Medical workers develop business to reduce ER visits

[Ridryder 911]

http://newsok.com/article/3213744/1204955530

I posted the link, but I believe one has to sign up. A little background on the physician. He is a progressive EMS medical director and entrepreneur-owning Minor ER Clinics, strip malls, banks, etc. Very well known ER Doc and businessman.

'Two medical workers co-found business that helps people regain health without visiting an emergency room

by Jim Stafford

Business Writer

It is an all-too-familiar scenario. Someone develops a high fever late at night. They need medical treatment, so they show up at a hospital emergency room — and the long wait begins.

After suffering for hours with others just as ill in the crowded waiting room, the patient is finally seen by a physician. The cost in terms of time and expense is high.

So is the frustration level.

"When hospitals get full, there is no place for an admitted patient to go, so they frequently get stuck in the emergency room for an extended length of time,” said Dr. Dan Donnell, who is emergency room director at Midwest Regional Medical Center in Midwest City.

Donnell has co-founded a business that might relieve some of that emergency room congestion. It is called House Calls Instead, which pretty well sums up the mission of the new business.

House Calls Instead is sort of a throwback to another era in which doctors routinely made house calls, carrying a black bag of medical equipment to patients' homes.

Donnell's partner in the venture is Eileen Ravella, a physician assistant who also works in the Midwest Regional emergency room. Donnell is company president; Ravella, a former Oklahoma physician assistant of the year, is vice president.

The pair began to develop their concept of a house call-based medical business in July and launched the venture last week. The idea was germinated in the busy emergency room environment, Ravella said.

"We are allowing you to have more convenience. We're going to save you some time, because your time is worth something,” Ravella said. "If you are sitting in an emergency room or urgent care office for two or three hours, your time is worth something. I think it's a pretty good deal to come to you.

"You don't even have to get out of your pajamas.”

The company will accept Medicare patients, too. But like other patients with insurance, Medicare recipients will have to file their own forms.

House Calls Instead is not in competition with patients' primary physicians, Donnell said. In fact, the House Calls' staff will file follow-up reports with patients' family doctors.

"Obviously, if they can see their primary care physician, they will,” Donnell said.

House Calls Instead staff is available for home or office visits from 8 a.m. to 8 p.m., Ravella said. The founders anticipate many of their patients will be busy workers who can't shake loose from their office or who can't get to see their primary care physician on a same-day basis.

Medical professionals from House Calls Instead can provide injections, strep tests and breathing treatments, and write prescriptions for patients. House Call doctors will follow up with a phone call to the patient the next day, Ravella said.

"Our initial thought is we can probably bring the urgent care center to your house,” Donnell said.

Midwest Regional Chief Executive Officer Doug Arnold said he sees value in a medical business that makes house calls. But it won't make much of an impact on emergency room visits at a hospital that has 65,000 such visits a year.

"There are probably a number of people out there who would really benefit from this,” he said. "It's certainly going to help caregivers when they have a patient they are taking care of that can't easily be moved.

"And then there are people who are just wanting the convenience so they don't have to go to the emergency room.”

House Calls Instead staff will recommend hospital admission to patients if the situation warrants it, Donnell said.

But their first mission is helping patients regain health without the hassle of a marathon emergency room visit.

"What happens is you get a large percentage of people who need to be seen but can't be seen, so they end up getting sicker,” Donnell said. "This is trying to do a pre-emptive strike and trying to keep people out of the emergency room.”

How does it work?

Who is House Calls Instead?

The company has recruited more than a dozen experienced emergency room physicians, physician assistants and nurse practitioners who will travel anywhere in the metro area or as far as Stillwater.

What's the cost?

The business offers home or office calls for $150 by a physician assistant or nurse practitioner, or $250 for a doctor's call.

Will insurers pay?

Most of the patient cost will be recovered though insurance payments, although it will be up to patients to file insurance claims. But the savings in time should motivate many patients to call House Calls Instead, Vice President Eileen Ravella said. "

[spenac]

In with the old but at a much better profit rate. $250 instead of a chicken. Great idea.

