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Today in Health IT, we're discussing the growing battleground for health systems. My name is Kate Gamble, and I'm Managing Editor at This Week Health, where we host a set of channels

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and events dedicated to transforming healthcare, one connection at a time.

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Learn more at thisweekhealth. com slash Google Chrome OS. So today we're talking about the growing battleground for health systems. I'm joined by Sarah Richardson, President of Community Development here at This Week Health.

Sarah, welcome to the show. Good morning, Kate. So we're diving into a fascinating shift in healthcare. Hospital systems acquiring urgent care centers at a rapid pace. This move is shaping patient access, operational efficiency, and even competitive positioning for major players. Let's break down why this is happening and what it means for the future of healthcare delivery.

Oh, absolutely. We're seeing health systems from community health systems to HCA making big plays in the urgent care space. The idea is simple though. It's meeting patients where they are, reducing emergency department strain, and creating new profitable entry points into healthcare systems, but it's not going to be without its challenges.

There's going to be staffing shortages, reimbursement models, and competition from retailers like CVS and Walmart. Which make this a high stakes move. And I'll just add what I love about this story is 25, literally, years ago, I worked at University Medical Center in Las Vegas, and we had urgent cares, we had 14 of them throughout the city, and it was like this groundbreaking idea, and something the community had never seen before.

And I'm versus staffing and planning for the urgent care model. And it really truly was something that allowed us to reduce emergency strain, create new entry points into the healthcare system and became a model that I'd like to say probably started in. The path to many organizations doing this because then it also creates that stickiness factor to your organization.

So I love that it's something we're literally continuing to talk about and refine 25 years later. Yeah, that's hard to believe 25 years. It's something that makes a lot of sense. Urgent care centers. Certainly address a need, but let's talk specifically about why health care systems are doubling down on urgent care centers to a degree.

It's always been about access, cost and competition. So consider the urgent care. That fills a major gap in same day, non emergency care. So instead of patients going to an EED for minor injuries or illnesses, they have an alternative that's faster and less expensive. This is when it first came out, way before you had the telemedicine option for sure.

And plus, from a financial standpoint, Health system CD centers as referral hubs. So a patient could come in with a primary care need and be guided toward a specific specialist for care within the same system. So it's a big opportunity to reduce leakage as well. It is. And from a personal standpoint, my husband is on the first aid squad.

And there are so many times when there are people who go to the ER and they still have to tell people go to urgent care in some certain. Start in some circumstances. It just makes more sense. So yeah, I can see why that partnership factors in. And so we're So this is also a direct response to competition, right?

We're seeing retailers, insurers, and independent urgent care. Start that again. We're seeing retailers, insurers, and independent urgent care operators aggressively expanding their footprint in this space. What are your thoughts on that? Oh, exactly. Because health systems don't want to lose their patient interactions to competitors.

So if a patient chooses CVS for minor care needs, they're more likely to stick with their ecosystem for follow ups, prescriptions, other services. Hospitals are realizing they need to be in the space to remain relevant. And the other thing too, is if you go to an urgent care and you need to be at an ED, They will coordinate that transfer for you, so it's not like you've hit an urgent care and you're super sick and now you have to drive yourself to an ED.

They're going to coordinate your transfer to an ED, whether that's have an ambulance come get you or ensure you have a safe way to get there. And then again, you're staying within their system, but they're also evaluating the acuity of your needs so that you get the right level of care. And it's not just, and it's not just the hospitals it's not just coming under the hospital systems, but from a health IT perspective, integrating urgent care centers into a hospital system is complicated.

It goes beyond just buying the buildings and buying the space. So what are some of the biggest challenges CIOs face in making this work? It's always been interoperability is the biggest challenge because making sure that Electronic health records of these urgent care centers sync with the hospital's existing infrastructure.

So many of these centers use different EHR vendors and merging data between systems can still be a logistical nightmare. And then that factors into care continuity and, what it takes to keep that up. Yes. If a patient visits an urgent care center on Monday and then sees a specialist on Friday, their provider needs immediate access to the details from that first visit.

