examinations o

patients using the medical kiosks.

While there are signs that retail clinics are beginning to augment the services they

provide, it is clear that many see an opportunity to play a role in accountable care

organizations (ACOs) or similar outcomes-based reimbursement models that are

beginning to go into eect as healthcare reorm slowly rolls out across the US.

Recently MinuteClinics in Tennessee inked a deal with HCA-owned hospital group

TriStar Health to create a collaborative care system in Middle Tennessee. Under the

agreement, TriStar Health physicians will serve as medical directors or MinuteClinic

locations in that part o the state. MinuteClinic and TriStar Health will collaborate

on patient education and disease management initiatives and will inorm patients

o the services each oers. From now on the health system will accept patients

that have issues that the MinuteClinic is unable to treat, and the two organizations

are now working to ully integrate their respective EMR systems to more eciently

coordinate each individual patients care.

Under this agreement it is likely that MinuteClinic will help TriStar prevent hospital

readmissions and manage patients with chronic conditions on an ongoing basis.

Partnerships like this one will change the game or retail clinics. As they shit their

services to become a partner in healthcare costs management, mobile health

tools will likely become even more attractive.

A Take Care clinic


15/15


As new entrants like Walmart step

up to build out retail clinics that

provide primary care services, large

employers continue to roll out on-

site clinics, and existing retail clinic

chains ink deals with local hospital

groups to orm collaborative care

systems, mobile health services will

have an increasing presence at

the clinic.

While a handul o disparate prima-

ry care providers will adopt these

connected health services, none

can match the scalability that

Walgreens Take Care clinics, CVS

MinuteClinics, or the many planned

Walmart clinics can oer mobile

health services. I any o these large

national retail clinic chains decides

to launch mobile health services at

its clinics, they will immediately be

one big step ahead o the majorityo primary care providers.

While the number o retail clinics has not grown as quickly as most industry ana-

lysts predicted, the coming year could still prove to be a pivotal one or clinics. The

opportunity or new services and revenue streams is ripe. New consumer health

devices and apps enter the market each month.

Clearly, mobile health is the clinics next step to becoming even more cost eective

and convenient or its patients.

CONCLUSION

A RediClinic at a Walmart store

mobile health at the clinic

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