Urgent Care Reinvented: Eliminating Handoffs with Clinical Concierge and Lean Design
Introduction: Urgent Care’s Tipping Point
Urgent care in the U.S. is at a crossroads. Patient expectations have soared, staffing is volatile, and traditional “assembly line” models are buckling under demand. The industry’s average door-to-door visit time hovers near an hour hardly consumer-friendly when retail and tech sectors have trained Americans to expect speed, convenience, and personalization. But what if urgent care could reliably deliver a five-star experience in half the time, without sacrificing quality or compliance?
Enter Brandon J. Robertson, founder & president of UCP Merchant Medicine and Intellivisit Solutions, whose “clinical concierge” approach and data-driven lean design are upending decades-old workflows. In a recent interview, Brandon outlined not only how his team has cut door-to-door times in half, but why eliminating handoffs and embedding AI-driven protocols at the front lines are key to the urgent care revolution. Below, we break down the conversation, answer executive-level questions, and pull practical lessons for leaders navigating the future of on-demand care.
What Inspired the Reinvention of Urgent Care?
Robertson’s journey from Johns Hopkins finance intern to urgent care disruptor was shaped by firsthand experience with bottlenecks and waste.
Asked what led him to focus on this niche, Brandon explained: “So when I was at Johns Hopkins, I had the opportunity to learn about how finance and healthcare actually work. … I didn’t understand the revenue cycle, and rate regulation is a nightmare unto itself.”
But the real turning point came during his administrative fellowship, where he realized, “I got into urgent care at AdventHealth in Florida. That’s where I started to figure out why I love consumer-centric retail medicine models and how to make the experience just better.”
The insight: Healthcare’s “provider bottleneck” isn’t a criticism. It is a solvable design challenge. Robertson saw that eliminating unnecessary steps and handoffs could fundamentally transform speed, satisfaction, and outcomes.
How Do Clinical Concierge and Lean Design Slash Door-to-Door Time?
Clinical concierge and lean, Six Sigma-driven workflows reduce urgent care visit time from a U.S. average of 58–68 minutes to as low as 28 minutes.
To answer directly: This is accomplished by radically streamlining patient flow and embedding diagnostic and administrative tasks into a single role, guided by AI and standing orders. Robertson details: “We rewired the whole process. There’s a person that greets you at the door—they’re called the clinical concierge… I register you, I collect your payment, I run all your insurance, I do your vitals, I ask you a series of AI-assisted medical interview questions… all the tests are run in the room.”
Here’s the typical old workflow:
-Registration (10 minutes)
-Wait/handoff (7 minutes)
-Rooming/vitals (5 minutes)
-Wait/handoff (7 minutes)
-Provider visit (10 minutes)
-Provider orders tests, more handoffs/waits (7+ minutes)
-Discharge (5 minutes)
Total: approximately 58–68 minutes (with 30–40 minutes spent just waiting between handoffs).
Robertson’s “clinical concierge” model:
One person handles registration, payment, insurance, vitals, history, and most testing—with AI recommending diagnostics based on standing orders.
The provider enters once, reviews AI-compiled findings and documentation, confirms or adjusts the plan, and signs off.
No redundant handoffs; no waiting between steps.
As Robertson puts it: “All these little handoff times have gone away. … When you chop all that down, you end up reducing from 58 minutes down to 28 minutes.”
Key takeaways:
-Each “handoff” adds about 7 minutes on average.
-Cutting handoffs slashes wasted time, cognitive load, and errors.
-Door-to-door time is halved—from a national average of 58 minutes to 28 minutes in the best models.
Why Haven’t Larger Consulting Firms or Health Systems Done This Already?
Despite evidence and ROI, entrenched habits and mental models have kept the “assembly line” urgent care model alive.
Why not sooner? According to Robertson: “If you always heard the Toyota way is the way to do things, then you would think…you would never even try it because you’d think Toyota is the way to do it. The reality is assembly line models are fantastic if you’re going to make 2 million of exactly the same car. … If you’re trying to be hyper-efficient at seeing one unique case at a time, you’ve got to do it more like Rolls Royce.”
Barriers have included:
-Reluctance to challenge accepted process-improvement dogma (“batching” vs. “single-piece flow”).
-Lack of integrated IT systems and AI-driven decision support.
-Inertia: “We’ve always done it this way.”
-Skepticism about cross-training and role expansion.
The inflection point: As AI and EMR integration matured, standing orders could finally be executed accurately and compliantly at scale, removing the last operational and clinical hurdle.
How Does AI-Powered Clinical Decision Support Change the Game?
AI enables standing orders to be executed consistently, safely, and efficiently, transforming care team roles and compliance.
Robertson is blunt about the limitations before AI: “Before we built the AI platform, we were using basically human memories to figure out when it would or would not make sense. … We found out that they were only doing it in about 4% of appropriate cases.”
Now, with AI:
-Clinical concierges get real-time prompts (for example, “Run a strep test if CENTOR score is met”).
-Medical leadership signs off on standing orders—not case by case.
-AI reviews intake answers, SDOH risk, and symptoms, then triggers appropriate diagnostics instantly.
Robertson shares a cautionary tale: “You’ll figure out real fast how bad your standing orders actually are when you have AI reminding people on every single case. … We had a client that increased their glucose testing from about two a week to about 30 a day.”
