From the ER to the Reinvented House Call — Why We Started DispatchHealth
Before founding DispatchHealth, I worked as an emergency room physician for over 20 years, managing 64 emergency rooms across the country at one point in my career. As you can imagine, I became extremely familiar with the ER setting and the inner workings of the hospital. My time at the bedside helped me realize both the integral role ER care plays within the medical ecosystem, as well as the inherent shortcomings of our acute care system.
Over time, I began to imagine an alternative care delivery solution that could deliver the elements of the ER setting that were working well, while addressing the areas that were not. After several years of careful research combined with many real-world studies, we built the DispatchHealth model.
How the ER experience influenced my approach
My background as an ER doctor shapes how I approach nearly everything in life. It taught me how to be comfortable working in the context of a minimal data set. In contrast to other medical specialities, ER providers are often required to make very significant decisions without a lot of historical context or information. More frequently than not, ER providers don’t have access to a patient’s complete health record or an adequate understanding of behavior, lifestyle and other social factors. As a result, you learn to read situations very quickly and develop care plans with the greatest chance of success given the lack of complete information.
ER providers become very adept at identifying patterns and then confidently acting on that pattern recognition. Employing quick, sound decision-making under stressful circumstances is perhaps the most critical component of being an ER provider. When we started DispatchHealth, I learned that my time in this setting would also influence my leadership skills. Running a startup is actually a lot like running an ER. You must triage and focus the company on the most important issues at hand. You have to trust your instincts and make decisions when you may not have all of the facts. Ultimately, you must become comfortable making tough decisions and learn to be decisive.
Recognizing what was working in the ER (and what wasn’t)
Emergency rooms are unquestionably essential and the model does get several things right. They offer patients a solution to treat acute injuries, illnesses and other conditions that require immediate in-hospital attention and save countless lives every day as a result. ERs often provide access to specialists when a case requires such care and access to life-saving procedures such as cardiac catheterization.
Despite the immense benefits offered in an ER setting, several issues impact the model’s success. One of the most widespread problems is overcrowding due to an influx of non-urgent patients. Roughly one-third of ER cases are more suitable to be conducted in a lower cost setting, such as with a primary care physician or urgent care facility.
Another obstacle for many patients seeking emergency treatment is the high cost of facility-based care. Depending on the patient’s ailment, a single visit to the ER can result in an enormous, often crippling, medical bill. Inadequate follow-up care, largely due to a lack of integration with longitudinal care providers, is another problem often resulting in readmission and additional health issues. Perhaps one of the largest issues resulting in high recidivism rates is a universal lack of contextual care planning or, in other words, the inability to plan care in the context of the patient’s social situation.
How DispatchHealth is combating issues plaguing emergency care
After witnessing firsthand what didn’t work, I began contemplating what would. We realized the solution was straightforward: offer high acuity care in a lower cost setting. DispatchHealth provides on-demand healthcare in the comfort of a patient’s home, bringing back the house call model — but powered by 21st-century technology.
Capable of treating higher acuity care needs, our providers and technology are able to meet the same standard of care as a typical ER setting. Our solution can handle the bulk of health issues that are complex and urgent, but not life-threatening. For these patients, the model can have transformative effects, offering a faster, cheaper, comfortable and convenient alternative to the ER. In-home care is particularly game-changing for the senior population and those battling chronic illness. In many cases, these patients don’t require acute emergency care, but simply needed better, more personalized and accessible support.
Perhaps one of the strongest advantages of in-home care is that it allows providers to identify and address key social determinants of health for each patient – such as financial challenges, mental health issues, food insecurity, health literacy, transportation and housing access. These issues are taken into consideration when developing treatment plans and then they are communicated to primary care and longitudinal care partners, ultimately improving outcomes. The approach is also highly beneficial for healthcare systems, as personalized, in-home care improves patient satisfaction and treatment success while significantly lowering costs.
Although ERs serve a critical purpose within health systems and communities, the one-size-fits-all system is outdated and consumers are demanding change. At DispatchHealth, the supplemental model we’ve pioneered is only the start. Healthcare will continue to be more personalized, affordable and efficacious. Our model of high acuity episodic intervention coupled with our recent service offerings of extended and advanced care (longer episodes of care that can substitute for hospitalization or a post-acute stay) will transform our approach to medical care.
Interested in finding out more about how DispatchHealth’s services could benefit your patients or community? Learn more about our partner programs here.