Two Healthcare Systems Use Telehealth Kiosks to Expand Reach

Within just a few weeks of each other, NewYork-Presbyterian and BayCare Health System each announced new telehealth kiosk programs with Walgreens and Publix, respectively.

Two health systems are expanding their digital health delivery programs by hosting telehealth kiosks at retail pharmacy locations.

Within just a few weeks of each other, NewYork-Presbyterian and Florida-based BayCare Health System each announced new programs with Walgreens and Publix, respectively, to allow patients to access doctors from those institutions via medical-device equipped, self-service, telehealth kiosks.

Patients can sit down at telehealth kiosks inside the stores and be connected within minutes to board-certified physicians. If a prescription is needed, one can be sent immediately to whatever pharmacy the patient wants.

The kiosks are located in private rooms and are equipped with high-definition cameras and tools such as thermometers, blood pressure cuff, and pulse oximeters.

NewYork-Presbyterian and BayCare already had existing telehealth programs in place, and both view the expansion into retail settings as a way to reach more patients—including ones that are underserved—in places that patients already frequent.

"We want to make healthcare accessible and put in places that our patients … go to on a daily basis," Jeffrey Held, MD, vice president and chief medical officer for BayCare Health System's ambulatory division, tells HealthLeaders Media. "That customer service partnership made sense. People often go to pharmacies to look for simple questions about healthcare."

Building on existing programs

Having well-established virtual medicine programs made it relatively uncomplicated to add kiosks to NewYork-Presbyterian and BayCare's service offerings.

For example, Daniel Barchi, chief information officer at NewYork-Presbyterian, says the first telemedicine kiosks at two Duane Reade locations in Manhattan are simply an extension of the exiting NYP OnDemand suite of digital health services.

"NewYork-Presbyterian has already made significant investments in the infrastructure, physicians, and processes for our NYP OnDemand program and virtual care," he told HealthLeaders Media via email. "Through the addition of the kiosks and the partnership with Walgreens, we are able to offer the service for $99 to patients."

Likewise, BayCare started its telehealth program in June 2016, and installed its first Publix kiosk in December 2017. Held says that for BayCare, the main cost of the program is for the kiosks themselves. Other costs, including bill processing and follow-up calls from telehealth navigators after the visit, are routine for the health system.

"We would have many of those expenses whether we were in Publix or not," he says.

In both cases, the pharmacy is a partner that hosts, rather than operates, the kiosk.

For example, the Walgreens pharmacy team operates like a concierge for the visits, performing tasks such as letting patients into the private rooms, cleaning the rooms and equipment when visits are over, and providing instructions to patients, if needed. Patients can also fill their post-visit prescriptions at any pharmacy they choose, not just Walgreens.

BayCare's four Publix telehealth kiosk sites are also self-service, and Publix staff cleans the rooms, too. Patients swipe a form of ID and a credit card, answer general information, select or type in their symptoms, then access the doctor via the video visit. Instructional videos can help guide patients, although pharmacy staff can provide support if needed.

Strategic partnerships

Both BayCare and NewYork-Presbyterian also had existing relationships with Publix and Walgreens.

"We've had a partnership around pharmacy with NewYork-Presbyterian at their flagship hospital," in the form of an on-site pharmacy, says Patrick H. Carroll, MD, Walgreens' chief medical officer for healthcare clinics and divisional vice president of clinical programs & alliances.

He adds that the kiosks piggyback onto NewYork-Presbyterian's already robust telehealth offerings.

"We're one part of that strategy for them," Carroll says.

For BayCare, the kiosks represent just one of the ways it's working with Publix.

For example, 100 Publix stores also include a BayCare Health Hub (a separate program from the telehealth kiosks) which feature free, interactive screening stations for blood pressure, pulse, body weight, and body mass index.

"It gets us partnering with someone in the community with a great reputation," Held says.

Expanding access

The kiosks are open to everyone and visits are relatively low-cost: $45 for BayCare's visits and $99 for NewYork-Presbyterian's visits. As Held notes, "we really want to keep it affordable."

In addition, BayCare scans telehealth visit summaries into patients' medical records, so if a patient's medical situation changes within 24 hours and the patient needs to visit urgent care, the $45 telehealth payment is deducted from the urgent care bill.

Plus, the built-in devices on the retail kiosks add an additional level of service for telehealth patients.

"While seeing a physician at home through the NYP OnDemand app is very convenient, our Walgreens kiosks have the added benefit of offering medical devices that remotely provide key information to physicians during virtual visits, such as a forehead thermometer that measures temperature with a gentle swipe of the forehead, a blood pressure cuff to measure blood pressure, and a pulse oximeter that measures the amount of oxygen in the body," Barchi says.

Most broadly, expanding telehealth services into retail locations also means that health systems will have a bigger reach.

"There's a big move on the part of health systems to make sure they have a broad, consumer friendly footprint and this could be part of their strategy," Carroll says.

Barchi echoes that.

"We believe that an ability to deliver medical care virtually is key to a continuum of services from preventive and primary care, to subspecialty care and procedures," he says.