One of the biggest concerns surrounding increasing the amount of care provided at urgent and retail clinics is the disruption of information — and potentially, the relationship — between patient and primary-care physician.
Much of health care reform is centered around primary care, with its focus on wellness and preventative care. But it is difficult for primary-care physicians to get the full picture of their patients’ health if some care is delivered at an unaffiliated clinic.
The advent of electronic health records, and the incentives that come with them, are beginning to encourage more collaboration between providers. Integrating systems is one of the chief reasons CVS Caremark’s MinuteClinic has taken up clinical affiliations with hospital systems like Virtua, Hackensack University Health Network and Atlantic Health.
“As part of (those) collaborations, we are working to integrate our electronic medical records system with the health system so patient records can be shared,” said Dr. Andrew Sussman, president and CEO of MinuteClinic.
Sussman said MinuteClinics “endorse the principles” of the patient-centered medical home model, which encourages information sharing and integrating providers.
“A MinuteClinic visit summary is shared with primary care providers via fax, mail or electronic record, typically within 24 hours with patient permission,” Sussman said. “We also provide patients with a printed copy of their entire record at the time of the visit.”
Similar policies are in place at PM Pediatrics, in Livingston, and St. Peter’s Healthcare System’s urgent care clinic, in the Skillman section of Montgomery.
“If at all possible, for follow up, we’re trying to get the patient to go back to whomever their primary care physician is,” said Frank DiSanzo, chief of strategy for St. Peter’s.
Steve Katz, co-founder of PM Pediatrics, said the clinics work to keep pediatricians in the loop when patients need urgent care. Katz said the centers do not provide any of the preventative medicine that primary care does, like immunization or school sports physicals, and the clinics traditionally are open when primary care offices are not.
“We want and expect people to go to their pediatrician,” Katz said. “Even if there are decisions to be made that evening, while we’re treating the patient, if there’s something serious and the patient maybe needs to be admitted to the hospital, generally we will find their pediatrician and consult with them, and let them know what’s going on.”
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