The Rise of Retail Clinics

Photo: Minute Clinic, Rockford Register Star 2011

Photo: Minute Clinic, Rockford Register Star 2011

The severe flu season currently underway has been all over the news and, as a result, the topic has been peppered throughout our office chatter for the past couple of weeks.  After an especially sniffle, sneeze, and cough-filled “T” (subway) ride to work one morning last week, I hopped onto CVS’s website and, after about 45 seconds, had an appointment to get my flu shot the following night.  Later in the week, I heard from a few colleagues who, after hearing how easily I signed up, had also gotten their vaccines at a CVS MinuteClinic.  This sparked thought on retail clinics and the role they’ll play in the future of healthcare.

Retail clinics, like those in popular drugstore chains and superstores like Target and Walmart, have rapidly grown in popularity in recent years.  According to HealthDay News, the first retail clinic opened in the U.S. in 2000, and there are now more than 1,350 such clinics operating around the country.  An American Medical Association news report says CVS opened 68 clinics from December 1, 2011 to December 1, 2012. With 620 locations, MinuteClinic accounts for approximately 44 percent of American retail clinics.  Clinicians at MinuteClinics have seen an astounding 14 million patients since 2000.

While retail health centers are not the answer to all health issues—obviously people with more serious symptoms like chest pain, shortness of breath, etc. should call their doctor or head straight to the emergency room— consumers should consider them as an option more often.  Until now, most retail clinics have addressed routine needs like flu shots, prescriptions, and blood pressure checks, but many clinics can also meet a variety of other health needs such as sports physicals, strep throat cultures, and diabetes testing.  Clinics are typically staffed by qualified nurse practitioners, and, in Massachusetts, they are regulated by the Department of Public Health to ensure the safety of all patients.

As a result of healthcare reform, more people now have access to insurance and will be seeking medical attention.  Outsourcing minor procedures and tests to retail clinics could ensure that a greater number of people will receive the care they need and at a lower cost.  Affordable clinics in convenient locations with convenient hours, short wait times (and sometimes no need for an appointment at all) staffed with qualified personnel, seems like a win-win situation to me.

Lucy Muscarella is a Consultant at Greenough. Follow her on Twitter:@lucymuscarella

Note to CES: More Innovation in Digital Healthcare, Energy Efficiency and Sustainability Please

Photo: Lotus flower, Flickr Creative Commons 2013

Photo: Lotus flower, Flickr Creative Commons 2013

In Greek mythology, the “lotus-eaters” were a race of people inhabiting an island near North Africa who subsisted on lotus flowers, a known narcotic that caused them to sleep in peaceful apathy. In the movie Percy Jackson & The Olympians: The Lightning Thief, the main characters barely escape a life of perpetual apathy in – wait for it – modern-day Las Vegas. As CES gets into full swing in the “Sin City,” it finally hit me that, like Percy, it may be time for another heroic escape.

Let me begin by confessing that I love technology. My mobile device is never more than a year or so old, I strategically position myself for the newest laptop at work and my home is as digitally tricked-out as my wallet allows.

Recently, however, I’m finding it harder to summon the same enthusiasm for consumer tech. Somehow the joy of moving from 720 to 1080p seems trivial in the face of a global water crisis, rising healthcare costs and government gridlock. This year, much of the reporting that I’ve read/seen coming from CES is mere sycophantic drivel. It’s as if I’m watching Percy eat lotus flowers, slipping into a mindless trance as he’s seduced by the surreal theater surrounding him.

But all is not lost. While entertainment-related gadgets such as the new Asus Qube still dominate CES (because we so need to enhance our TV-watching experience with the help of Google TV), consumer electronics innovation isn’t for entertainment alone. And that’s enough to excite me.

With comparatively less fanfare, companies such as iHealth, HealthSpot and Ideal Life (which announced a partnership with ADT during CES) are bringing innovation to Las Vegas that promises to solve real problems, not just entertain. The iHealth Wireless Smart Gluco-Monitoring System includes a detachable dongle that snaps onto an iPhone, iPod touch or iPad to simplify blood sugar monitoring. Convenient, yes, but there’s no reason it won’t also lead to better doctor-patient communication, better disease management and, ultimately, lower healthcare costs.

