If it works for Disney and restaurants will it work for the Emergency Room? Maybe not

When I was growing up huge lines for rides at theme parks like Disney were the norm. Meanwhile, at least in suburban Maryland where I grew up, it was possible to go to the emergency room and be seen by a doctor within a reasonable time frame. Now things are more or less reversed. With innovations like Disney’s FASTPASS, patrons can essentially reserve a spot in line and then show up when it’s their turn. It’s a nice innovation –I know it made my family’s last visit to Disney a little more fun. Meanwhile, online booking services like OpenTable have made it easy to reserve a spot without speaking to anyone.

Now a clever 23 year-old from Powder Springs, GA is applying the same concept to emergency rooms. From the Atlanta Journal-Constitution (Online service holds your spot at hospital)

InQuickER guarantees its customers will be seen by a physician or physician’s assistant within 15 minutes of the specified time. If not (and if the correct information is given online), there is no charge to you or your insurance company for the visit.

Here’s how it works: People go to the company’s Web site, which shows the next available time at the closest hospital that uses the service. Users are then directed to a page where they describe their symptoms. The reserved time is usually determined by the charge nurse, who factors in current patient load, time of day and ambulance runs.

The cost is $24.99 per use.

I understand the appeal. But really, if someone has time to use this tool it means the emergency room isn’t the right place for them. They should be going to a primary care physician, an in-store clinic, or having an online visit with someone. At least some patients seem to like it, though:

[I]t worked for Bob Neal, a Smyrna resident and sports broadcaster.

Neal, an allergy sufferer, woke up one day feeling like he was walking around with a bucket on his head.

He had heard about the service from a neighbor who works at the hospital. While still at work, Neal went online and made a reservation for 40 minutes later.

“It’s absolutely worth paying $25,” he said. “I have a regular personal physician; however, I can’t just show up at his office and say, ‘Hey, my ears are plugged up.’ He has back-to-back patients. If I did, I would just be sitting there waiting.”

That’s really a commentary on the sad state of primary care. With open access scheduling Bob should have been able to see his own doc that day.

Also, instead of paying $25 to learn of a 40 minute wait, why didn’t he just call the hospital and ask how long the wait should be? And if hospitals have this information why don’t they just provide it by phone rather than having people pay a fee?

This service reminds me a bit of the sort of nuisance service that you shouldn’t need to purchase in the first place: like Credit Watch services that report on what’s happening with your credit rating or the Clear program to get through airport security faster.

To its credit, the InQuickER website is clean and simple. It also doesn’t pretend to be more than it is:

Hospital emergency departments treat patients in order of severity, using a process called triage. Patients who use InQuickER do not receive preferential treatment in this process. A patient using InQuickER will wait the same amount of time as a patient arriving in the waiting room, but can do so from the comfort of home (or at another location), rather than waiting in the ER waiting room.

There are three hospitals using the site. It’s about 9:15 pm as I write this post. One hospital is offering a 12:30 am appointment, one a 1 am, and the other 10 pm. If they’re really using triage then why are they offering fixed times first rather than starting by asking symptoms? If the hospitals are actually promoting their emergency departments as primary care sites with appointments, that doesn’t seem like a very responsible way to operate. It’s certainly costly for payers.

June 1, 2009

3 thoughts on “If it works for Disney and restaurants will it work for the Emergency Room? Maybe not”

  1. It is impossible to predict what ER volume and acuity would be an hour from now. All they are “guaranteeing” is that you will be encountered by an MD or PA within 15 minutes. So when one of these patients shows up the provider is summoned, says hi, the clock is stopped and the guarantee is met. You then have a seat. There is no guarantee that you will be out of the ER that day or month and they make the point that they still care for patients based on acuity. You pay $25 for a quick greeting. I don’t know of any law forbidding this and med mal potential should be enough to discourage putting patients at risk (though that may be a delusional statement when marketers and certain administrators get together).

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