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Epic EHRs Added to In-Store MinuteClinics; the Pursuit of Connectivity

Posted Mar 10 2014 12:00am

Walk-in clinics located in CVS and Walgreens stores offer a wide range of basic services such as vaccinations and the treatment of minor ailments. Some are even some offering lab tests (see: Lab Testing Now Being Offered in Walgreens California Stores ). Although there are other players in this business, I think that these two companies dominate the field. They offer the convenience of multiple locations and effective marketing. Since their inception, one of the weaknesses of walk-in clinics in general has been their rudimentary electronic records. This gap now seems to be closing, at least for the CVS MinuteClinics (see: CVS-Epic deal will add EHRs to Minute Clinic in run-up to major expansion ). Below is an excerpt from an article on this topic:

Just as CVS Caremark is poised to expand its MinuteClinic system, it’s inked a deal with Epic Systems to provide ambulatory electronic health record support for the clinics. The EHR/EMR  giant will replace the homegrown EHR system CVS developed....It reflects a growing maturity of the MinuteClinic concept as it moves beyond flu vaccinations and blood pressure readings to provide more non-emergency care, and it is one of the healthcare industry trends to reduce healthcare costs by providing alternatives to hospitals or the doctor’s office. The clinics are equipped to provide vaccines, do some lab tests and provide several non-emergency care services....Dr. Nancy Gagliano, MinuteClinic’s chief medical officer, said Epic’s support of national interoperability standards, analytics and customization helped cement the deal. CVS currently has more than 800 MinuteClinic locations and expects that to almost double to 1,500 locations....“We need a robust IT system, an EHR that will effectively interconnect with our affiliated partners,” as well as health information exchanges, [Gagliano] said. “We’re going to have over 1,500 clinics in just over a couple of years. We see 4 million patients a year and we’ll see 10 million patients a year in the near future. So we need a big company to support the volume that we’ll have.”

It will be a while before people should expect to see Epic’s EHRs in action. It will take about 12 months to train staff and set up “specialized interfaces” and another year to roll out the EHR network across MinuteClinic locations. A couple of components of the EHR network CVS is installing are Care Everywhere, which works as a health information exchange between Epic customers; and Care Elsewhere, which makes interoperability possible between Epic systems and other non-Epic providers or health information exchanges....CVS just joined the CommonWell Health Alliance — a group of health IT companies to improve the way healthcare data is shared. At the time of its launch last year, the alliance was perceived...as an attempt to better compete with Epic....In the announcement last week at HIMSS, a statement said that CVS is joining CommonWell as a contributing member, and would work with RelayHealth to embed these services natively into its pharmacy system.” It will also help providers securely access prescription information to improve patient safety. “Through the Alliance, pharmacies and health care providers will be able to better connect with the broader health ecosystem.”

These deals and alliances with Epic, RelayHealth, and CommonWell on the part of the CVS MinuteClinics are all about the integration of information and access to prescription data for patients. I suspect that the long-term plan for CVS is to position their clinics as the most basic rung in the U.S. healthcare delivery system. As such, they need to provide clinical and drug information up the line and also get access to the medical records of other providers. This yields both integration and legitimacy.

So what's in this deal for Epic. A huge number of patient records, obviously. Here's a quote from above: [CVS is] going to have over 1,500 clinics in just over a couple of years. We see 4 million patients a year and we’ll see 10 million patients a year in the near future. Although Epic will continue to connect its hospital clients with health information exchanges (HIEs) when available, I also believe that Epic's goal is to become a de facto HIE for their large client base (see: Connectivity and Hospital-Based EMRs; The EMR as an Operating System?A Reader Comments on Epic Interoperability and Care EverywhereSurescripts May Capture the Health Information Network (HIN) BusinessSharing Medical Records across Hospitals with Epic's Care EverywhereJudith Faulkner, EMR Interoperability, and Washington IT Politics ). In this context, providing support for the MinuteClinics makes perfect sense.

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