The Migration to Medical Record Software and Web Applications

Emergency rooms are being flooded with patients who don't need to be there. These patients have minor maladies such as the flu, small fractures, or sinus infections.

The cost of treating these patients in the E.R. is about three times higher than it would be at an outpatient medical or urgent care clinic.

Retail outpatient clinics, such as Minute Clinic and Wal-Mart's in-store clinics, provide a convenient way for patients to deal with minor medical problems. They like to call it healthcare on demand.

Consider Zoom Care, a retail healthcare company that operates three clinics in Oregon.

Zoom Care patients already know the length of their wait time and the price of their visit before they arrive.

This convenience is made possible by a web-based software system connected to each of Zoom Care's clinics.

Online healthcare information is available through audio and video clips posted to the Resources area of Zoomcare's website. This information serves a dual purpose of providing healthcare education and marketing to patients interested in changing their lifestyles.

The type of treatment available is outlined in a customer friendly "menu" also available on the website. Services include vaccinations, physical exams, strains, sprains, and fractures.

The patient leaves the office with a receipt for the exact amount of services and can ask follow up questions using an online form.

Wal-Mart's in-store medical clinics take this a step further by storing patient health records electronically and making them available online.

In his excellent article, "the Wal-Martization Of Health Care" William Sage notes that retail clinics start with electronic record keeping. The old "primary Care"business model stores records on paper before digitizing them.

When this emphasis on electronic medical record keeping is combined with the low rental costs of a retail space, overhead costs drop dramatically. This results in lower costs for the customer.

While effective use of healthcare management software makes it possible for retail clinics to lower costs and increase convenience, the lack of innovation taking place within primary care clinics is disappointing.

A visit to the websites of the larger HMO's revealed few features that increased patient convenience.

Unfortunately, good care does not always occur at retail clinics. Browsing a customer opinion site such as Yelp! yields good and bad stories about retail clinic care.

Many of these clinics employ nurses with advanced degrees and physician's assistants. Most problems occur because the supervising doctor is not always onsite.

It is interesting to note that HMO clinics, such as Kaiser Permanente, also rely on a high percentage of R.N.A. nurses, student physicians, and physician's assistants.

While retail clinics might represent a big change for community healthcare, they will not replace primary care.

It is likely that retail clinics will reduce the volume of patients who are flooding primary care facilities for minor medical issues.

It is clear that the "health Care On Demand" model, which effectively uses online interaction, transparent pricing, accessible locations, and electronic medical records, creates strong competition to HMO businesses. What isn't clear is how good the quality of care actually is.

The self-service model of web driven client management systems is most certainly in full swing by this point, though underutilized. HMOs and even small practices can now effectively compete in this realm thanks to the increased affordability of web technology.