New urgent care clinic open inside Safeway in Sonoma

New urgent care clinic offers ‘telehealth’ from inside Safeway|

Questions to ask:

When asked for his opinion on the value of telehealth services, Jack Resneck, Jr, MD, praised the innovation but cautioned patients to beware of low-quality care. He suggested that patients consider:

• Transparency. Who are you seeing? What is their license and training background?

• Level of care coordination. Does the team have access to your entire medical records (not just the intake questionnaire) and even more importantly, will they share the results of your visit and your treatment plan with your regular doctors?

• Evidence-based care. Do the telehealth providers provide evidence-based care? Patients should be able to expect the same standards of care as that provided in a traditional setting.

Resnick is board chair-elect of the American Medical Association and vice-chair of dermatology for UCSF School of Medicine.

“You shouldn’t compromise quality of care for convenience,” he stressed.

When Danielle Crompton’s 4-year-old son woke up late on a Friday night crying because of a painful ear ache, she faced an agonizing wait until Monday for her pediatrician’s office to open.

“In the past, I‘ve taken him to the emergency room, but it is just so expensive,” she said.

Thanks to Sonoma’s new Action Health Urgent Care Clinic, Crompton was able to bring her son in to be seen on a Saturday morning. He didn’t end up having an ear infection, but if he had, she could have had a prescription in hand within the hour, all for a standard office visit fee of $75 – hundreds of dollars less expensive and much faster than an emergency room visit.

Sounds ideal, right?

Well, the reality is a bit more complicated. And how you view the experience will depend on how comfortable you are with technology and the burgeoning concept of “telemedicine.”

Tucked in the back of Safeway, between the pharmacy and the eggs, a new urgent care facility has been quietly seeing patients seven days a week since late last year.

Inside the tiny clinic, patients are typically greeted by a nurse on a computer monitor. Sometimes there is a live nurse in the Sonoma location, as there was the day that Crompton visited, but not on the six times Index-Tribune staff stopped by last week.

A nurse on a large overhead monitor oversees four locations, so patients might have to wait on hold, while the nurse finishes with another patient elsewhere. Brittany, a licensed vocational nurse, walked us through a typical visit.

Whether it is in person or by remote, a “triage” nurse starts by taking down all patient information including the reason for the visit, medical history and insurance information (Action Health accepts all PPOs, most HMOs plans and it accepts Medicare at the Sonoma location).

Then you wait – maybe five minutes or maybe an hour – for one of Action Health’s San Jose-based stable of doctors to be available to connect via video-conferencing. When that physician is ready, the patient is given a punch-in code to enter a private room, and then another code to connect via a monitor to that doctor. Once you are connected, the doctor reviews the notes from the nurse, and you speak with the doctor directly.

Another patient, a local real estate agent, was much less satisfied than Crompton. She made an appointment hoping to get some quick blood work done to test for anemia because she had been feeling run down.

“I had high hopes for the clinic because it really seems like there aren’t enough doctors in Sonoma,” she said. “But it took the nurse forever to check me in because she was helping patients remotely at other clinics and it ended up being two hours before I saw a doctor.” She said that when she “finally” got the go-ahead to have blood drawn, “it took the nurse three pricks to find a vein.”

“Worst of all, three days later I got a message that they hadn’t collected enough blood for any testing to be possible and I still got a bill for $200 for the visit,” she said.

The Medical Board of California hasn’t taken a position on what it more broadly labels “telehealth.” A spokesperson only confirmed that physicians are held to the same standard of care whether they are practicing via telehealth or face-to-face.

So, exactly how did Danielle Crompton’s doctor diagnose an ear infection remotely?

Attached to the “treatment room” monitor is a camera that can see in a child’s ear (or throat) and the doctor can use that image for his or her diagnosis. If a nurse isn’t on site, the patient can even work the camera themselves.

The Action Health promotional materials tout access to urgent care, primary care and specialists – including pediatrics, cardiology, dermatology, gynecology, orthopedics and more, for any patient 18 months or older. It offers a dozen screening tests and a dozen different vaccines as well as physical exams, sports exams and drug testing. Its staff can handle anything short of an emergency room visit, says Action Health CEO Garick Hismatullin.

“Ninety-eight to 99 percent of common conditions can be treated at the clinic,” he said.

The clinic can’t treat deep lacerations that require stitches, so certain injuries (i.e.: a lot of blood) are referred to an emergency room, but Action Health doesn’t have articulated relationships with specific hospitals.

“If a patient needs to head to the hospital, we work with them to figure out where to go based on their insurance,” said spokesperson David Gomez.

Sonoma Valley Hospital doesn’t have any relationship with the company, according to CEO Kelly Mather, and no way of tracking if its patients are referred to the SVH emergency room.

“If our community members use the urgent care clinic and the quality of care is good, then this addition should be positive for healthcare in the Valley,” she said.

Hismatullin, 30, believes that Action Health’s model is unique, valuable and scalable, and its rapid growth supports his claim.

In two short years, the San Jose-based company has opened urgent care clinics inside 40 supermarket and drugstore locations across California and 130 more clinics are set to open here and in Washington state in the next 24 months, according to Hismatullin. Currently, the only other North Bay locations are Novato and Vallejo.

When asked why Action Health decided to open in Sonoma, Hismatullin said that the company uses an internal algorithm to analyze location data.

“Sonoma came up as a great opportunity for our model and we hope to be there a long time,” he said.

Action Health is not affiliated with Safeway, it’s just a tenant, but Safeway spokesperson Wendy Gutshall said that the partnership “enhances” Safeway’s health and wellness offerings and she hinted at potential synergies of products and service.

“With these facilities based in a grocery store, it provides a platform to generate food/dietary recommendations for customers and patients in assisting them in living a healthier life,” she said.

This is not Safeway’s first push into the broader wellness services area. In 2015, the supermarket giant ended its $350 million partnership with the health technology company Theranos. The grocery store chain built wellness centers in about 800 stores, but the relationship dissolved and Theranos has since made front page news having been accused of making false claims to have devised revolutionary blood tests using very small amounts of blood.

But Hismatullin believes that beyond the convenience and the expanded hours of an Action Health Clinic, its unique selling point is its ability to provide on-demand access to 50 different specialties.

“For a parent to be able to access the decision making of a pediatric cardiologist for same day peace of mind, for example, that’s where this gets really special,” he said.

Email Lorna at lorna.sheridan@sonomanews.com.

Questions to ask:

When asked for his opinion on the value of telehealth services, Jack Resneck, Jr, MD, praised the innovation but cautioned patients to beware of low-quality care. He suggested that patients consider:

• Transparency. Who are you seeing? What is their license and training background?

• Level of care coordination. Does the team have access to your entire medical records (not just the intake questionnaire) and even more importantly, will they share the results of your visit and your treatment plan with your regular doctors?

• Evidence-based care. Do the telehealth providers provide evidence-based care? Patients should be able to expect the same standards of care as that provided in a traditional setting.

Resnick is board chair-elect of the American Medical Association and vice-chair of dermatology for UCSF School of Medicine.

“You shouldn’t compromise quality of care for convenience,” he stressed.

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