Mike Hennessy, Chairman

In March 2020 the United States was in the early stages of the coronavirus disease 2019 (COVID-19) pandemic. We shut down the entire country and ground the economy to a halt to slow the spread of the virus. Think back to March and how much uncertainty we were living under.

Nine months later, the FDA approved 2 COVID-19 vaccines under emergency authorization. Before New Year’s Day, millions of Americans had received the vaccine, including health care providers and nursing home patients, our most vulnerable citizens.

Nine months. Take a moment to let that sink in.

The mainstream media has crafted a narrative about the COVID-19 pandemic that’s almost entirely negative. For the purpose of ratings, they have described the US response to the pandemic as blundering from 1 mistake to the next. This narrative is false.

There is another way—a more accurate and underappreciate way—to tell the story of the past 9 months. It is a story of heroism, innovation, and precise science, performed under unbelievable pressure.

Let’s not mince words: The US and the world must appreciate the role of the pharmaceutical industry—the investigators, health care providers and business leaders—who are rescuing the world from COVID-19. It’s the medical breakthrough of our lifetime.

Instead of dwelling on why many in the media are ignoring this, let’s review some facts.

Since the discovery of COVID-19, here is what scientists have accomplished: They identified a novel virus; unlocked and sequenced its genetic code; created new therapies to save lives; and developed multiple safe and effective vaccines using messenger RNA technology, a technology hopefully applicable to future vaccine development. Margaret Liu, MD, a biomedical scientist and member of the MJH Life Sciences™ COVID Coalition, called it a breakthrough for mRNA vaccines. 

The United States has 2 vaccines approved for emergency use, 1 from Pfizer/BioNTech and another from Moderna, and the AstraZeneca/Oxford vaccine has been approved for emergency use in the UK. In addition, there are 64 vaccines undergoing clinical trial at the moment, including 20 in phase 3 trials. In the US and throughout the world, the pharmaceutical industry has answered the call and invested heavily in this effort.

This was the fastest vaccine development program in history, and it’s not even close. David Pride, MD, PhD, a microbiologist at the University of California, San Diego, estimates that vaccines typically take 10 to 15 years to develop. Until the COVID-19 pandemic, the fastest development timeline was 4 years, for the mumps vaccine.

Many government systems moved quickly to lessen the burden of onerous regulations and provide funding so that vaccines could be developed quickly but with rigorous standards. Perhaps it should be a lesson to all of us that regulation and innovation can be calibrated more effectively during “normal” times as industry races to develop new therapies for other epidemics—cancer, diabetes, heart disease, and more.

The next step of the process—distribution of the vaccine—will be as challenging as the development phase, if not more so. But again, the pharmaceutical industry is rising to the occasion. Factories worldwide are working overdrive to produce hundreds of millions of vaccine doses.

Less than a month after the Pfizer vaccine was approved, more than 15.4 million doses of vaccine have been distributed throughout the country, and more than 4.6 million individuals have received their first dose, according to CDC data. Many patients are already receiving their second dose.

Although 15.4 million doses are impressive, some expected 20 million doses. But that is moving the goal line, as 6 months ago many observers didn’t think a vaccine would be available until 2021.

Members of our COVID Coalition told us that the holidays slowed the rollout considerably. Nancy Messonnier, MD, a physician with the National Center for Immunization and Respiratory Diseases at the CDC, expects a rapid increase in administered vaccines during the first few days of 2021.

Every day, more people will be vaccinated. After health care workers and our most vulnerable citizens, other frontline workers will be next. Teachers will be vaccinated so our children can return to school. And soon, all Americans will be able to receive the vaccine at their primary care provider’s office or at a local clinic such as those in CVS or Walgreens stores.

Remember, we accomplished this in 9 months, with the help, dedication, and expertise of our pharmaceutical industry heroes. Next time you turn on the TV and see negativity, turn it off and imagine instead where we will be in 9 months.

Articles

The US and the world must appreciate the role of the pharmaceutical industry—the investigators, health care workers, and business leaders—who are rescuing the world from COVID-19. 

How Pharmaceutical Innovation is Saving the World

MinuteClinic recently sealed a deal to allow patients in Ohio to virtually visit Cleveland Clinic clinicians through American Well’s telehealth platform. This partnership is significant because it’s the first time Cleveland Clinic providers will be available to MinuteClinic customers via telemedicine.

To echo the words of American Well Chairman and CEO Ido Schoenberg, MD, “This is the future of telemedicine—or simply, medicine.”

Telemedicine is a perfect union between technology and health care. It has been praised as a cost-effective method for clinicians to examine, diagnose, and manage patients’ medical conditions in a way that transcends time and distance.

