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InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

inquicker.com

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Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#61

Post by tptacek »

cscott wrote: post #51

Talk about contributing to the public health problem in our ERs. Emergency medicine in the US is in a horrible state. Overcrowding is one of the primary reasons. See: http://www.ama-assn.org/amednews/2009/01/19/prsb0119.htm One of the primary reasons for the large influx of patients is the diversion of primary care visits into the ER for non-urgent matters. A booking system that encourages non-urgent care visits to t…

Your argument is that on-site ER wait times are an effective deterrant for frivolous ER visits. They aren't: they impose costs on both legitimate and illegitimate visits. That cost is also imposed randomly: currently, your ER wait is luck-of-the-draw.

If you want to solve the ER overcrowding problem, you should do it directly, by adding a surcharge (over and above the one that already exists) for nonessential ER visits. There's no rational reason to force people to sit in a crowded ER waiting room.

Meanwhile, a retail interface to the ER scheduling systems that already exist is more likely to help than hurt overcrowding, because it will route patients to the least crowded ER in their area.

Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#62

Post by delano »

jdminhbg wrote: post #52
delano wrote: post #44

This is a great service but it seems unfortunate that it has to exist at all. The health system in Canada isn't ideal (or the Netherlands where I am now) but having to check emergency room wait times has never even occurred to me.

http://www.torontosun.com/news/canada/2009/05/03/9330606-sun... 'Down a hospital hallway, a row of stretchers line the wall near the nurse's station. On one of them is an elderly woman who's in pain. She has been waiting for four hours to get into a room with a bed, but there isn't one available. This is happening nearly every day in hospitals across the province and the GTA," said a nurse with 22 years of on-the-job…

That's fair. I should have been more accurate since Canada is a gigantic country. My experience is based on living in Vancouver and Montreal (although I went to a hospital in Toronto on one occasion and waited only 30 minutes).

Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#63

Post by paulgb »

tkiley wrote: post #28
matt1 wrote: post #23

Earlier quoted context omitted.

To answer one of your questions... From the registration page: "Your credit card will be charged a fee of $24.99 to complete the registration process."

Exactly. Originally, we experimented with offering this service to patients for free or for $2.99, but the hospitals were experiencing significant numbers of no-shows and bogus registrations; the $24.99 price point was actually requested by our pilot hospital as a form of data validation. If we could find another way to keep the signal-to-noise ratio high, I would love to offer this service at a lower price point.

Have you considered treating some of the fee as a deposit, refunded when the person shows up?

Awesome job, by the way.

Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#64

Post by bestes »

tkiley wrote: post #7
absconditus wrote: post #4

If you can afford to wait do you actually have an emergency? There are many other options, including clinics in drugstores, which don't burden emergency departments.

This is a very good question, and a very complicated one. In many markets, retail clinics and urgent care centers are open 60 hours per week at best; nights and weekends, treatment options are scarce. Additionally, many hospitals operate onsite "fast-track" clinics which are connected to the ED, so low-acuity conditions are essentially treated in something resembling a retail clinic. Our goal is to make the emergency…

As yet another parent, this looks promising. My ER visits are usually in the 5-7 hour range. I also don't really care what the place is called: if I have an issue, I want to go to the closest place that can help me. If it happens to be the Walgreens three blocks away (it isn't), fine. Urgent Care, ER, trauma center or whatever.

Until recently, I always thought these places would triage, but my experience has been that it is just 'take a number and wait' I've been in with a broken arm, a torn nose (that required stitches) and couldn't believed we were treated exactly like a headache. So, this looks great. Try the Silicon Valley next so we can try it!

Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#65

Post by bestes »

delano wrote: post #44

This is a great service but it seems unfortunate that it has to exist at all. The health system in Canada isn't ideal (or the Netherlands where I am now) but having to check emergency room wait times has never even occurred to me.

You might be watching too much TV. Nothing happens quickly in a real ER.

Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#66

Post by mediaman »

tkiley wrote: post #28
matt1 wrote: post #23

Earlier quoted context omitted.

To answer one of your questions... From the registration page: "Your credit card will be charged a fee of $24.99 to complete the registration process."

Exactly. Originally, we experimented with offering this service to patients for free or for $2.99, but the hospitals were experiencing significant numbers of no-shows and bogus registrations; the $24.99 price point was actually requested by our pilot hospital as a form of data validation. If we could find another way to keep the signal-to-noise ratio high, I would love to offer this service at a lower price point.

