House Calls, a win-win for Healthcare in America
In a recent New York Times OP-ED, “Bring Back House Calls,” by Sandeep Jauharot, he describes one of the key advantages of house calls, as reducing the readmission rates that annually cost Medicare $17 billion. Additionally, he mentions, “The key to improving the hospital-to-home transition is a better understanding of the home component. For doctors, patients’ homes shouldn’t be a black box.”
Sandeep hits on a critical point, house calls will improve home care and reduce hospital readmissions; although, it is the use of that ‘black box’ and the doctor’s black bag that are critical to enabling urgent care in the home and monitoring to become an essential part of the healthcare ecosystem.
It is with that in mind, that Pager (www.pager.com), a technology company started 2 years ago with a founder that developed the Uber app, began this exact service in Manhattan, now San Francisco and soon to be in many other major cities. The premise of Pager, and to Sandeep’s article, is that consumers want better care that runs in parallel to the on-demand desire for convenience, affordability and access to quality healthcare.
The Pager ‘black bag’ is not the “Marcus Welby” model of old — it comes fully equipped to provide urgent care on wheels. Pager can treat lacerations, nearly any infection, sprains, and other illnesses that would normally require an urgent care or emergency department facility. Blood drawing, immunizations, wrapping sprains, and treating most of the common medical problems are daily affairs for Pager doctors.
A few other companies have recently entered the market, validating the concept that Pager began. Hospitals, particularly Accountable Care Organizations that are at financial risk for expensive venues of care, are enthusiastically embracing the house call. Using the technology that Pager has created, hospitals can now offer multiple venues for their patients to access care: telephonic or video (telemedicine), home care, urgent care, doctors’ offices, or emergency rooms. Patients receive excellent care at the convenient right time, in the most cost-effective site.
Hospitals and large medical groups have identified the technology and house call delivery as not only cost-effective, but also a marketing tool to differentiate itself in the local market where all healthcare is determined. It becomes a referral engine: if a patient is seen by a primary physician in the home, a trust is built, and if the patient also has a medical or surgical problem, the patient would be referred to a specialist in the medical group or hospital. Further, the patient likely does not have a primary care doctor and could become a patient affiliated with the doctor’s practice. Any initial loss of money by the group or hospital for the house call, is effectively overcome by the marketing benefits of those who use the service.
House calls benefit the entire eco-system of health care: first and foremost, the patient; the doctor and his/her group or hospital, the insurance company to reduce expensive venues of care; and the health care economy as a whole. Truly, a win/win/win/win for all.
Richard Boxer is the Chief Medical Officer at Pager. He is the founder of Boxer Health Strategies and actively practices medicine. He was Surgeon General of the United States Finalist and was a Senior Advisor to the Health Security Act of 1993 for President Clinton’s administration.