The "Retailization" of Primary Care

Everyone is abuzz about 亚马逊 buying One Medical . Not a new story, Amazon led the way for self service in retail (e-commerce) which then led to a revolution in powering self service in technology (#AWS cloud), why not healthcare???

?Amazon senior vice president Neil Lindsay said (in a press release/company communication) health care is “high on the list of experiences that need reinvention.” The Seattle-based tech giant believes it can expand and improve health care through a “human-centered and technology-powered approach,” he said.“Booking an appointment, waiting weeks or even months to be seen, taking time off work, driving to a clinic, finding a parking spot, waiting in the waiting room then the exam room for what is too often a rushed few minutes with a doctor, then making another trip to a pharmacy — we see lots of opportunity to both improve the quality of the experience and give people back valuable time in their days,” Lindsay said in a statement.

Sounds familiar. Amazon reinvented retail by blending innovation with technology and fanatical customer service. It has its own fleet of branded trucks and delivery vans to drop off packages - drones soon to come. It isn’t too difficult to vision what will happen in healthcare.?

?“Alexa, I don’t feel well.”? Alexa responds in a few minutes with a diagnosis. Schedules an appointment or spins up a virtual telehealth session with a One Medical practitioner who sees you in minutes. With a variety of digital health tools, vitals can be taken. Not serious? Treatment is prescribed. This transpired within minutes and you, the patient, never left your home.? More serious, schedule an appointment and visit the clinic to physically see a doctor. Need a prescription? Click and be done with medication being sent to your home from Amazon Pharmacy. Your bill presents in your Amazon account. Need a referral or find a doctor? Intelligent tools will connect you to the right specialist. Refills, reminders, scheduling - all automated.?

?Some of this already exists, but the trend will continue with greater emphasis on home care and virtual visits.? Additionally, there is a merger happening between retail and healthcare with retailers like Wal-Mart, Walgreens, CVS, and now - Dollar General adding more services and expanding healthcare offerings.? They not only have the physical locations which are ‘close to the customer’, they have the supply chain and infrastructure to support localized care - they already know how to personalize delivery based on demographics and will capitalize on that.? They can deliver standardized care with volume discounts/mass buying power? to lower healthcare costs.?

Fierce Healthcare published the 2022 Healthcare Forecast: Competition in Retail Healthcare will heat up. What to Expect from Amazon, CVS, Wal-Greens. (Rebecca Torrence, Dec 21, 2022). ? There were five predictions with key support noted by different analysts (summarized below):

1. Retailers will embrace omnichannel strategies while leveraging strengths.?
2. CVS is emulating Kaiser Permanente by creating more specialized locations dedicated to primary care, HealthHUB sites, and traditional retail.? Amazon expanded virtual services and home-based care services in 2021. “They have a substantial customer base, and ultimately, that’s going to lead to lower drug prices for Amazon customers, which is a huge competitive advantage,” she said (Natalie Schibell, Senior Analyst Forrester).?
3. Patients will get more personalized healthcare experience from retailers.?
4. Using new technologies and strategies tailored to each population, retailers will focus on customizing the consumer experience in healthcare to boost access and build patient trust, said George Van Antwerp, managing director at Deloitte.“It’s about understanding the consumer and being able to create a personalized set of experiences for them that blends that omnichannel strategy,” he said. “Based on where I am and my disease and my benefit coverage and my existing dynamics, what’s the best path for me to choose and the best way for me to be supported?”
5. More money will go toward primary care at the expense of traditional clinics.?
6. Walgreens increased it's stake in primary care company VillageMD in October to become the majority owner with a $5.2 billion investment, with the goal of opening hundreds of clinics through the partnership over the next four years. Those investments are likely to only increase next year as retailers look to replace traditional providers, at least for certain kinds of care. Traditional providers will have to adapt if they want to survive, digitizing their services where possible and making it easier for patients to get appointments, Schibell said. “Primary care physicians all around the country: Look out. You’re going to have to make sure you’re offering those digital services and that level of convenience,” she said. (emphasis added)
7. Retailers will confront the interoperability problem.?
8. If retailers want to be a consumer’s sole source for primary care, they must create solutions for data sharing. Relying on retail clinics for a portion of a patient’s care could help drive down overall costs, Schibell said. But though some retailers have made efforts to link patient records, like Walmart in its September partnership with Epic’s electronic health record, she said the current solutions don’t fully allow for the new care model these companies propose.
9. Expect more investments in cloud solutions.?
10. Seeing potentially millions of patients also requires robust systems for data collection and analytics, and experts expect retailers to pour more money into cloud-based technologies for their range of needs. CVS’s partnership with Microsoft, announced at the beginning of December, aims to personalize customer care by leveraging the tech giant’s tools—especially cloud computing. As part of the collaboration, the pharmacy behemoth plans to migrate 1,500 new and existing business applications onto Azure. Those investments will help retailers personalize the consumer experience, too, Huseby said. “They’re going to invest in technology for sure, it’s going to be cloud-based because that’ll help them automate and innovate faster, and it’ll drive a lot more self-service for consumers on mobile devices,” he said.

What does this mean?….Remember Sears? K-Mart? Two Guys? Bradlees?? Joe’s Hardware Store? Yep - that will likely be the fate of many primary care physicians. Especially those *old school* who do not invest in technology or become more patient centric in terms of service.? The days of the independent physician who overbooks, keeps patients waiting, forces un-necessary visits for refills (as my physician annoyingly does) are numbered.? I would even argue the independent physician’s days are numbered generally as the need to compete will likely create larger ‘conglomerates’ of practices or limited locations with more emphasis on virtual care.?

Seriously, does one think that technology behemoths like Wal-Mart or Amazon can’t build a better EMR or innovate with respect to health record sharing?? I bet that is on the roadmap.?

Technologies like WellAI are enablers and can level the playing field for smaller clinics and physician offices. They create a mobile patient pre-visit workflow and #digitalfrontdoor - putting more services and convenience directly in the hands of the patients.? They streamline the front office workflow and can automate many tasks involved with patient intake. The competition is increasing in #directprimarycare which is moving to a #haas (Healthcare as a Service) subscription model and technology enablement is a critical piece of that. Just as retailers beefed up e-commerce and “buy online pick up in store” and other digitization strategies, physicians will follow suit and transform or go #extinct.?

Written by Rachel Schneider, Marketing