Markets in Everything: Virtual Retail Clinics

American Medical News -- "When patients walk into a NowClinic at any one of nine Detroit-area Rite Aid pharmacies, they can choose among multiple physicians to see about what's ailing them. Not see in person. See on a computer monitor.

What's going on at these Rite Aids is a merger of multiple trends focused on providing more convenience to patients than, presumably, a physician's office can deliver. Neither telemedicine nor retail clinics are new -- but combining them is.

Rite Aid and OptumHealth joined forces to find a less expensive alternative to traditional clinics, which are staffed by nurse practitioners and physician assistants who are contracted from a local hospital group. Those startup costs have been a factor as to why growth of retail clinics, until a nearly 100-location expansion by CVS' Minute Clinic in 2011, had been mostly flat in recent years. Rite Aid and OptumHealth decided it would be more cost-effective to go with virtual visits -- nurses and physicians seeing patients via a computer screen.

Here's how NowClinic works:

A patient walks into a private room, usually near the pharmacy counter, and registers himself or herself on the computer terminal. Either an account can be created with OptumHealth, or UnitedHealth Group plan members can use their member information, to avoid the registration process on subsequent visits. When registration is complete, the patient goes through a series of computer-prompted questions to get at the problem or complaint. The patient can access several free educational tools or talk with a nurse via video chat.

The services offered at Rite Aid are the same as for the online NowClinic: treatment of allergies, bladder infection, bronchitis, cough and cold, diarrhea, fever, insomnia, nausea, pink eye, rash, seasonal flu, sinus infection, sore throat and viral illness. There's no charge for virtual consultations with a nurse, who also can advise patients whether a doctor visit is warranted.

If the patient would rather talk to a physician -- or the nurse advises that the patient should -- he or she can pay $45 for a 10-minute visit and enter credit card information. The system does not accept insurance coverage, though patients can submit claims to their plan to get reimbursed. Patients can pick a physician from a list with background information, including specialties and customer reviews, for each physician. The physician can help guide the patient to in-person care, if needed, or write a prescription when appropriate."