The HealthSpot Station is a cutting-edge “tele-health” system that provides high-quality medical diagnostic technology to patients anytime, anywhere. The private, walk-in kiosk increases access to diagnosis and treatment by board-certified doctors via high-definition videoconferencing and interactive digital medical devices. This is high-definition, interactive TV that doesn’t entertain; it improves health.

What’s missing? Beyond the exciting and transformative healthcare solutions, I’d like to see something related to water and/or sustainability, starting with technologies to help rapidly build out “smart water grids.” Next year, it would be nice to see companies such as Itron, Cisco and their potential partners – including companies such as Zonoff (which is at CES this year) – showing off technologies to a CES audience that push water conservation and “individual sustainability” deeper into the consumer consciousness.

I’m guessing that I’m not alone in hoping for innovations in consumer technology that aspire to more than just better entertainment. Since we rely on CES to set the tone for upcoming year, I’m hoping the glimmer we see in healthcare technology is just the beginning of even greater changes in 2014. After all, if we continue to wantonly worship “lotus flower tech,” innovation that simply encourages our society’s precipitous lull into peaceful apathy, we’re missing a heroic opportunity. Percy eventually woke up and escaped the lotus eaters, so should we.

Scott Bauman is executive vice president at Greenough. Follow him on Twitter @sbauman

Electronic Medical Records are Worth the Growing Pains

Photo: Discovery News 2012

Photo: Discovery News 2012

The implementation of electronic medical records (EMRs) has become a hot-button topic in the medical arena. This New York Times article published in October nicely lays out both sides of the ongoing debate.

The fact that EMRs have the ever-elusive bi-partisan support, and wide industry support as well, makes them seem fail-safe; but the complicated initiative brings up a number of hurdles ranging from privacy concerns to the new maze of questions and options doctors must navigate for each patient.  Some of the biggest concerns (challenges which all digital databases face) are vulnerability to crashes and hacking.  Hospitals will have to create contingency plans for how to access records if the system fails, and systems must come equipped with major privacy and anti-hacking mechanisms. The biggest complaint from the doctors’ side is that the interfaces are not completely user-friendly and were seemingly created with little input from doctors themselves.  The databases can be awkward, often not quite fitting exactly what the doctors need.  And clicking through all of the questions and menus is often time consuming resulting in the physician spending more time interacting with the computer instead of the patient.  As one doctor put it in a Wall Street Journal article, “it seems as if this is all about taking care of the chart, as opposed to taking care of the patient. Documentation is important, but the pointing and clicking and cutting and pasting we are so focused on in demonstrating meaningful use of EMR may be getting in the way of meaningful encounters with our patients.”

There are definitely growing pains that come with implementing an EMR system, but in my view the benefits far outweigh any initial difficulties.  New equipment and protocols always take getting used to, but the value of having an individual’s entire medical history on record is immeasurable.  These digital records offer tremendous convenience when it comes to refilling a prescription, scheduling an appointment, or even emailing your doctor a quick question, rather than having to make a phone call or wait for an appointment.

A recent Huffington Post article details a prime example of how one individual used his EMR online system to get a hold of prescription information he needed while traveling abroad.  I actually have personal access to the PAMF My Health Online site he refers to in the article and can confirm how helpful it is.  Not only is it a luxury to have easy access to all of your medical information, but in the end, I believe it results in better care for patients.  If someone is taken to the ER, even a doctor who has never worked with that patient before can pull up his or her entire medical history, allowing for easier diagnosis and better treatment.  Having that wealth of information on hand for all doctors’ visits ensures that nothing is missed, and ultimately improves the quality of care.

Our home state of Massachusetts, often looked to as a pioneer in the healthcare arena, has been taking steps forward to make easy access to medical records a reality.  It recently launched its Health Information Exchange, inaugurated by Governor Deval Patrick ceremoniously sending his records from a hospital in Boston to one in Springfield.  The program began with the participation of nine healthcare providers, including Partners Healthcare, Beth Israel Deaconess Medical Center and Network Health, and now has “over 40 organizations that are in our pipeline to bring on board,” reported Laurance Stuntz, director of the Mass HIE, in a recent Healthcare IT News interview.

From my millennial perspective, it seems ludicrous not to have such important data electronically recorded somewhere.  I understand there are imperfections in the new system, but if the only source of information I have on my vaccine history is that little piece of yellow cardstock that has been following me since my early childhood – that seems incredibly inadequate.  I envision the transition to digital health records will be much like the switch to online banking.  Initially people feared having personal financial information on the web, but now couldn’t imagine not to being able to pay their bills online or check their account balance on their phone.