Otherwise, we are going to reduce, start over. Otherwise, we risk redundant tests, misdiagnoses, and inefficiencies that frustrate the patient and the clinician. So the million dollar question, because interoperability comes up all the time, as it should, what do CIOs do about this? How do they tackle that? I love that we've had so many ways to get better about this over the years.

So the best approach now is either mitigating, the best approach now is either migrating all acquired urgent care centers onto a health systems EHR or building a robust, or building a robust interoperability framework. Investing in fire based APIs, cloud based data exchanges, and patient portals that aggregate records across different sites is crucial.

And to do all this, you need people, you need good, you need top talent. And staffing is obviously one of the issues that comes up with this as. With so many others, so we know that the U. S. is facing a massive healthcare workforce shortage, especially in primary and urgent care, and how does this impact the urgent care expansion?

It's a huge issue that comes up in just about every conversation we have with our community today. Many of these urgent care centers rely on nurse practitioners. And physician assistants due to the shortage of primary care physicians. So health systems have to be really strategic in recruitment, training, and even, as previously discussed, the now available telemedicine integration to bridge some of these gaps.

And we'd be remiss if we didn't talk about burnout, which we know is at an all time high among health care providers. Are we just adding more strain to an already stretched workforce? It's a valid concern, Kate, because if urgent care centers are overbooked and understaffed, it can lead to a high turnover rate.

And health systems need to implement scheduling tools and potentially AI driven patient triaging and workplace culture initiatives to retain top talent. You and I have discussed mentoring programs that need to be humbled and need to be curious and creative in solving some of these challenges. And what's really interesting about urgent care centers is.

There are basically many eds with, the whole aspect of a primary care office mixed in the pace of that work is tremendous. And so you've got to think about ways to have the staff have that continuity of care that is commensurate with. Feeling like they're visiting their PCP in that space because you're already scared as a patient.

You're already sick. You're not sure what's going on. You hope you went to the right site of care for what you need in that moment. And that place needs to operate as if it's a finely tuned machine. If you have constant turnover, that is just not going to happen. Yeah, I like what you said about it should feel like the PCP because I think that's something that's been missing.

And as we've gone through this topic, there is so much that needs to happen. This is not easy, but all things considered, do you think more health systems will follow suit and invest in urgent care centers? I do, and there's going to be some caveats. So not every health system has the financial bandwidth to compete in this space.

It is a significant investment, not just in real estate, but in IT staffing and operational support. And that's why we're seeing larger systems like HCA leading the charge. And what about the competition from nontraditional providers, whether it's Amazon, CVS, Walgreens, and even private equity backed urgent care chains?

You and I covered PE ownership a couple weeks ago, and that's where things get interesting. So if these retail giants continue expanding their healthcare footprint, traditional hospital systems will have to get creative, whether that's leveraging virtual care. Building strong patient loyalty programs and even forming partnerships with insurers to maintain a competitive edge.

I'm the first one to tell you, I go to CVS for all my vaccinations because it's, I can walk. It's really, it's down the street, literally. And then I have to share that information with my primary care physician so that he knows I already have my annual vaccinations. I do the same, and I think that we're not outliers there.

So it's clear that urgent care centers are becoming an essential piece of the health care puzzle, but there's still a lot of work to be done. So as a health care leader, what are your thoughts? We want to know, does your organization see urgent care as a growth opportunity, or are the risks too great? And if you're in a health care IT leadership role, how are you handling the challenges of integrating urgent care centers into your system?

This, like so many issues we talk about, is what we in the biz like to call a developing story. More to come on this, I'm sure. Remember to share this podcast with a friend or colleague. Use it as a foundation for daily or weekly discussions on the topics that are relevant to you and the industry. They can subscribe wherever you listen to podcasts.

Sarah, thank you as always for your input, and thank you for listening. That's a wrap.