WIRED.COM — Kaiser Permanente has long relied on a simple strategy of building complete, self-sustaining hospitals—employing 50 doctors or more—in each region it serves. “It’s an efficient model,” says Michele Flanagin, Kaiser’s vice president of delivery systems strategy. “It offers one-stop shopping: pharmacy and radiology and everything you want from health care in one building.” But that approach forces patients who don’t live near a hospital to drive a long way for even the most routine doctor’s appointment.

In 2007, Flanagin and her colleagues wondered what would happen if, instead of building a hospital in a new area, Kaiser just leased space in a strip mall, set up a high tech office, and hired two doctors to staff it. Thanks to the digitization of records, patients could go to this “microclinic” for most of their needs and seamlessly transition to a hospital farther away when necessary. So Flanagin and her team began a series of trials to see what such an office could do. They cut everything they could out of the clinics: no pharmacy, no radiology. They even explored cutting the receptionist in favor of an ATM-like kiosk where patients would check in with their Kaiser card.

What they found is that the system performed very well. Two doctors working out of a microclinic could meet 80% of a typical patient’s needs. With a hi-def video conferencing add-on, members could even link to a nearby hospital for a quick consult with a specialist. Patients would still need to travel to a full-size facility for major trauma, surgery, or access to expensive diagnostic equipment, but those are situations that arise infrequently.

Flanagin believes these clinics will enable Kaiser to add thousands of new members. And they’ll do it for less. The per-member cost at a microclinic is roughly half that of a full Kaiser hospital. The first microclinic is set to open in Hawaii early next year.

MP: Would we get this type of cost-saving innovation under government-run health care?

Originally posted at Carpe Diem.

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