National

Drug-store clinics could improve veteran’s health care

Steve Carr volunteers to drive military veterans from Bellingham to the VA Hospital in Seattle.
Steve Carr volunteers to drive military veterans from Bellingham to the VA Hospital in Seattle. eabell@bhamherald.com

When former U.S. Army Reserve Sgt. Christine Poblete comes down with the flu, an ear infection or other common illness, the San Jose resident usually calls the advice nurse at the Veterans Affairs San Jose Clinic or the VA Palo Alto Health Care System, seeking a timely appointment.

But she can never be sure whether it will be that day or the next.

As of this week, Poblete can ring the nurse and decide if she would rather head straight to the nearest of 11 Bay Area CVS Health MinuteClinics for treatment instead.

Some say the MinuteClinic venture could be a template for other MinuteClinic-VA partnerships nationwide.

There, she can get medical care on a timely basis for acute conditions that may not require a visit to a VA facility.

“I like my care at VA, so it’s not like I would stop getting any type of treatment at the VA,” said the 30-year-old ex-military intelligence analyst.

“But in those instances where it is much quicker and more convenient for me to be referred to CVS for a minor illness, that’s what I’d want to do.”

Already well known to CVS customers, MinuteClinics are walk-in clinics open seven days a week in 33 states and Washington, D.C.

They are staffed by nurse practitioners to treat acute illness such as strep throat, ear infections, flu, vaccines, and preventive medicine, among other conditions.

However, unlike everyday customers who can walk in any time, veterans would need to call a VA helpline first, which will refer a veteran to a MinuteClinic. All services are free of charge to veterans, and billed to the VA.

As an added convenience, veterans who get a prescription written during a MinuteClinic visit will be able to fill it at CVS Pharmacy.

“Our concern was for vets who have minor issues but still need to be seen, and it may not be convenient to travel to Palo Alto to get that care,” said Dr. Stephen Ezeji-Okoye, VA Palo Alto’s deputy chief of staff. “Was it possible to offer them another option?”

Enter the one-year pilot program between CVS Health and the VA Palo Alto Health Care System, which both sides believe is the first such venture in the U.S.

Dr. Sarah Russell, chief medical information officer at the VA Palo Alto, asked why the growing popularity of retail health clinics used to treat the general public couldn’t be adapted for veterans.

If it succeeds for 60,000 mostly Bay Area veterans who are enrolled in the VA Palo Alto — but get their services from VA clinics as far away as Modesto, Sonora, and Monterey — some say it could be a template for other MinuteClinic-VA partnerships nationwide.

“MinuteClinics have been around now for 15 years, providing walk-in service within 10 miles for over 50 percent of Americans,” said Dr. Andrew Sussman, an executive of CVS Health and President of MinuteClinic.

“Half of MinuteClinic appointment visits are evenings and weekends,” Sussman said. “At a time when access can be limited, we can help with minor illnesses and injuries.”

Ezeji-Okoye credits Dr. Sarah Russell, chief medical information officer at the VA Palo Alto, for raising the idea after she wondered why the growing popularity of retail health clinics used to treat the general public couldn’t be adapted for veterans.

After studying the notion, the VA Palo Alto issued a request for proposal about 18 months ago and by September had selected CVS Health’s MinuteClinic for the $330,000 winning bid.

Ezeji-Okoye said there wasn’t a lot of competition.

“CVS met the quality and timeliness of care the VA was looking for, and the ability to integrate with the VA’s medical records system,” he said.

The VA Palo Alto, he noted, already gets 100 to 150 calls a day to advice nurses, the first step for all veterans seeking medical care. Those nurses act as triage agents, determining the priority of patients’ treatments based on the severity of their condition.

Ezeji-Okoye said he estimates 30 percent to 40 percent of the veterans calling the VA Palo Alto may have health issues that could be addressed by the MinuteClinics.

In 2014, the VA started Veterans Choice, which allows veterans to receive health care from a non-VA health care provider in their community.

“It aligns with the VA mission to make sure that vets are able to get timely access to care,” he said. “And also to make sure that it’s the right care, at the right time, in the right place.”

Many veterans, however, may scoff at that notion after enduring egregious wait times for medical care from the VA; investigations later revealed some VA employees had covered-up months-long wait times.

By March 2013, the national backlog had ballooned to more than 600,000 claims (a backlogged claim is one that has been waiting more than 125 days for a decision on whether an injury or illness is service-connected and warrants compensation).

The scandal ultimately led to the resignation two years ago of Eric K. Shinseki as secretary of Veterans Affairs.

In 2014, the VA started Veterans Choice, a program for veterans who suffered unacceptable waiting times for necessary medical care, or for whom a regular VA medical facility is inaccessible. That program allows veterans to receive health care from a non-VA health care provider in their community.

The new MinuteClinic venture is not related to Veteran’s Choice, but because it will divert lower-level health issues from VA hospitals and clinics, could relieve wait times for more serious medical problems, said Damian McGee, spokesman for the VA Palo Alto.

The Northern California initiative is being publicized via social media, posters, fliers, as well as the VA staff, alerting veterans whenever they call in to make appointments.

“It’s not a solution for everything,” Ezeji-Okoye said, “but for things where it could be a solution, it’s wonderful to give that option — that choice — to the veterans.”

  Comments