[gvandellen]

Sort of sad, The MD gives a treatment, pt clears and they leave, paramedics give a treatment and we have to transport to be cleared. How many CHF patients treated at home by EMS are clear by the time they hit the ER stretcher?

[Ridryder 911]

Ironically, he is a very progressive ER and EMS Doc, probably seen what has been described as EMS "getting the patient better". He is only seeing the light of a 30 minute visit as $250 and the patient costs is cheaper, no wait, the insurance company much rather pay $250 than $800 for an EMS unit and $3000 for an ER bill for the exact same thing.

Now, which do you taking off? EMS advancement with increase in reimbursement, or $250 for visiting Doc.

R/r 911

[JPINFV]

Interesting. My family's old PMD went into a service similar to this where they only took on so many patients and made house calls. Let's just say that it cost a little more than $250 a year and they didn't accept medicare.

[DwayneEMTP]

Hell, 10% of the cost of the ER and I get to sit at home and watch Oprah or soap operas (Or whatever shows are on during the day) while I wait?? And I would imagine they'll come to my work same as home...

SCORE! I think I love this guy....

Dwayne

[Dustdevil]

Most of the patient cost will be recovered though insurance payments, although it will be up to patients to file insurance claims. But the savings in time should motivate many patients to call House Calls Instead, Vice President Eileen Ravella said. "

I'm not sure exactly what this means. Does it mean that they are going to just trust you to file the insurance forms? And if they don't file the forms...? Or if the insurance doesn't pay...? They're not going to collect on-scene? I smell a financial failure in the making.

I also have some misgivings about how this is going to work out for patients. How many people who "just don't feel good" turn out to be having an MI, a bleed, or a dissecting aortic aneurism? How many of those people are going to lose an hour or more of valuable time waiting for a PA to come to their home?

Don't get me wrong. I like the concept. I just see some bugs that need to be worked out.

[DwayneEMTP]

Hell, I was stoked about getting something for my sore throat...

Once again a ton of things I failed to consider...

Dwayne

[spenac]

I'm not sure exactly what this means. Does it mean that they are going to just trust you to file the insurance forms? And if they don't file the forms...? Or if the insurance doesn't pay...? They're not going to collect on-scene? I smell a financial failure in the making.

I also have some misgivings about how this is going to work out for patients. How many people who "just don't feel good" turn out to be having an MI, a bleed, or a dissecting aortic aneurism? How many of those people are going to lose an hour or more of valuable time waiting for a PA to come to their home?

Don't get me wrong. I like the concept. I just see some bugs that need to be worked out.

I'm sure it's cash up front, then you file for refund with your insurance. I was thinking same thing about people waiting when they needed care yesterday.

gvandellen we used to treat and release at my old service. I miss doing that. I hate working for a you call we haul service.

[triemal04]

Hell, I was stoked about getting something for my sore throat...

Once again a ton of things I failed to consider...

Dwayne

Maybe so, but it doesn't change the fact that, if done correctly, this could be a well run service and and great thing for whichever community it serves.

Unless this guy is independently wealthy, or has a lot of backers, I don't think that it will start off where it should be, but, if it's profitable, over time more could be added to it. Get a dedicated billing service contracted; assuming people will do everything on their own is just dumb. Buy and bring plenty of diagnostic equipment to each call; 12lead capable monitors, portable ABG machines, SAO2, etc etc, as well as meds for both prescriptions and acute problems. Contract with a clinic or lab to get bloodwork done as well as x-rays and MRI's (this would actually be easier if they were already associated with a facility that supported this but is still possible). And most importantly, have a way to get these people transported that doesn't utilize 911 ambulances unless it's neccasary.

A lot of people that we take to ER's don't have a severe acute problem; they need to be evaluated by someone who understands medicine and the human body and is able to prescribe them the appropriate meds as needed.