Katie Schugel isn’t so worried about COVID-19 that she’s afraid to walk into her obstetrician’s office.
Even so, Schugel appreciated the chance to avoid a medical office building — where patients from a variety of clinics walk the halls and push elevator buttons — in favor of a simple prenatal visit while sitting in her car.
“The thought of less exposure eases your mind,” Schugel, 37, of Lakeville, said before driving in for curbside care earlier this month at OBGYN Specialists in Burnsville.
“We sort of took a cue from the retail and the restaurant services,” said Dr. Regina Cho, an obstetrician at the clinic. “We’re offering as much of the personal touch as we can, while still trying to offer that extra layer of protection.”
Clinics across the Twin Cities are experimenting with drive-through medicine to better reach patients when many are staying away due to concerns about COVID-19.
Before the novel coronavirus, it was unusual for diagnostic tests to be provided through drive-in clinics. Now, in a span of three months, in-car testing has become commonplace and doctors are trying to extend the concept to everything from immunizations to blood pressure checks.
The pandemic has fast-tracked innovations that health care providers say they already were considering as part of the never-ending struggle to make health care more consumer friendly. COVID-19 forced the issue by presenting clinics with a difficult reality: Worried patients are staying away. “I think people are still going to be nervous about going into any kind of health care provider facility,” Allan Baumgarten, an independent health care analyst in St. Louis Park, said.
“These health systems, these providers need to try a lot of different things,” he said. “The biggest example is the surge of telemedicine, the virtual visits.”
Minneapolis-based Allina Health System said in a filing with bondholders this month that 60% of all scheduled clinic visits now occur through secure online video visits — 5,000 per day now compared with just 150 per day before the pandemic.
During March and April, Fairview Health System hosted more than 26,000 visits to its OnCare program for online diagnosis and treatment of minor ailments. That’s more than triple the 7,000 visits in all of 2019.
Through its M Health Fairview brand, the Minneapolis-based health system launched last month a stand-alone lab just for high-risk patients who are particularly vulnerable to COVID-19. Now, there’s also in-car care for patients seeking immunizations, blood pressure checks and certain medication injections.
“A lot of people are just afraid to come to care,” said Todd Gilbertson, director of laboratory services.
Fairview moved quickly in March to create drive-through COVID-19 testing, so patients wouldn’t have to come inside clinics and caregivers could conserve personal protective equipment. Last month, the health system started offering drive-up care at clinics in Woodbury and Brooklyn Park.
Patients drive into a big tent and park. Depending on the service, they stay seated behind the wheel or take a nearby chair.
“We actually have some safety procedures in place to ensure your car is turned off — that’s part of our process,” said Michelle Stevens-Brioschi, vice president of primary care.
The tent provides privacy — perhaps more than a typical office visit, since patients don’t see one another in the waiting room, said Dr. Jeffrey Norman, a physician who is vice president of medical practice for primary care. Patients seem to like it, including one who drove in for services unannounced and was redirected to the nearby clinic, because drive-in care requires an appointment.
Curbside care and other changes are simply a reaction to the moment.
“There’s a lot of fear all over the board right now, for a lot of different reasons around COVID,” Norman said.
But some changes could stick, he added, because they’ve already overcome barriers that often block new ideas.
“Medicine is very change-averse in my experience,” he said.
In March, Children’s Minnesota reworked its network of 12 primary-care clinics to designate one office as the place to go with sick kids and four others dedicated to “well” visits, such as children who simply need immunizations. Other offices split the day into distinct periods for well and sick visits, said Dr. Gigi Chawla, chief of general pediatrics at Children’s Minnesota.
Last month, the clinics for healthy patients started offering appointments for drive-up vaccinations. Pediatricians are doing everything possible, Chawla said, to help children stay current on vaccinations, because immunizations are being missed with COVID-19.
“I think it does offer some families a sense of security to remain in their personal space — in their car,” Chawla said. Another factor: “Toddlers touch everything.”
The pandemic “has caused all of us to essentially reinvent health care and question every central dogma that we’ve held about how we do things,” she said.
At OBGYN Specialists in Burnsville, Cho said drive-through checks are only for women with low-risk pregnancies. They take place directly beneath a skyway for protection. Patients recline seats as doctors check vital signs, listen to the fetal heartbeat and offer counseling.
During the course of a woman’s pregnancy, curbside appointments alternate with visits inside the main clinic when patients need an ultrasound or blood work.
When the medical group came up with the idea, they were talking about how to keep patients out of clinics and delay care, Cho said, due to COVID-19 risks.
“But obstetrics is a different field in medicine,” she said. “Patients don’t want to delay care. We don’t feel comfortable delaying care. This was a way they could still receive their prenatal care, but it was in a more flexible way.”
Patients are concerned about exposure to coronavirus, Cho said, and health care providers are worried they might expose patients. For those reasons, curbside care makes sense, she said, even thought it’s an odd sign of the times.
“I never would have imagined we would be offering this service,” Cho said.