On-site clinics cut costs, but privacy fears remain a barrier

On the eve of Nov. 15 Sebelius sent a letter offering more decision-making time.

Companies and their employees have a lot to gain from on-site health clinics, but fear over health information privacy still remains as a hurdle, according to speakers at the 17the Annual National Business Coalition on Health, held Nov. 12-14 in the nation's capital.

Ross Miller, MD, medical executive and principal investigator for Cerner Corporation in Kansas City said Cerner’s on-site clinic focuses on four key elements: empowering medical insight with data analytics; aligning incentives; engaging individuals and providing good service.

“Healthcare is too important to stay the same,” he said. “Together we can change the way employers and employees think about the focus on health, pay for healthcare; share and use data, and improve clinical and health economic outcomes.”

But, there is a barrier; “trust is still a concern,” Miller said. Patients are afraid their data will be shared with their employers.

Julie Girten is the executive director of Tri-State Business Group on Health in Evansville, Ind., which provides an on-site clinic to Evansville ARC, a non-profit that provides support for the disabled. The clinic has shown tremendous ROI and has improved the health of its users.

When the clinic was opened in 2009, utilization was at 60 percent. Now it is at 84 percent. Users of the clinic were concerned about the privacy and security of the paper medical files being kept on location at their place of employment. The use of electronic health records made them feel more secure, Girten said. No paper files are kept at the clinic.

Since the clinic opened, there has been a 46 percent reduction in medical costs, Girten reported. From 2010 to 2012, there has been a 44 percent decrease in drug costs and high-risk patients went from 14 percent of all the patients to 1 percent. Initially, the clinic was projected to save $106,654 over a three-year period, but the ROI came in at $380,194, she said.

Patients weren’t the only skeptics at first. The private physician community has also harbored fear, but for different reasons, speakers said. Private physicians were threatened by the on-site clinics. Ross explained that outreach plays an important part of smoothing things over.

“We try to reassure [local physicians] that the on-site clinic is not meant to replace them,” Girten said. “It is often a struggle to keep communication going well.”

Bill Updyke, a chiropractor and leader of physical and complementary medicine at LifeConnections Health Center on the Cisco campus in San Francisco Bay area said patients who come to the on-site clinic still have need of their primary care physicians on weekends.

Getting patients aware of the on-site clinic in a campus of 150 buildings has been somewhat difficult, Updyke said. “We market it just like you would any other private practice,” he said.

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