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Careworks Convenient HealthcareThe Geisinger Health System ExperienceNational Retail Clinic Summit - Philadelphia 3.1.10

Dean Q. LinCEO, Careworks Convenient HealthcareVP, Business Development, Geisinger Health System

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Retail Clinics

An innovative, growing segment in healthcare. But …

Wolves in sheeps clothing?

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Retail Clinics

An innovative, growing segment in healthcare. But …

Fragmentation of carePossible effects on quality of careAccess to health record with pertinent patient informationImpact on medical home model

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Geisinger Health System

Careworks Convenient Healthcare

Non-Geisinger Physicians With EHR

Last updated 07/09/09

Geisinger ProvenHealth Navigator SitesContracted ProvenHealth Navigator SitesGeisinger Medical GroupsGeisinger Specialty Clinics

Geisinger Inpatient FacilitiesAmbulatory Care Facility Geisinger Health System Hub and Spoke Market AreaGeisinger Health Plan Service Area

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Longitudinal Medical Management

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Geisinger Careworks

Retail and worksite clinics powered by Geisinger’s EMRFounding board member of Convenient Care Association 10/06Alliance with Lehigh Valley Health 9/08Provide consulting and management services to other health systems

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Geisinger Building Blocks(How We Got Started)

Innovation focusOperational capacity Retailer relationshipFinancial appetitePolitical willKnow-how

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Investment Rationale

Clinics will open in the community, with/out usBeing on the offensive offers upside potential Being on the offensive also provides a strong defensePresence of kiosks could allow for reduced physician requirements during off hours

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Time Required for Primary Care of Patients

Hours/Day

Acute Care 4.6Preventive Care 7.4Chronic Care 10.6

22.6

10 Source: 2009 Survey of Health Consumers, Deloitte Center for Health Solutions

11 Source: 2009 Survey of Health Consumers, Deloitte Center for Health Solutions

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46% open to non-traditional care

Source: 2009 Survey of Health Consumers, Deloitte Center for Health Solutions

13 Source: 2009 Survey of Health Consumers, Deloitte Center for Health Solutions

Opportunity for patient activation

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Our ExperienceSquare peg in a round holeSite strategyConsumer marketingBrand developmentReferrals and downstream revenueNew target marketDelivering quality carePatient satisfactionPhysician acceptance

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Integrating Retail Clinics into a Local System of Care

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Continuum of Integration

Traditional Community Hospital Model

Fully IntegratedHealth System

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Force Field Analysis

Access constraints

Consumers

Competition

Healthcare reform

Physician resistance

Execution risk

Focus

Plan: Collaborate with a like-minded health system with retail clinic experience

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Initial physician support (or lack thereof)

Physician leadersEmployed physiciansAffiliated physicians

FM ▪ GIM ▪ EM ▪ Peds

Size of practice

Local competition

Stage of practice

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Community Physician Liaison

Primary care physicianIndependent and localMedical community credibility

InterfaceTrouble shootQuality oversightFacilitate collaborationClinic promotion and outreach

Background

Role

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Development Principles

Focus on services that are least threatening to PCPs and build trustMake respect for patients medical home tangibleIdentify physician communication preferencesFollow-through on communication promise

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Communication Tactics

Department chair meetingsMedical staff presentations Outgoing email and letterPromote awareness of medical liaison roleOutreach to individual practicesLeverage trust of health system

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Our Experience (So Far)

Physicians interested in collaborationNo detectable impact on patient visitsQuality of care not a concernImproved continuity of careWell received by patients