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Want to Reduce Your Hospital Transfers by 80%?

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By Steve Moran

A couple of weeks ago I was talking with my friends and Senior Housing Forum partner, LWDA Architecture and Planning, and they started to tell me about this really cool company that was, in effect, creating an emergency room in skilled nursing facilities. The goal: providing more rapid emergency care in order to reduce transfers to hospitals and deaths.

It was a story I had to check out and write about.

The Problem

Call9 was founded by Tim Peck, an emergency room physician and Harvard professor. He was frustrated about the deteriorated conditions of many of the patients they were seeing from nursing homes (about 19% of all ambulance runs) because it would take, on average, 60+ minutes before they were seen by a physician.

Even for those whose lives were in immediate jeopardy (heart attacks and strokes), the average time to a physician was more than 30 minutes.

He wondered what kind of difference it would make if there were an emergency physician with the patient as the critical incident was happening.

Call9

Call9 was founded to solve that problem. Here is how it works:

  • Each nursing home has an EMT, paramedic, or emergency room tech along with a telemedicine app that connects to an always-on-duty person. This individual is a part of the Call9 team. In addition, the team member has a suite of field diagnostic tools that includes ultrasound, EKGs, and basic labs.    
  • When an incident happens, the Call9 technician responds and immediately connects with the emergency doc -- who does an assessment and makes recommendations. Around 80% of the time, problems can be addressed without the resident going to the hospital. The rest of the time, the resident is still transported but with earlier interventions substantially improving survival rates and the likelihood of that resident returning to the skilled nursing facility.

Money

First . . . right now they are only working in New York state and only in nursing homes with at least 150 beds. They are getting ready to expand to more states, but have not released which ones. In addition, they have near-term plans to release the technology platform to additional nursing homes and maybe, who knows, assisted living.

The financing is still somewhat complicated. They charge a platform fee to the nursing home, which is pretty easy money to pay because it has such a positive impact on occupancy and revenue. In addition, they have contracts with all or most of the big payor systems. Finally, there is a lot of movement in Congress to recognize and pay for telemedicine services.

They are currently serving around 3,500 beds in 10 facilities with more to come.

I see three huge benefits for communities in moving this direction:

  1. Increased length of stay

  2. Higher occupancy

  3. A significant marketing advantage

Are any of you doing telemedicine currently; if so, how is it going?

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