There is always a “breaking-in” period when a major overhaul happens, especially when it involves a system that has been in place for decades. Kinks always take a little time to work their way out of new software, but medical records, and the quality care that will come from easy-access to them, are too valuable to keep stored in file cabinets.

Lucy Muscarella is a Consultant at Greenough. Follow her on Twitter: @lucymuscarella

Visual Storytelling Crucial to Marketing Success

For years, video was an entertainment-only medium – a plop down on the couch, feet up, relax after a hard day activity.  Workers caught watching videos at their desks were seen as slackers.  But nowadays, video is no longer a novelty.  It’s a marketing necessity because of how powerfully it can tell brand stories.
72 hours of video is uploaded to YouTube every minute. The site boasts 4 billion views per day and the demand keeps growing.  In fact, Cisco predicts that by 2013, 90% of all Internet traffic will be video.

So what makes it such a powerful and versatile tool?

Video – more than any other tool at a brand’s disposal – can establish a personality for your company.   It can put a face to your brand, bring your products to life and connect the company with customers in ways that print and web collateral simply cannot.  But that is not to say that traditional media should be ignored.

Check out MC10’s two-pronged approach.  A winner of the Wall Street Journal Technology Innovation Award, Massachusetts-based MC10 is on the brink of revolutionizing the medical industry with its conformable electronics.  This recent article in Time details the medical benefits the company offers while the video below brings to life how the technology integrates with the body.

MC10 Demo:  Making Stretchable Electronics

MC10 Demo: Making Stretchable Electronics

By combining company-created visual storytelling with more conventional storytelling, companies like MC10 are building a greater connection with their audiences and more rapidly moving from awareness to affinity and, ultimately, customer action.  So what role does video play in your communication and marketing strategy?  How can video increase your brand affinity or loyalty?  If your brand has yet to embrace visual storytelling and video, then it’s missing out on a huge opportunity.

Christine Williamson is a senior consultant at Greenough. Follow her on Twitter @ChristineDBW

Choosing Wisely: Trimming Fat in the Health Care Industry

In corporations, it’s common to implement and continuously refresh best practices to eliminate inefficient, low-value activities. A similar principle is now being applied to the U.S. healthcare industry due to excessive medical spending in the United States. David Cutler, an expert in Economics at Harvard University, suggests that one third—up to $750 billion— of our country’s medical spending does not contribute to improved health.
Through a campaign called Choosing Wisely, nine specialty medical groups have identified tests or procedures “commonly used in their field, whose necessity should be questioned and discussed.” The end goal: Reduce costs and improve care. Launched last year by a foundation of the American Board of Internal Medicine, the campaign galvanized around a controversial opinion piece by Dr. Howard Brody, director of the Institute for the Medical Humanities.

Since then, nine medical specialty societies have committed to this campaign and eight more are expected to join this fall. While the Choosing Wisely campaign is not the panacea for spiraling healthcare costs, it is surely a positive step forward in raising awareness about excess spending. Ultimately, by reducing healthcare costs we can ensure that all patients have access to safer, higher-quality care.

The original medical specialty organizations of the campaign, who are leaders in cardiology, oncology, radiology and primary care, last month released their recommendations for areas where healthcare costs can be trimmed. Suggestions include skipping treatments such as cardiac stress tests for annual checkups in asymptomatic patients and brain imaging scans after fainting. Arguably the most controversial recommendation is that oncologists limit or decline chemotherapy treatments for late-stage cancer patients; most oncologists agree that these patients would be better off receiving hospice care.

With reducing health care costs as its core mission, Choosing Wisely has certainly sparked a healthy but contentious debate. One argument against their recommendations is that cutting “waste” could actually be healthcare rationing in disguise. The campaign’s architects make it clear, however, that their fundamental goal isn’t rationing care or denying services to those who need them. Instead, they emphasize that Choosing Wisely is about eliminating care that has no value.

Measures to contain and reduce healthcare costs in this country are vital—especially in this uncertain economy. I support this campaign, not only for its potential to trim costs but also for its ability to fill a gaping void in today’s healthcare system: The troublesome lack of communication between patients and physicians. In addition to making doctors more accountable in their practices, Choosing Wisely’s recommendations also place equal responsibility on patients to ask important questions that may ultimately lead to better care.

