Not that long ago, treatment for acute injuries or illnesses were provided either in the doctor’s office or the hospital-based emergency department. However, in the last decade, we’ve seen the growth of several alternative venues for the treatment of acute illnesses and injuries.
While free-standing emergency departments are limited to certain states and telemedicine visits are just starting to gain traction, retail clinics and urgent care centers (UCCs) are enjoying significant growth as patients seek venues that are both convenient and lower in cost. Retail clinics are typically associated with pharmacies and offer a limited menu of services, often by advanced practice providers such as nurse practitioners and physician assistants. Whereas, UCCs are typically staffed by a physician and offer an expanded list of services, including X-rays and a limited number of laboratory tests.
Rapid expansion of urgent care centers
According to PricewaterhouseCoopers' Health Research Institute (HRI), the number of UCCs nationwide is estimated to grow 32 percent from 2014 to 2019. Many consumers are seeking care in settings outside of the traditional doctor’s office; of those surveyed with employer-based insurance, 60 percent said they received care in an UCC and 25 percent received care in a retail clinic. A study conducted on patients enrolled in a large health plan from 2008 through 2015 found a 36 percent drop in emergency room visits for low-acuity complaints and a 119 percent increase in use of UCC. This was not just a shift from one venue of care to another, but an increase of 31 percent in the number of visits for low-acuity conditions. Despite this increased use, spending per member from 2008 to 2015 was only up 14 percent, which the authors attribute to a 79 percent increase in price per emergency department visit. This same study notes a 214 percent increase in the use of retail clinics as well. The latest Urgent Care Association white paper notes millennials among the highest users of UCC. Younger consumers are more likely to embrace a new and innovative product. They also have a higher expectation when it comes to speed and convenience.
Historically, patients have gravitated to UCCs for their convenience, longer hours and lower cost. Now large health plans are either purchasing or partnering with UCC operators to give members an alternative to higher-cost emergency departments. Health systems are also utilizing UCC to decompress crowded emergency departments, expand their footprint and drive referrals. Even large physician practices are opening UCCs to better serve their patients.
Increased need for interoperability and streamlined EHRs
As UCCs take on a greater role and become an important part of the delivery of health care services, the demands on the electronic health record (EHR) used by UCCs is also going to increase. With more patients getting treatment and services at UCCs, it becomes important that the urgent care treatment records be visible to the other providers taking care of that patient. There will likely be various state and local entities that require information from the UCC, such as vaccine registries or health departments that collect communicable disease information. Integrating prescription monitoring program data into the provider’s workflow is also necessary as we seek to limit improper prescribing of controlled substances. Integrated delivery networks will use patient and treatment information as part of their population health management program and their value-based care initiatives.
Not only is it important that the UCC’s EHR exchange information with other EHRs, but it also must support the workflow of its providers. Patients choose urgent care clinics expecting short wait times and quick throughput. To accomplish a short throughput time, providers need an EHR that helps them order tests, medications and treatments quickly, while minimizing the amount of time spent on documentation. In the fast-paced urgent care environment, urgent care providers expect a system that is going to help them take care of their patients quickly, while accurately documenting the care delivered with minimal effort.
What was once a convenient place to get treatment for a minor illness or injury is becoming an important venue of care for many patients that also happens to be convenient and cost-effective. With so much care being provided in UCCs, it is becoming increasingly important that the EHR from those clinics facilitate the quick treatment that patients expect, while contributing to the coordination of care that providers need.
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