Lean Management Folks Says Walk-in Clinic Improves Patient Care

I’d argue that walk-in clinics are great for business, great for patients, and great for the economy. In fact, it’s an application of Lean Healthcare. Let me explain.

Wal-Mart and other retailers are opening clinics to capture the walk-in market. Bloomberg reports:

To capture walk-in patients who will buy drugs and other merchandise, Wal-Mart Stores Inc., Duane Reade Holdings Inc., CVS Corp. and Walgreen Co. are opening clinics mostly run by nurse practitioners and physician assistants who treat everyday ailments and write prescriptions. Executives say at least 5,000 U.S. outlets will open in the next few years, even as doctor groups express concern over the quality of patient care.

“This is a first step by CVS and some of the others to say we are going to fill the void of where the general practitioner used to be,” says Dan Genter, president of Los Angeles-based RNC Genter Capital Management, which manages more than $2 billion including CVS shares. “It’s a big void, and there’s a real need for it.”

In a similar announcement, yesterday Wal-Mart announced that they will begin selling generic prescription drugs starting at $4.00 — this is a great, strategic move to in support of the walk-in clinic model currently in the minds of retailers.

On Time-traps, Waste, and Waiting

When consuming services, there are often time-traps and wastes. Time-traps is any activity that inserts delay into a process. This delay is often manifested in the form of waiting. Walk-in clinics can drastically change the current patient-care model an can eliminate or reduce non-value added steps.

A while ago, I spoke about lean consumption maps. Below is an example of a lean consumption map, taken from Jim Womack’s article in the Harvard Business Review, March 2005:

The map above shows, from the customer’s perspective, all the value-added and non-value added activities she has to go through in order to have her car repaired. There’s a lot of waiting and hassle. After an activity like this is documented as in the above map, we can then begin to reduce or eliminate the non-value added activities through operational improvements. Below is the process after the improvements were made:

Several steps were eliminated, which increased the value-added time for a consumer from 53% to 94% and for the provider from 27% to 59%. Both parties win when operational improvements are made.

Value-added time for Walk-in Clinics

I can see the same scenario playing out for walk-in clinics. Rather than the standard patient-care model of [making an appointment, driving to appointment, check-in, waiting, receiving care, exit], it could look drastically different. The [waiting] step could be replaced by [shopping] and then when the doctor is ready to see the patient, her name could be broadcasted by the retailer to the shoppers. This method replaces a non-value added step with a value-added step. The consumer and the provider both win in this scenario.

Note: I’m not addressing coordination of care or any medicine-specific issues.

The Future of Healthcare

I’m excited for this innovation in medicine and patient-care. The less hassle there is for the consumer, clearly the better it is for business in general: less waste, fewer time-traps, more value-added time — is a formula for return customers, loyal customers, and happier customers.

From a business development point-of-view, this is a great market to enter. In fact, the Bloomberg article cited above mentions Steve Case entering the market. I see big opportunities here.