Google Health 2018: Best — and Worst — Case Scenarios

We went brainstorming to see how open architecture might affect wellness, sex, eldercare, insurance and other health concerns.

Walmart’s Loss Leaders: First Beyonce, Now Prozac (fluoxetine hydrochloride)

Walmart’s ability to drive down the cost of genercic drugs is a good thing. But in the pharmaceutical context, questions arise…

Wal-Mart Medical Clinics

At yesterday’s National Governors Association Winter Meeting in Washington, Wal-Mart president Lee Scott (at right) announced the opening of 50 new in-store clinics adding to the handful now run by RediClinic, a division of Interfit Health, a Houston-based firm. Interfit is backed by Revolution Health Group, the post-Time Warner venture of AOL founder Steve Case with a stellar board of tech-savvy directors.

As we wrote in Wal-Mart’s Tough Choices last December, the biggest employer in America faces the biggest employee healthcare problem, and Scott says he’s dedicating himself to getting state governments focused on realistic solutions — instead of the employer mandates they’ve been contemplating. But the most disruptive line from the speech is: “We’re making health care more affordable and accessible to our
associates.  And with the clinics, we’re using our business strengths
to do the same for our customers and our communities

When Wal-Mart starts competing with ol’ Doc Welby, things will start changing.

MinuteClinic Retail Care: “You’re sick. We’re quick.”

The sign on the wall at Minneapolis-based MinuteClinic presents the price list for common medical procedures: $49 for a Sinus Infection, $59 for Wart Removal, $39 for a Pregnancy Test. Office hours are 8 to 8 weekdays, 8 to 4 weekends, no appointment necessary. The 90 square foot clinics are located in high traffic retail locations like Target, CVS and CUB Foods stores, usually with free parking. A nurse practitioner backed up by a proprietary evidence-based diagnosis and treatment system gets you in and out in 15 minutes, faxes your primary care physician a report, and accepts most insurance plans. If you have a medical problem not on the list — about 7% of walk-ins, says MinuteClinic — you’re referred to a primary care physician, urgent care center or emergency room.

Like a JiffyLube, the MinuteClinic does a few things, and does them efficiently and well. The company says that a Sore Throat visit — including prescription medication — costs about $62 and 30 minutes versus a primary care physician’s $109 and 90 minutes versus an emergency room’s $325 and God-know-how-many hours waiting time. Patients are satisfied: 50% are referred by friends, 40% to 45% are regulars, and the firm claims 4 complaints per 10,000 visits. Employers are satisfied: many companies actively promote MinuteClinics and even discount co-pays for employees.

Price transparency. Careful quality measurement. Evidence-based practices. Electronic medical records. 21st Century customer service. You know it’s a disruptive innovation when the first item on the agenda for the NAFAC urgent care physicians conference in April is:
"Are you threatened by the recent openings of clinics inside big-box retailers or chain drug stores in your community?"