The campaign is working with Consumer Reports magazine to broadly disseminate the list of “unnecessary” treatments and procedures; however, for the time being, there is no regulation that forces patients and healthcare professionals to treat these recommendations as rules. I believe it’s up consumers to question procedures that may be unnecessary. It’s really about making well-informed decisions and thinking before we act. After all, every test, necessary or not, has a cost to the system.

I urge you to get involved. Read the lists from the nine partners and use these resources to learn how you can be a smarter patient. Then tell me if you agree or disagree.

Sarah Hurley is a consultant at Greenough. Follow her on Twitter at @Sarah_Hu

Sugar: A Looming Health Crisis?



A 2010 United Nations report  revealed that more people globally are dying from chronic, non-communicable diseases, also called “lifestyle diseases,” than from infectious disease. The UN report identified “tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol” as the primary causes of heart disease, stroke and cancer.  While tobacco and alcohol are regulated, diet is not—and many scientists and doctors are now touting the harmful effects of America’s dietary choices, particularly the perilous effects of sugar.

One pioneer in the public health campaign around sugar is Dr. Robert Lustig, professor of Clinical Pediatrics in the Division of Endocrinology, and Director of the Weight Assessment for Teen and Child Health (WATCH) Program at the University of California, San Francisco.  Lustig spearheaded this movement with his 2009 YouTube video Sugar: The Bitter Truth,  which explores the health damage caused by sugary foods and encourages dietary regulation. Dr. Lustig argues that sugar in all forms, such as sucrose and high-fructose corn syrup, is one likely cause of lifestyle diseases. Lustig’s video, to no one’s surprise, went viral, and The Bitter Truth opened the door for further research on the topic of sugar and health.

Lustig’s campaign is supported by molecular biologist Kimber Stanhope, whose studies have shown that people who consume large amounts of high-fructose corn syrup are at higher risk for heart disease and stroke.  And researchers at Beth Israel Deaconess Medical Center are studying whether sugar can cause a sudden spike in the hormone insulin, which in turn may fuel certain types of cancers. This is an alarming premise, especially considering that America’s consumption of sugar has increased dramatically in the last two centuries, from just around six pounds annually in 1822 to more than 100 pounds in 1999.

Despite these recent findings, sugar’s effect on the diet is a complicated issue. Lustig admits that scientists are still trying to understand how different forms of sugar are processed by the body—the theory is that some types of sugar are worse than others (Is brown sugar worse than white sugar? And so on). Furthermore, the debate continues regarding the effect of sugar in healthy foods. Dr. Lustig admits that an apple is good for you, despite its high fructose content. Many nutritionists would say the apple’s  high fiber content and complex interplay of nutrients offsets the fructose.

Settling on a solution may be equally complex, especially considering the consequences.  Some groups are calling for the U.S. Food and Drug Administration (FDA) to mandate that food companies list any added sugars on the nutritional panel of every item.  Radical proponents such as Lustig are even more rigid, proposing stopgaps to sugar access, much like what we have with drugs and alcohol today. This includes sugar taxes, placing age limits on sugary food purchases and even limiting advertising of sugar-sweetened food and beverages.

In the absence of government intervention, I believe the onus is on healthcare providers and leaders in the healthcare industry to raise awareness of the sugar/health issue and offer solutions.  As one of the world’s most advanced cities for healthcare, Boston and its medical community has risen to this challenge. A number of Boston-area hospitals have created Public Health Campaigns to encourage limiting excessive sugar consumption. Last year, Carney Hospital in Dorchester  became the first hospital in Massachusetts to ban the sale of sugar-sweetened beverages on its campus. Since then, nine additional Boston hospitals, including Beth Israel Deaconess Medical Center, Boston Medical Center and Children’s Hospital Boston, have pledged to work together on efforts to reduce consumption of sugary beverages.

Absent government intervention, if that’s even warranted, I believe today’s leaders in the healthcare industry must work together to encourage lower sugar consumption. To date, I’m impressed with what many of Boston’s leading hospitals have initiated to raise awareness to the issue, and I believe it bodes well for future public health campaigns. Do you agree?

Sarah Hurley is a Consultant at Greenough. Follow her on Twitter at @Sarah_Hu