South

Hospitals branch out in the suburbs with more urgent care centers

Mark Lorenz for The Boston Globe
Medical assistant Jill O'Brien spoke with Dr. Miguel Martinez at Lahey Health Urgent Care in Gloucester.

When Marilyn Nickley, 83, of Abington woke up recently with pain in her abdomen, she called her doctor’s office but was told there weren’t any openings for two months.

So, she called a local urgent care center she had visited previously. After learning she could be seen right away, she got herself a ride and headed there.

“I understand how busy they are,” she said of those in her primary care office.

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For many people looking for non-emergency medical treatment, choices are as close as their local shopping center. Hospitals and other health care providers are striving to bring medical care nearer to where people live, with less cost and wait.

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South Shore Health System plans to partner with Health Express and become connected to its seven urgent cares, from Quincy to Plymouth, by July 1. South Shore Health is also beginning a contract with the town of Weymouth to respond to 911 medical emergencies.

“It’s really designing the care around the community and the patient,’’ said Dr. Gene E. Green, president/CEO at South Shore Health System, which includes South Shore Hospital and South Shore Medical Center, South Shore Visiting Nurse Association, and Hospice of the South Shore. “It’s an exciting time as we continue to try to transform.’’

Lahey Health opened an urgent care center in January in the Gloucester Crossing shopping complex, and will soon establish one in Marketstreet Lynnfield. Another is in Danvers, and more are planned.

Partners Healthcare operates urgent care centers in communities including Medford, Canton, Woburn, and Burlington.

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Dr. Sree Chaguturu, vice president and chief population health officer for Partners, said there are several factors contributing to this paradigm shift. On the demand side, he said, aging baby boomers prefer the convenience and experience of services at home or nearby.

On the supply side, Chaguturu said, technology is allowing for new devices that “don’t need to be tethered to the structure of a hospital.”

For example, Partners is working with Apple to make medical records available soon on iPhones.

Similarly, Beth Israel Deaconess Medical Center is inviting patients to read health care notes that doctors and nurses have written via “OpenNotes” on PatientSite, a secure website that allows patients to help manage their healthcare.

Joseph Restuccia, a professor of healthcare and operations management at Boston University, and a onetime hospital manager, said there has been a push nationally to shift the financial risk to care organizations and make them more accountable for reducing costs.

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“The idea is to keep people out of the hospital, especially as an inpatient, especially in emergency rooms,” he said.

Chaguturu said Partners needs to do more research to determine the effect of urgent care centers on its organization.

“To be frank, we still don’t know if these sites are allowing people to avoid the emergency room or inducing demand because it’s now easier to get care,’’ he said.

Meanwhile, consumers are also frequenting CVS, Walmart, Walgreens and other local and online outlets to get vaccinations and other medical services. Walgreens’ website advertises services such as video chats with doctors “24/7 visits for $49 or less” or “video therapy starting at $99” via MDLive, a “telehealth provider” headquartered in Florida.

“About a quarter of emergency room (ER) visits are not necessary,” writes Dr. Troy Brennan, CVS Health’s executive vice president and chief medical officer in his blog.

He said CVS is working to meet the challenges of affordability and access. “Key to these efforts is bringing affordable, high-quality care closer to home to the people who need it most — namely those patients managing chronic diseases, those who are especially fragile, and those who are transitioning from the hospital to the home or long-term care settings.”

Denis Gallagher, chief operating officer for Lahey Health Primary Care and Community Practices, said the Lahey Health Urgent Care in Gloucester Crossing is meeting patients’ call for convenience and access.

He said there is some concern that healthcare could become fragmented, but said providers are trying to protect against that by using common accessible electronic health records and coordinating with primary care doctors.

He said the location in Lynnfield will also offer speciality services such as cardiology, orthopedics, obstetrics/gynecology, ophthalmology, and dermatology/plastic surgery.

Of the Gloucester location, he said, “It’s exceeding our expectations by a wide margin.”

Debee Tlumacki for The Boston Globe
Physician Assistant Guy Nubar examined Kim Mondeau of Bridgewater at the Health Express in Abington. South Shore Health System plans to partner with Health Express and become connected to its seven urgent cares, from Quincy to Plymouth.

Jean Lang can be reached at jeanmcmillanlang@gmail.com.