Zipnosis: Giant leap forward for retail health

MinuteClinic co-founder 

ST. PAUL, Minn. — Convenient care industry pioneer Kevin Smith took a leap more than 10 years ago and helped create the successful nurse practitioner-staffed retail clinic concept. Today, the industry trailblazer is embarking on a new venture to further revolutionize access to health care. Enter

“In a sense, it is doing triage. It’s almost functioning like an online advice source, and then it can also function as treatment, when it’s appropriate,” said Smith, who co-founded QuickMedx — now MinuteClinic. Prior to his current role as chief clinical officer of Zipnosis, Smith served as director of clinical informatics at MinuteClinic.

With patients increasingly turning to the Internet for medical information and the nation battling a physician shortage, Zipnosis — coupled with the evolving retail-based health clinics — may be the ideal prescription to help ease the overburdened U.S. healthcare system and move one step closer to consumer-oriented health care.

Furthermore, healthcare systems increasingly are looking for ways to respond to patients via e-communication, yet often lack effective tools. That’s a unique niche that Smith believes Zipnosis is ideally equipped to fill. In fact, Zipnosis teamed up in May 2010 with healthcare provider Park Nicollet Health Services in Minnesota and is looking to expand via partnerships with other health providers.

Zipnosis — which had about 1,800 patient visits since its May launch — is hoping to expand to 10 additional states by the end of 2011.

“As we move into accountable care organizations and the future of how healthcare reform is shaping up, I think more and more of these options will tease themselves out, and there will be opportunities for new ideas like this that fit into a [healthcare] system that really needs to be re-engineered,” noted Tine Hansen-Turton, executive director of the Convenient Care Association.

Unlike other telemedicine service providers, the Zipnosis interview process is asynchronous, meaning it is driven by a mediated form of communication in which the sender and receiver are not concurrently engaged in communication. How it works: The patient logs on to the Zipnosis site, answers a set of questions that mimic those that a healthcare provider would ask the patient and, based on the responses, goes to the next appropriate question. Once the patient completes the evaluation, a healthcare professional — a physician, nurse practitioner or physician assistant — receives a text message, and the patient receives a response within an hour with a recommendation.

Depending on the condition and the patient’s interview, there are three different outcomes:

The condition is determined to not be urgent and does not require a prescription, so a self-care recommendation is provided to the patient with detailed instructions on suggested OTCs, when to follow up with a physician and warning signs to look for;

If the patient meets the criteria for safe, appropriate online care, then he or she receives a recommendation from a clinician and, if necessary, a prescription is sent electronically to a pharmacy of the patient’s choice; or

The patient receives a referral — either automated or from a clinician — to visit a physician for further care. If the interview suggests a serious condition, the system immediately will notify the patient to visit a physician or urgent care facility, and he or she will not be charged a fee for using Zipnosis.

Like the early days of retail-based health clinics, the services offered by Zipnosis are limited to such minor, acute ailments as sinus infections, sore throats and bladder infections, as well as such conditions as acne and smoking cessation. Each “visit” is a flat fee of $25 paid via credit card or HSA/Health Savings Card. Patients can answer the set of questions anywhere, anytime using a computer, mobile phone or iPad. The same goes for healthcare professionals.

Smith, who has more than 25 years of healthcare experience, undoubtedly understands the importance of “appropriate” treatment, and stressed that Zipnosis uses evidence-based guidelines to ensure that treatment is safe and appropriate for online care. Patients can access their Zipnosis health record at any time and are encouraged to share it with their primary care provider.

With financial backing from private investors and a venture capital group, and a second round of funding in the works for second quarter 2011, Zipnosis clearly is on a growth path. “We are looking for additional provider partners [in other states], and we have had some physicians contact us and want to jump on board,” Smith said. “We really feel that for our provider partners there is an upside for using their marginal capacity to see more patients and to even conceivably draw patients to their practice.”

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