Even though I had stopped by
our local walk-in clinic to conduct
my own interview and get
a sense of the operation, I was the one
who got the first question: "Have you
had your flu shot?"
Family Nurse Practitioner Amy Luster,
RN, APN-C, of the MinuteClinic at CVS
Pharmacy in Plainsboro, New Jersey,
told me that patients seeking flu shots
and strep tests are the ones she and
her colleagues see most often this time
of year. Not surprisingly, patients with
conditions like sinusitis, bronchitis, and
conjunctivitis also are frequent clinic
visitors during the winter months.
In the spring, allergies are a common
complaint; the end of summer is a time
when teenagers heading off to college
visit the clinic for their meningitis vaccinations.
"It is a lot faster than doctors'
offices," noted Luster. "Once they have
tried us, they do come back."
One reason patients are turning to
clinics, explained Kathleen Caridi, RN,
APN-C, manager of MinuteClinic's operations
in central New Jersey, is the convenience.
Because walk-in clinics are
open 7 days and weeknights for patients
without an appointment, they offer an
alternative to often crowded physicians'
waiting rooms or costly emergency
department visits during off-hours.
MinuteClinic health care centers are
staffed by board-certified family nurse
practitioners and physician assistants
who are trained to diagnose, treat, and
prescribe medication when it is part
of a treatment plan for common family
illnesses. Though patients are not
required to fill their prescriptions at the
pharmacy, they often do, noted Luster—for the convenience.
A Full Menu of Services
The services offered by MinuteClinic
cover everything from common illnesses
like ear infections, to vaccinations,
wellness programs, and camp
physicals (Table). Currently, more than
550 MinuteClinics are operating in
27 states. Since its inception in 2000,
MinuteClinic reports more than 2 million
patient visits.
"We're always looking for more services,"
noted Caridi. She and Luster
pointed out the many prevention and
screening programs also offered at the
clinics. Through a promotion last May,
for example, patients could get free
cholesterol, blood pressure, or glucose
screenings.
"This starts the discussion," said
Luster. "Then we can sit down with
the patients, discuss what the readings
mean, and also give them informational
materials." Smoking cessation counseling
is another popular service the clinic
offers.
Individuals with illnesses outside
MinuteClinic's scope of services, or who
exhibit signs of a chronic condition, are
referred to their physician or, if critical,
to the nearest urgent care center or
emergency department.
Complementing a Physician's Care
When patients arrive at the MinuteClinic, they sign in at a touch-screen
kiosk, answering the typical questions
one might receive at the doctor's office,
before being ushered into a private
exam room. This sets up a record for
future visits, when visitors will only
need to enter their name and birth date
to sign in. Most patients simply pay the
office visit copay indicated on their
health insurance card. Treatment prices
are posted at the clinics as well, for
patients paying by cash or credit. Most
treatments at MinuteClinic cost $59.
MinuteClinic staff use a software program
that, at the conclusion of each
visit, generates educational material,
an invoice, and a prescription (when
clinically appropriate) for the patient, as
well as a diagnostic record that is automatically
sent to the patient's primary
care provider. If a patient does not have
a "medical home," a list of physicians in
the area is provided.
"We encourage all of our patients to
have a medical home," said Caridi. "We
send the record of their visit to their
primary care doctors. This is especially
helpful for keeping track of children's
immunization records."
Every MinuteClinic patient assessment
and treatment follows nationally
established clinical practice guidelines
from the American Academy of Family
Physicians, the American Academy of
Pediatrics, and the Institute for Clinical
Systems Improvement. These guidelines
are embedded in the clinic's electronic
medical records system. MinuteClinic
also has received accreditation from the
Joint Commission on Accreditation of
Healthcare Organizations.
Outreach, Too
Table |
CVS MinuteClinic Servicesa
Common Illnesses
Allergies
Bladder infections
Bronchitis
Ear infections
Pink eye and styes
Sinus infections
Strep throat
Swimmer's ear
Skin Conditions
Athlete's foot
Cold sores
Deer tick bites
Impetigo
Minor burns
Minor skin infections and rashes
Minor sunburn
Poison ivy
Ringworm
Shingles treatment
Wart removal
Vaccines
DTaP, Td, Tdap (diphtheria, tetanus, pertussis)
Flu (seasonal)
Hepatitis A and B
Meningitis
MMR (measles, mumps, rubella)
Pneumonia
Polio
Wellness & Prevention
Camp physicals
Health screening:
Cholesterol
Diabetes
Hypertension
Obesity
Smoking cessation
Additional Services
Ear wax removal
Flu diagnosis
Mononucleosis
Pregnancy testing
Suture removal
a Provision of some services is restricted to
certain age groups.
|
|
Caridi said that one of the most exciting
aspects of the clinic model is how it has
helped to forge partnerships between
clinic staff and pharmacists. "It has
helped to join the professions together
in a way that helps patients," she said.
She teams up periodically with CVS
pharmacists to go out into the community
to places like senior centers, to
let area residents know about the many
services the pharmacy provides, such
as free home delivery, as well as the
MinuteClinic. They end their talks with
a question-and-answer period, when
patients often ask about their medications.
This outreach, said Caridi, "helps
to bring health care back to the community."
Caring Professionals—When You Need Them
While I was on-site, the business was,
indeed, mostly flu shots. CVS recently
reported that it surpassed its goal of
delivering 1 million flu vaccinations during
this fall's flu shot season.
Staff at the Plainsboro MinuteClinic
explained that new regulations in New
Jersey—requiring flu shots for all children
aged 18 months to 4 years 9 months
who attend day care or preschool—
have upped the number of flu shots
requested. The regulations took effect
January 1, and MinuteClinic circulated
flyers on the new state requirement this
fall to help keep families informed.
One woman, waiting for her prescription
to be filled, came by and asked
about preservative-free vaccinations,
which the clinic had in stock. She got
her flu shot and decided to bring her
4-year-old son, who, like many children'
has anxiety about doctor visits, back to
the clinic for his flu vaccination the next
time they go out shopping.
As I departed, Caridi summed it all up
while she was busy answering questions
and assisting another patient with the
check-in process at the kiosk: "We are
here for the convenience."
Inside the Issue
