By Karen Kroll
With 70,000 branches nationwide and many banks open to creative ways to use that real estate in a hybrid work environment, can bank branches double as healthcare facilities? For several decades, healthcare providers have offered a limited range of services in grocery and drug stores. Now, add financial institutions to the list of channels for extending healthcare access.
Higi Telehealth-Enabled Smart Health Stations have been installed at several Five Star Bank locations in upstate New York. Customers can link to a live medical professional, learn basic health data immediately and gain more information via mobile app.
The branches selected are in communities with few local health care providers, and where many residents lack ready access to the internet at home. “The bank takes its stewardship of the 48 communities in which it operates seriously,” says Marty Birmingham, Five Star president and CEO. “We want to be a great place to work and a force for good.”
URMC covers much of the western half of New York state, says Michael Hasselberg, chief digital health officer. Because of a lack of clinicians, and the impracticality of maintaining brick-and-mortar locations in every rural area, some residents struggle to easily access healthcare, he adds.
For several decades, healthcare providers have offered a limited range of services in grocery and drug stores.
Now, add financial institutions to the list of channels for extending healthcare access.
Lessons from the pandemic
Like many healthcare providers during the height of the pandemic, URMC turned to telehealth options. “We saw good outcomes with our most vulnerable populations,” Hasselberg says. Many patients gained improved access to care and appointments. As important, they didn’t end up in the emergency room any more often.
At the same time, many of these patients were engaging in telehealth only through the audio service on their phone, and not using video. While many of the communities had decent broadband access, some residents could not afford internet in their homes. And if they used the data plans on their phones, they would quickly hit data limits. Most, however, have unlimited talk, so they would connect via audio. Moreover, the privacy and encryption requirements for the medical field often limit the technology options for patients connecting to telehealth on personal devices.
URMC began thinking of convenient locations within these communities that also would have internet access, such as community centers and libraries, Hasselberg says. While there was some data to show these might be potential options for delivering telehealth services, URMC would probably have to make substantial investments in each location.
Hasselberg and his team also considered retailers, given that many already have pharmacies and are making other forays into healthcare. “But retailers’ primary business is selling products,” Hasselberg says. Allocating even a small portion of a store to telehealth would cut into their revenue.
“As a health system, we asked what’s in a small town?’” Hasselberg says.
The answer: banks.
URMC and Five Star connect
Birmingham serves on the board of URMC. After one board meeting in which Hasselberg discussed the challenges in reaching rural patients, Birmingham told him Five Star has a presence in many areas discussed in the presentation.
“From our perspective, the utilization of branches continues to evolve,” Birmingham says. As it does, Five Star is looking to become a “solution center for the community,” he says. Offering healthcare services in a way that’s convenient for residents would be one more way in which the bank could do this.
Five Star’s focus on community aligned with URMC’s, Hasselberg says. “We said, ‘Let’s give this a try and see if patients are receptive to health care in a bank,’” he says.
To start, URMC did a deeper dive to understand banking. Hasselberg and his team learned that banks are trusted institutions in many towns. “Customers know tellers and feel safe having their money managed there,” he says.
Another early step was identifying branches that could provide healthcare without undergoing a lot of construction. URMC also looked at which banks were in communities that lacked other primary healthcare providers. Their research showed that 75 percent of URMC patients had to travel between 10 and 15 miles to their closest primary care providers, but half were within about three miles of a Five Star bank branch.
Checking egos and experimenting
The project moved forward. As the two entities met, “everyone pulled a chair up to community table and said, ‘Let’s experiment,” Birmingham says. They would adjust and evolve, with a goal of seeing if they could prove the concept.
A willingness to be agile and flexible also has been key to launching this initiative, Birmingham says, noting that both URMC and Five Star are large organizations operating in highly regulated industries. “Everyone needed to check their egos, have an open mind, and deal with the factors that might be natural obstacles,” he says.
URMC team members found mean bank employees found supported the mission of giving back to their community, Hasselberg says. “The bank staff live in these communities and are passionate about them.” Creating access points for healthcare appealed to them.
One concern was the risk of infection. As Hasselberg and his team considered where to locate the healthcare stations within each bank, they looked at ways to minimize this risk. For example, one health station is located on the second floor of the bank and thus somewhat removed from public lobby and client service areas. Some renovation was completed to ensure the spaces comply with the Health Insurance Portability and Accountability Act, Hasselberg says. The health stations self-sanitize with UV lights that kill germs, Hasselberg adds, so the janitorial staff doesn’t need to handle the rooms differently from other areas of the bank.
In addition to URMC, Five Star Bank and Modivcare, the company behind the Higi stations, two other firms are part of the initiative. DexCare provides a virtual on-demand platform. The internet connection is through Verizon’s fixed wireless access. The pilot also received funding from the New York State Health Foundation, the American Heart Association and the Greater Rochester Health Foundation.
The Higi stations measure key health indicators, including patients’ risk for high blood pressure, type 2 diabetes and heart attacks. “The goal is for the stations to handle about 95 percent of what a primary care doctor might do in person,” Hasselberg says.
Building awareness
“As the first health system delivering care through a telehealth solution in a financial institution, we know it will take time to build awareness, interest and utilization,” says Allison Wendorf, URMC director of marketing strategy. URMC is leveraging community partnerships to drive grassroots initiatives, and engaging influencers who can drive word-of-mouth discussions. It’s also using hyper-local media, including both news coverage and paid advertising, and direct-to-consumer mailings to reach people who live near the stations and do not have the ability to connect to telehealth from home, she adds.
Early on, Five Star made the decision to let URMC take the lead in marketing the health stations. “UR Medicine is the unifying and central piece of this unique alliance; their research and focus on meeting the healthcare needs of rural communities in upstate New York was central to bringing Five Star Bank, Higi/Modivcare, DexCare and Verizon Business together to pilot a solution,” Croft says. “UR Medicine’s providers and the care they are delivering through the health stations is the most vital element, making it important that UR Medicine’s voice comes first.”
Five Star Bank has been supporting and promoting the partnership through various digital and in-branch channels, including on its website, through email outreach to customers in the communities, as well as through social media promotion and paid advertising, and via in-branch promotional signage, Croft says. The bank also will be holding community events at the pilot branches, where attendees can see that the machines are in secure, private spaces.
A positive reception
Hasselberg says the team is giving the project six months to prove itself. “It’s part of the mission to get greater access to healthcare,” he says. The goal is to determine if residents use and like the stations, he says, noting that the sample size will be too small to look at patient outcomes in terms of improvements to physical health, and the stations aren’t intended to be revenue generators.
As of March, the reception to the health stations has been “overwhelmingly positive,” Hasselberg says. He adds that he knows of several other health systems that have contacted their state banking associations, expressing interest in similar initiatives. “If this does work, it can be really transformative for healthcare,” he adds.
Similarly, Five Star is open to adding new sites to this effort. “This supports community development,” Birmingham says. “This is what we’re here for.”
Karen Kroll is a frequent contributor to the ABA Banking Journal.
