Issue link: https://beckershealthcare.uberflip.com/i/1255100
32 PATIENT EXPERIENCE Walmart health clinics will drive 'consumer revolution,' former Apple CEO says By Jackie Drees W ith the promise of low prices and convenient point-of-care delivery, Walmart's standalone health centers are set to create a "consumer revolution" in healthcare, according to former Apple CEO John Sculley. Since September 2019, Walmart has expanded its footprint in the primary care market, opening two standalone health clinics in Dallas, Ga., and Calhoun, Ga. The clinics offer vari- ous services, including primary care, urgent care, labs, X-rays and dental. "We're going to have a consumer revolution in retail for point of care," Mr. Sculley on Feb. 26 told CNBC Make It. "Why? Because if the Walmart tests are successful, and I suspect they will be, people will be able to go in and get these kinds of health services at a lower cost than if they had health insurance." Walmart Health's website says the clinics offer "quality med- ical care at low prices you'll love – no insurance required." Patients can have a medical checkup done for $30, a teeth cleaning for $25 and mental health consultations for $1 a minute, without insurance, according to the report. Other retail giants are following Walmart's lead, Mr. Sculley said. CVS, Walgreens and BestBuy have all launched care delivery strategies, and CVS has more than 1,300 Minute- Clinics for urgent care within its stores across the country. Mr. Sculley served as Apple's CEO from 1983-1993 and currently is chairman of RxAdvance, a pharmacy benefit management company. The retail giant also plans to open two more of the stand- alone health clinics this summer. n members by Zoom to sit in a virtual vigil as their loved one with COVID-19 was dying. In another, we were able to reunite a patient with her incarcerated son on Zoom before she died. Standard practice is that we have any patient connect with their family by phone or Zoom before they are placed on ventilators. We are also doing everything we can to allow visitors for end-of-life sit- uations. We try to bring visitors in one at a time as safely as possible. Our team is so busy and overwhelmed trying to care for people, so we also want to be mindful of the balance between bringing visitors in and safeguarding clinicians' well-being. Jeanne Wirpsa, research chaplain for the department of spiritual care and education and program manager and clinical ethicist for the department of medical ethics at Northwestern Memorial Hospital in Chicago: e hardest thing is shiing to this new framework and really understanding why we have the visitor restrictions in place as we do. We need to make sure staff and the public at large understand restrictions are not meant in any way to be punitive toward families because we are afraid of them — it has to do with protecting the most vulnerable patients in our care. e visitor restrictions for COVID-19 and all patients are grounded in the moral obligation we have to protect as many lives as possible. e only way we can do that is social distancing and stopping the traffic of people through healthcare institutions. We don't know what exposure people have had in the real world [to the virus]. Patients are alone right now, and their anxiety is heightened. How do we help mediate that family presence to their loved one in the hospital, even when they can't be present? Our support services have been collaborating to make sure patients who are alone receive more virtual or in-person visits from chaplains, social workers and other members of the healthcare team. When they can't enter the room of a COVID-19 patient — because we're trying to limit the use of PPE — they interact outside the door or Skype the patient to provide that virtual presence in lieu of physical touch. Patients and families have been grateful for the efforts we have taken to use technology to communicate. I've heard from our bedside staff, patients and families about the difference it makes to have someone pick up the phone and hold it to the patient's ear so they can hear the voice of their loved one. Our institution has also expanded the capabil- ities of our VRI interpreter machines so they have Zoom or FaceTime for family consults. We have purchased iPads for isolation units so they can remain in the patient's room and not have to be shared. Some of our nurses actually purchased or brought in chargers for patients' phones, which are easy to forget when leaving home for the hospital. Patient engagement services, patient relations, social workers, chap- lains and volunteer services have also combined their efforts to address the gap in the physical presence of family members at the bedside. e truth is none of the virtual technology replaces being able to be at the bedside, and I think we have to be honest about that. We are so used to being with our loved ones — seeing them, being able to whisper in their ear and say things in real time. It's hard to appreciate the level of suffering it causes to families when they can't have that in the flesh. But the risk we face if we don't limit exposure far outweighs that need. Some things we have suggested to families is to wear a piece of their clothing or sit in their loved one's favorite chair [when communicating virtually]. One thing that's really important doesn't relate so much to our visitor restriction policy, but has to do with the lack of family at the bedside. When somebody comes into the ER or is admitted to the general med floor with COVID-19, it is important that we know who they trust to make decisions for them. If they have any advanced directives, it's important we have those in our possession or at least know what they say. We have a conversation fairly early on with decision-makers, as we're seeing that breathing can quickly deterio- rate and patients need support from mechanical ventilation. Before that happens, how do we plan for what patients want their loved ones to know and things they need to say to them? "I've lived a really good life. I'm 75 and I will be okay, and I know you will be okay if I'm one of those people who gets really sick and doesn't make it out of this." We have been proactive in ensuring people know who they want identi- fied as their decision-maker so we don't have conflicts at the moment of crisis. at has been critically important. n