This forces organizations to re-examine sensitivity and specificity, and continually refine protocols—an unexpected but valuable side effect.
What Are the Staffing and Productivity Implications?
Clinical concierge models can double provider productivity, improve satisfaction, and shrink clinic square footage by 40 percent, all while maintaining quality.
Direct answer: By redesigning workflow, each provider can now see up to 60 patients a day, supported by three clinical concierges each handling one patient at a time.
Robertson spells it out: “If a provider is going to spend even 10 minutes with a patient, how many 10 minute blocks are there in an hour? Six. So if you have three clinical concierges and one provider…that puts you at a level of basically them seeing somewhere between one and three patients at any given time throughout a 12-hour shift, one patient at a time under the responsibility of each one of those concierge.”
Operational impacts:
-Dramatic reduction in provider “room-hopping” and task-switching.
-Clinics operate profitably at just 15.7 visits per day (versus industry average break-even of approximately 43).
-Average urgent care site size shrinks from 3,500 sq ft to approximately 2,000 sq ft, slashing fixed costs.
This is not theoretical: “Our centers are about 2,000 [square feet] … you can chop that way down because of, again, consolidation of productivity methods.”
Can This Model Work for Both Large Systems and Rural Clinics?
Yes. AI-powered, handoff-free urgent care models are deployed across both multi-hospital giants and single-site rural settings.
Robertson emphasizes scalability: “We’ve used it in the most densely packed urban environments of America to…a location with a population of 5,000 right now. … It’s total ends of the spectrum. All payer mixes, all levels of social determinants of health.”
-Works in multi-state, 30-hospital systems (think CommonSpirit, Advocate Health/Atrium Health).
-Already operating in rural clinics with as few as 5,000 residents.
-AI normalizes intake, testing, and risk assessment—regardless of geography or patient mix.
Bonus: AI can highlight SDOH needs and ensure unbiased, guideline-concordant care, helping underserved populations get the right tests and referrals.
Why Invest in Urgent Care Instead of Primary Care or the ED?
Urgent care is the “gateway” to long-term patient relationships, especially for healthy, commercially insured patients.
“Urgent care has a very unusual patient population. Specifically, the people that utilize urgent care are healthy people. Health systems are highly adept at connecting with patients that are 65+ or pregnant, but if you don’t fall into those buckets, health systems don’t really have a great way to connect with patients directly,” Robertson explains.
-Urgent care is often the only “touch point” for young adults, families, and university students.
-Profitability: Primary care usually runs at a loss; urgent care can break even at low volume and drive margin.
-Each visit becomes a “primer” for future health system loyalty.
-Downstream value is enormous:
ROI is measured in three phases:
- Income statement: Immediate profitability by right-sizing sites and workflow.
- Downstream referrals: Specialty care, imaging, surgery, etc.
- Lifetime value: Multi-year NPV based on capturing young, healthy patients who later require complex care.
How Does the Implementation Process Work for Health Systems?
UCP Merchant Medicine customizes urgent care transformation “soup to nuts”—from strategy to site selection, rollout, and ongoing support.
Robertson lays it out: “We get brought in to do things soup to nuts. So we start all the way from ‘what is the purpose of urgent care? Why are you doing this?’ … Then we figure out markets, do site selection, design the model, build it for every health system partner, roll it out, and then we teach them how to run it and step away.”
Key steps include:
- Define the strategic purpose for urgent care in the system.
- Market prioritization and data-driven site selection.
- Model customization based on local strengths, needs, and patient mix.
- Operational rollout, staff training, and real-time performance metrics.
- Handoff and ongoing support for optimization.
What Leadership Skills Are Needed to Build Transformative Systems?
Robertson credits “individualization”—the ability to quickly identify and nurture top talent—as his core leadership strength.
He’s matter-of-fact: “I’m not saying I have such a superpower, but what I am good at is I reliably pick the best people and it doesn’t take a lot of time for me to engage with somebody to figure out whether or not they’re a rockstar.”
He continues: “This individualization…has allowed me to have just great people—the best people that know exactly what they’re doing, and as such, they’ve been able to build a lot of capabilities within our organization, which have allowed us to achieve key performance indicators that no one else achieves.”
For leaders looking to replicate these results:
-Invest in team selection, not just process.
-Cross-train staff for multi-functional roles.
-Cultivate a culture that adapts, iterates, and measures relentlessly.
Takeaway: The Path Forward for Urgent Care Leaders
The reinvention of urgent care is not theoretical. Robertson’s team has proven that eliminating handoffs, embedding clinical concierge roles, and leveraging AI can halve visit times, delight patients, and drive new ROI for health systems. But success is not just about technology or process. It is about rethinking assumptions, breaking away from batch-process dogma, and investing in people who can deliver on the promise of healthcare’s next chapter.
Actionable Insight: If you are a health system executive, challenge your team to map every handoff, measure every wait, and pilot a clinical concierge model—even in a single site. The results will speak for themselves: shorter visits, higher Net Promoter Scores, less staff burnout, and a real competitive edge in America’s changing care landscape.
“We get to have massive impact. It’s just so much fun. We’re at the best time.” – Brandon J. Robertson
Want to hear more from leaders transforming healthcare delivery? Subscribe to The American Journal of Healthcare Strategy for fresh stories, evidence, and strategies every week.