I say don't lower your price. What you want to do is segment the demand curve for ER services and slice out those who are willing to pay more to avoid wasting hours of their time.

It seems lowering the price would gut your revenue but you wouldn't increase your userbase enough to make up for it (there would be a big deadweight loss of utility that patients get, but don't have to pay for -- lost revenue for you).

Also, ER is an incredibly expensive thing to go through, so mentally your users may be more price-insensitive than usual--they'll bucket all the costs together in a 'big bath', so you can charge more.

Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#67

Post by stevenbedrick »

tptacek wrote: post #61
cscott wrote: post #51

Talk about contributing to the public health problem in our ERs. Emergency medicine in the US is in a horrible state. Overcrowding is one of the primary reasons. See: http://www.ama-assn.org/amednews/2009/01/19/prsb0119.htm One of the primary reasons for the large influx of patients is the diversion of primary care visits into the ER for non-urgent matters. A booking system that encourages non-urgent care visits to t…

Your argument is that on-site ER wait times are an effective deterrant for frivolous ER visits. They aren't: they impose costs on both legitimate and illegitimate visits. That cost is also imposed randomly: currently, your ER wait is luck-of-the-draw. If you want to solve the ER overcrowding problem, you should do it directly, by adding a surcharge (over and above the one that already exists) for nonessential ER visi…

The problem with the surcharge idea (and lots of other market-oriented solutions to health care problems) is that, under our current system, market forces don't really apply in the same way that they apply to, say, items in the grocery store. Very few people going to an ER are paying out of pocket: many don't have insurance[1], and will either not pay for their visit or will negotiate some sort of payment plan at a reduced rate with the hospital. And, of course, those visitors with insurance don't care what the hospital ends up charging their insurance company- that's the whole point of insurance. This is, of course, especially true during emergency or urgent care situations.

[1] To the extent that emergency room overcrowding is due to people without other health care options (i.e., the un- and under-insured) using ERs as their primary care facilities, surcharges really won't help: by definition, these are people who can't pay for medical care... so adding additional surcharges probably won't have much effect on their ER utilization.

Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#68

Post by aaronblohowiak »

prakash wrote: post #58
tkiley wrote: post #2

This is my startup. 100% bootstrapped and ramen profitable. Questions and comments encouraged. Thanks for checking it out!

fantastic idea. The first ER experience I had in the US, I waited for 5 hours -- completely baffled that it was called ER.

Triage is the new priority queue.

Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#69

Post by tptacek »

stevenbedrick wrote: post #67
tptacek wrote: post #61

Earlier quoted context omitted.

Your argument is that on-site ER wait times are an effective deterrant for frivolous ER visits. They aren't: they impose costs on both legitimate and illegitimate visits. That cost is also imposed randomly: currently, your ER wait is luck-of-the-draw. If you want to solve the ER overcrowding problem, you should do it directly, by adding a surcharge (over and above the one that already exists) for nonessential ER visi…

The problem with the surcharge idea (and lots of other market-oriented solutions to health care problems) is that, under our current system, market forces don't really apply in the same way that they apply to, say, items in the grocery store. Very few people going to an ER are paying out of pocket: many don't have insurance[1], and will either not pay for their visit or will negotiate some sort of payment plan at a r…

The people who are using the ER because they have no other option and who cannot pay out-of-pocket are not at all germane to this startup idea, which is part of my point.

There is no reason at all that our respective agendas about how US healthcare should be run should require me to wait on-site in the hospital, as opposed to in my home at 1AM, or in my hotel room when I get violently ill on a trip.

There will always be cases when people need to use the ER, and there will never be a good reason they shouldn't be able to call ahead for a soft appointment. Everything about the system, from patient routing to triage to hospital staffing, works better with a system like InQuickER in place.

Re: InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free

#70

Post by tptacek »

calambrac wrote: post #48

Great idea, but why focus on the ER in your branding? The question that the end user has is "How can I get treatment for this health problem as soon as possible, without having to wait around in a waiting room"? It seems like the way that you're answering this could easily be extended to clinics and urgent care centers, couldn't it? Also, I echo the calls for a map-based or local-search interface.

Because from a pure marketing perspective very few people have the problem of having horrendous waits at clinics, but tens of millions of people have had the experience of waiting 3-5 hours in an ER waiting room.
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