In 2011, Henry Ford Health System signed an affiliation agreement with CVS Caremark Corp.'s MinuteClinic unit under which Henry Ford doctors act as MinuteClinic medical directors and do consulting for the retailers' patients. Henry Ford also refers its own patients to MinuteClinic locations for night and weekend primary care.
But the big Detroit-based health system has not yet connected its electronic health record system to the pharmacy chain's in-store clinics because it hasn't completed its own EHR installation. Henry Ford patients treated at a MinuteClinic location have their records faxed to primary providers. Henry Ford is using Epic as its EHR vendor while CVS has a proprietary EHR.
Retail clinic operators such as CVS are rapidly expanding into the estimated $5 billion market for simple primary-care services. But their growing presence and popularity is raising concerns about further fragmentation of medical care, even as momentum grows for tighter coordination across the continuum of care.
Critics contend that continuity of care can be disrupted when patients visit a walk-in clinic rather than their regular primary-care physician or clinic. In a 2012 study published in the Journal of General Internal Medicine, patients were less likely to return to primary-care doctors to treat simple acute conditions after visiting a retail clinic, though the same study found no evidence that patients sought less preventive care or disease management.
In addition, retail clinic visits may go unreported to primary-care doctors, creating a gap in patients' medical histories. Patients who visit retail clinics may be due for screenings or more complex care that can get missed in retail settings, where the scope of services is limited.