The past 50 years have seen a transition in healthcare from the Marcus Welby model of a kindly physician taking charge, even ownership, of a patient’s well-being to a phenomenon called participatory medicine, where physicians play the role of senior, expert collaborators with an individual in their plan for health.
In the past, the medico/hospito/pharmaco players were gatekeepers who doled out medical information and care with schedules at places that served their needs. Today’s patients demand greater and more convenient access to health information and medical care. They want care to be provided with the convenience of any other retail service. Simply said, they want it now, wherever they want it… now.
Healthcare On Demand
An early manifestation of “retail” convenience in healthcare was the standalone, limited service clinic. This movement began in the workplace with employers contracting with companies such as CHS Health Services to operate health clinics. These services have offered free services to employees as a benefit, and for the employer as a means to reduce absenteeism and healthcare costs. CHS, newly merged with Walgreens-owned Take Care, operates more than 500 workplace clinics for major US companies.
Beyond the workplace, people seek care at retail locations of urgent care or so-called walk-in clinics. Common features of these clinics are the ability to address accidental injuries, administer sports and employment physicals, prescribe medications for infections, and similar time-sensitive acute care. Urgent or walk-in care is offered in more than 9,000 locations in the US, most often in convenient, suburban locations, with long daily and weekend hours.
According to the most recent data published, Urgent Care Association of America clinics served more than 160 million patient visits in 2012. Most centers are owned by individual physicians who typically own and operate a limited number of clinics. Among the largest national operator of small urgent clinics is Concentra, a subsidiary of Humana Corporation, with more than 300 facilities.
Pushing the concept toward more traditional retailing are the clinics operated, usually by nurse practitioners, in CVS, Walgreens/ Duane Reade and other pharmacies. CVS’s Minute Clinics have serviced more than 20 million patient visits since 2000 and are on track to have more than 1,500 sites by 2017.
Walmart, in conjunction with medical provider QuadMed, is beginning to open its Care Clinics, which are full-primary care medical practices operating within their stores. The clinics intend to go beyond the one-visit acute concept of other clinics to provide continuing care for chronic diseases, presumably involving a continuing stream of patient visits.
Urgent care and walk-in clinics represent the “going retail” trend of emergency and acute care. Another trend in healthcare delivery are the medical services built around a single procedure. Often built around innovative and often expensive, equipment, physicians practice in standalone facilities that only offer LASIK vision correction, mammography, dialysis or infusions of IV medications. These dedicated practices are sometimes owned by hospitals and often owned by physician- entrepreneurs who establish them in standalone locations of greatest convenience to the patient customers.
Standalone medical care, whether near or inside of typical retail business, is a response to a very real demand on the part of patients who want care on their terms, meaning at their convenience with respect to time, place and, where possible, at predictable cost.
Most of the entrepreneurs responding to these needs come from the medical establishment… physicians who see opportunities in making traditional healthcare more easily available. With the exception of pharmacies, those who truly understand the retail environment and experience have not yet reimagined how the principles of retailing in their world could reform the delivery of healthcare.
Healthcare delivery involves, of course, tailoring a unique “product” for each customer, and there are substantial issues of privacy, security and liability, but the dollar value of each customer encounter should inspire some creative thinking.
A New Wellness Delivery Model
Could selling healthcare become like selling shoes, watches or sweatshirts? You bet!
Just substitute the phrase “healthcare” for “wellness” or “fitness.”
Euromonitor and McKinsey both forecast global markets for wellness to reach $1 trillion annually as early as 2017. This figure includes all products formulated with some wellness advantage, loosely translated as Diet Coke, for instance. Nearly all of this trillion dollars in revenue will pass through one retail channel or another and will be sold, perhaps at a premium price, on the basis of its wellness or preventative features.
While health-directed foods is the largest category, some of the highest growth rates are forecast for clothing and shoes with sensors or other electronics built in to report fitness or health status to the user or their healthcare provider.
Using Bluetooth connectivity and SmartPhone computing power, shoes can measure steps or gait or tendency to fall; pillows can measure insomnia or apnea; watches can measure blood pressure, glucose levels and blood pressure. Google is experimenting with the use of sensor-containing contact lenses to measure glaucoma and systematic diseases that can be observed through the eye. Some of these sensor-based products provide approximate information for “educational” use and others are obtaining FDA approval to be used as serious health-reporting tools, sending data back to the patients and their physicians about adherence and efficacy of prescribed treatment.
Well-being and Big Data
In all cases, though, retail products that “do something” to contribute to health and well-being of the owner will command premium prices over similar items of routine functionality.
According to the Pew Research Center’s Internet & American Life Project, 70% of US adults say they track at least one health indicator; one third track some symptomatic measure such as blood pressure, glucose or sleep.
Collecting such data is a central focus of the several thousand entrepreneurs and hopefuls who gather at industry events focused on the intersection of health information needs and sensing and reporting technologies. Health 2.0, held annually in Santa Clara, California, is among the most robust of the annual meetings. Seemingly every one of the 3,000 attendees at these meetings is working on a plan to develop some solution to a healthcare problem, in many cases incorporating some health purpose into a more routinely purchased items (a scale, shoes, bracelet, sports bra, thermostat, etc.).
The massive amount of data available in aggregate from such sensing devices, coupled with narrative reports filed by patients, offers the prospect of observational studies on causes and effects of disease. Data- and experience-sharing websites such as smartpatients.com and patientslikeme.com provide patients and their caregivers insight into the efficacy of treatment alternatives, even foreshadowing the results of clinical trials as patient participants share their experiences.
The Patient Will See You Now
The growth and future growth potential for the “retailization” of healthcare has come from initiatives of patients and caregivers demanding greater, easier access to healthcare service and their desire for a higher level of participation and control in the management of their well-being and health.
Retailers who understand how these motives for health and wellness impact the goods or services they offer can fill a real need for customers. Inventive thinkers might begin to experiment with cross-merchandising combinations that have heretofore been “out of the box.”
Is it time to offer sensor-driven clothing at the walk-in clinic? Is it time to join Walmart in exploring full-scale medical practices in typical retail stores, or medical fitness services at outdoor and camping stores? Or medical supplies at the dialysis or infusion centers?
Every customer in every store is also a healthcare customer. Every one of them wants to maintain or improve their quality of life. Are there ways that you can compose or present your products or services so that they appeal to the health and wellness interests we all share? This is a real and present revenue opportunity whereby you can do well by doing good.