Telehealth provides another way for retail pharmacies to provide clinical services

Seven million Americans to face primary care doctor shortage after 2014, study finds

Rite Aid announced Friday that it had expanded its "virtual clinic" model to additional markets, now offering NowClinic Online Care service in 58 stores.

Retail clinics are an area in which Rite Aid has not invested to the same degree as Walgreens and CVS, but NowClinic shows that there are more ways to offer clinical services in a retail pharmacy setting than building an extra clinic. In 2011, Rite Aid became the first to provide such virtual clinics in a retail pharmacy setting when it launched the program as a pilot in nine stores in Detroit.

NowClinic is part of the growing segment known as telehealth, or telemedicine, which ranges from services like those at Rite Aid to remote monitoring of patients by their physicians. Last month, a report by healthcare market research firm IHS indicated that telehealth was expected to reach 1.8 million patients around the world by 2017, finding that in 2012, there were already 308,000 patients remotely monitored by healthcare providers for various chronic conditions. In the United States, according to the American Telemedicine Association, there are currently about 200 telemedicine networks, with 3,500 service sites, and telehealth will also feature prominently at the Retail Clinician Education Conference this May.

But whatever form telehealth takes, as the IHS report indicated, a major driver of its growth is a need for primary care services that the current availability of primary care providers has been and will continue to be unable to meet in the near future. Through services like immunizations, pharmacy retailers have already sought to step in to fill this void, which experts say will be exacerbated when nearly 30 million people become newly insured under the Patient Protection and Affordable Care Act.

According to a study in the journal Health Affairs published online last month, the expansion of health insurance under the healthcare reform law could lead to 7 million Americans facing a primary care physician shortage after 2014. Such shortages already affect many rural areas of the country, such as some parts of West Virginia and Ohio, where regional chain Fruth Pharmacy's pharmacists often find themselves providing certain clinical services due to an acute shortage of primary care providers in the area, president and chairman Lynne Fruth told Drug Store News in a recent interview. But the study found such shortages could become a problem in many urban areas too, such as poorer parts of Chicago. All in all, the healthcare reform law will create a need for 7,200 more primary care providers, according to the study.

Washington has taken notice. A new bill, H.R. 6719, the Telehealth Promotion Act of 2012, introduced in the House by Rep. Mike Thompson, D-Calif., would establish that "no [medical] benefit covered shall be excluded solely because it is furnished via a telecommunications system," allowing greater access to telemedicine services through Medicare, Medicaid, the Children's Health Insurance Program, Tricare, Department of Veterans Affairs and federal employee health plans.

Other clinical models are likely to see growth as well. CVS is planning to accelerate the growth of its MinuteClinic business and have at least 1,500 in operating by 2017, while 3-of-the-106 new accountable care organizations announced by the Department of Health and Human Services in January are affiliated with Walgreens. Walgreens also has a program, WellTransitions, announced in October 2012, which provides such services as bedside medication delivery, patient counseling, 24/7 pharmacist support and follow-up calls in an effort to reduce re-admissions to hospitals; according to Washington Adventist Hospital in Maryland, of the first 48 high-risk patients enrolled in the program, only three were readmitted within 30 days of discharge, compared with the nearly 1-in-5 Medicare patients readmitted on average around the country, according to a 2009 study published in the New England Journal of Medicine.

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