As practical evidence that telemedicine isn’t a passing phase but here to stay, MinuteClinic already boasts 1000 locations offering telehealth services in 32 states, and by next year, that number of sites is expected to grow to 1500. Moreover, in a recent

online poll, the majority of our readers believed that more retail clinics should provide telehealth referrals to other clinicians.

Using MinuteClinic’s new partnership with the Cleveland Clinic as an example, here’s how telehealth referrals work in the retail clinic setting. When a MinuteClinic practitioner is seeing a patient and deems it necessary for the patient to consult a primary care clinician at Cleveland Clinic for nonemergency urgent care needs, a virtual visit for this purpose can be arranged in about 5 to 10 minutes during working hours, although the health system is also looking to set up around-the-clock access. Patients can expect to pay about $50 for a mobile consultation, on top of the cost of seeing a MinuteClinic practitioner.

The results of a recent Oliver Wyman survey indicate that the use of telehealth visits has increased from 35% in 2013 to 45% in 2015, while retail clinic use has risen from 15% to 26% in the same 2-year period. Between their flexible scheduling and typically lower costs, telemedicine and retail clinics both have an enormous amount of potential to deliver care to hard-to-reach patient populations and boost patient engagement. Continued efforts to combine these 2 care models could only certify a bright future for the field of medicine.

MinuteClinic recently sealed a deal to allow patients in Ohio to virtually visit Cleveland Clinic clinicians through American Wellâ€™s telehealth platform. 

Telehealth in Retail Clinics Is the Future of Medicine

Because most treatments have been designed with a one-size-fits-all approach, clinicians may see a medication work very well for some patients but not for others. What if there was a better way to identify the best anticoagulant for each atrial fibrillation patient, for instance? Or, as the President pondered in his 2015 State of the Union address, “What if figuring out the right dose of medicine was as simple as taking our temperature?”

Fortunately, data-driven research is accelerating advances in precision medicine to make this a reality. According to the National Institutes of Health (NIH), precision medicine is an innovative approach that takes into account individual differences in a patient’s genes, environment, and lifestyle, thus supplying health care professionals with the tools they need to better predict which treatments will be most effective.

Although some advances in precision medicine have already been made—most notably in the form of routine molecular testing that is guiding cancer treatment&mdash;the practice is not currently used for most diseases, including those commonly treated in retail clinics. That’s where the Precision Medicine Initiative comes into play.

Launched with a more than $200-million earmark in the President’s fiscal year 2016 budget, the Precision Medicine Initiative supports ongoing efforts to build a national cohort of at least 1 million research participants, scale up strategies to identify genomic drivers in cancer, and develop curated databases to support the regulatory structure needed to advance innovation in precision medicine.

Recently, NIH granted the first award under this initiative to Vanderbilt University, in collaboration with Verily, formerly Google Life Sciences, to begin building the largescale research cohort. Simultaneously, NIH is collaborating with the Health Resources and Services Administration to create partnerships with community health centers and expand the initiative’s reach in underserved populations. On the private- sector side, more than 40 health-focused organizations are making commitments that will accelerate precision medicine.

It is only a matter of time before clinicians can provide the right treatment to the right patient at the right time.

Because most treatments have been designed with a one-size-fits-all approach, clinicians may see a medication work very well for some patients but not for others.

The Right Dose of Precision Medicine

As more and more consumers seek care at retail clinics, health systems may want to follow in the footsteps of Advocate Health Care, which is taking ownership of 56 Walgreens Healthcare Clinics across the Chicago area in May.

This isn’t the first time Walgreens has opted to outsource its retail clinic operations to a traditional health system. Last August, the drugstore chain announced a deal to open 25 new in-store retail clinics in Oregon and Washington State that will be owned and staffed by Providence Health & Services, the third-largest not-for-profit health system in the United States.

Historically, Walgreens and other retail pharmacy chains have staffed their clinics with their own employees, nurse practitioners, and physician assistants. The new health system-staffed model, however, seemingly allows drugstore chains to streamline their retail clinic operations and cut costs.

In addition to cutting costs, this approach helps establish and maintain a coordinated care continuum for patients and their providers, which is key as major health insurance plans such as United Healthcare and Aetna shift from the traditional fee-for-service model to value-based reimbursement under the Affordable Care Act (ACA).

