Undoubtedly, these words are a lifeline for millions who need emergency medical assistance. And for the five years that I served as a volunteer EMT in Stratford, CT, I saw first-hand the critical importance of first responders everywhere. Each night if a call came into 911, my two colleagues, Carol and Connie, and I would immediately jump into ambulance 804 and leave with ‘lights and sirens’ to get to the patient as quickly as possible. On the way, our dispatch would continue to provide more information so we were prepared to provide life-saving care for the patient or triaged them for transport to the hospital. Few words can completely describe the intensity of this work.
Unfortunately, I also witnessed incredibly expensive house calls or, frustratingly, patients who simply wanted a ride to the hospital. In some cases, patients didn’t have anyone to turn to or didn’t know who to turn so they would call 911. Whatever their reason, the end result is categorized as inappropriate ambulance use. And some studies have even tried to quantify inappropriate ambulance use based on a number of factors including patient’s age, available transportation, and understanding of the 911 system. Ultimately, though, critical emergency resources are diverted from addressing life-threatening situations and substantial financial waste is created in our system. For example, an ambulance ride can cost anywhere from a few hundred dollars to several thousand depending on the region and insurance coverage. Our in-home EMT treatment could also have a substantial cost associated depending on the individual’s insurance coverage. To be clear, if this was a life-saving situation, the last thing on anyone’s mind is the price but my point is that for many of the routine procedures that could have easily been administered outside the home, these costs are a very steep price to pay.
In terms of alternatives, there are now approximately 10,000 urgent care facilities across the country in easily accessible locations, such as downtown areas or shopping centers, that can provide urgent outpatient care without an appointment. Stating the obvious, the patient needs to leave their home, and nowadays, with the heightened concern for personal space and safety, sitting in a waiting room is not high on anyone’s list of preferred things to do.
So where is all of this leading to?
I believe that we are on the cusp of a major transformation in outpatient care. Due to the pandemic, we’ve adapted to doing almost everything from home — from working to socializing to shopping and just about anything is now being shipped directly to your doorstep. We should have the ability to get safe, high-quality and affordable medical care right in our own home. Companies are springing up to provide urgent in-home care that replicates the same types of procedures that a patient would receive at an urgent care facility, doctor’s office or an emergency room. No more waiting rooms, instead medical practitioners, including a nurse practitioner, come directly to you.
It’s the right care at the right moment for a fraction of the cost all within the comfort and safety of your own home. The value of this type of service for patients cannot be overstated and these are the types of challenges that I get excited about taking on. It’s the next evolution of outpatient care and, if done correctly at scale, could profoundly reshape health and care in the United States.