Better coordination between retail clinics and health systems could also translate to more timely treatment and referrals for conditions such as gastroesophageal reflux disease (GERD) and other potentially problematic digestive health disorders—which is exactly what this issue of

is all about. The associated articles in this issue include “GERD in the Retail Clinic: When to Treat and When to Refer,” “Best Approaches to Acute Gastroenteritis,” “Counseling Pearls for IBS Patients,” and “PPIs and Antacids: How to Avoid Interactions.”

On a business note, don’t miss the article “How Retail Clinics Can Capture Newly Insured Patients,” which describes the retail health implications of health care coverage expansion through the ACA’s third open enrollment period that ended on January 31, 2016.

As more and more consumers seek care at retail clinics, health systems may want to follow in the footsteps of Advocate Health Care, which is taking ownership of 56 Walgreens Healthcare Clinics across the Chicago area in May. 

Will More Retail Clinic Ownership Shift to Health Systems?

When retail-based clinics first appeared on the health care landscape, they offered a limited scope of services, mostly treating seasonal conditions such as cough, cold, and the flu. Today, the nurse practitioners and physician assistants staffing retail clinics continue to provide this acute care, but in some cases, they are also managing chronic conditions like hypertension.

This expansion of clinical services is just one factor driving rapid growth in the retail clinic footprint, which is expected to reach 2150 clinics by the end of this month and surge to 2805 by 2017. Other factors that continue to have a profound impact on retail clinics’ profitability and will serve as key drivers of future expansion in this space are investments in integrated electronic health record (EHR) technology and partnerships with other health care players to grow patient volume.

The 2 largest providers of retail clinics, MinuteClinic and Walgreens Healthcare Clinic, are both implementing Epic’s state-of-the-industry Care Everywhere platform. This robust EHR network will securely interconnect their retail clinics and practitioners with other health care organizations and even health information exchanges to share patient medication lists, as well as assist with medication reconciliation during clinic visits.

MinuteClinic chief medical officer Nancy J. Gagliano, MD, noted that the customization and data analytics capabilities of the Care Everywhere network will allow MinuteClinic to build workflow rules that will streamline the work of its retail clinicians, who follow tight clinical guidelines.

Enhanced EHR platforms also present an opportunity for the nurse practitioners and physician assistants working in retail clinics, as they stand on the front line of navigating the Affordable Care Act and have a mandate to provide high-quality, streamlined care. Taking these growth factors into account, new projections show that retail clinics will add capacity for 25 million patient visits in 2017—significantly up from 16 million a year ago.

, we are providing the latest clinical updates across acute, chronic, and preventive care to help our readers make each and every one of these patient visits a clinical and commercial success.

Today, the nurse practitioners and physician assistants staffing retail clinics provide acute care and manage chronic conditions.

From the Chairman: Retail Clinic Growth Shows No Signs of Slowing

Because of its affordability and accessibility, the retail-based clinic is starting to replace the primary care physician for many Americans. As a result, the nurse practitioners and physician assistants who staff these clinics are providing treatment for more than just acute conditions. Chronic conditions such as asthma, high blood pressure, and diabetes are now being treated in the retail clinic. With nearly 29 million individuals living with diabetes in the United States, many Americans will visit a retail clinic for treatment of their disease. At Intellisphere, we are committed to providing research and information the retail health care providers can utilize to help attack this global health care crisis.

, our newest publication, we are providing the latest clinical updates on focused therapeutic areas as they relate to providing patient care in the convenient care setting. As an entrepreneur, I want to call your attention to the newest section in the journal: “Business Focus: Build Your Practice.” In this issue, we provide important information on the ICD-9 to ICD-10 transition. You may be wondering what this has to do with diabetes, and I can sum it up for you in one word: data.

The newest update to the International Classification of Diseases will provide for more specific codes and aid health care providers in following epidemics, such as the Ebola outbreak, to help establish a common language across all networks. Patients with chronic diseases such as diabetes need to ensure that all aspects of care are met, and therefore, a collaborative care model is not only beneficial, it is necessary to treat the disease. A common language is a necessary component to this model.

We are not alone in thinking that data are essential. Recently, CVS Health announced that it is partnering with IBM to use supercomputer Watson to aid in chronic disease management by providing more data on patients “to identify subtle signals of disease progression that allow us to intervene in a more timely fashion and prevent poor outcomes.” CVS Health isn’t the only one interested in capitalizing on more data to improve patient outcomes with diabetes. Pharmaceutical giant Sanofi recently partnered with Google to harness the power of Google’s electronics and analytics capabilities to collect and analyze data like blood glucose and glycated hemoglobin levels.

As we make this transition and start to harness data more effectively, the way we look at treating patients will evolve. As the leading provider in health care education, we will be providing our readers with information every step of the way.