The room for cost-savings in healthcare is enormous, especially when you combine the average cost for an emergency room (ER) visit ($3,712, according to a 2015 Milliman Report) and the fact that 136 million people in the U.S. visited an ER last year. While ER visits are certainly warranted in emergency situations, many of those trips can be re-routed to less costly providers, like urgent care centers and walk-in clinics. Now, technology has created another avenue for cost reductions—on-demand healthcare. This is due in part to the “perfect storm” for change — the expectation patients have for more convenience, the ongoing need for healthcare cost reductions and a wholesale shift to value-based care for providers. Denver-based DispatchHealth realizes that if the company had tried to revolutionize healthcare delivery five years ago, it would not have worked. But it’s five years later and the industry mindset is now on how to do more with less, how to treat more individuals, and how to keep people healthier outside of its brick and mortar facilities.
DispatchHealth co-founders, Mark Prather, MD (CEO) and Kevin Riddleberger (Chief Strategy Officer) first met while working on a symptom checker for another Denver startup. That close tie led to many lunches and afternoons spent talking about clinical aspects around their current project, as well as discussions about the next improvements needed in healthcare. They knew that as healthcare providers began taking on more risk-based contracts, that shift would create a need for some treatments to move beyond the four walls of care and to treating people in their homes. “Mark and I envisioned a solution far beyond the classic house call of the 30s and 40s, where someone with a black bag shows up with limited treatment capabilities,” explains Riddleberger. Ultimately, that vision led to the company’s current mission: “To provide right-sized mobile treatment for complex cases through the power of technology, convenience and service.”
Originally known as True North Health Navigation, the company formed in 2013 after developing a partnership with one of Denver’s innovative and premier fire departments — South Metro Fire Rescue Authority. At the time, the fire and rescue department recognized that many of its 911 calls could be handled more efficiently and effectively by a lower level of care. For 18 months, the startup founders developed their proof of concept by going through a pilot phase of their idea. “We collected data and validated what we were doing to ensure that we could prove that we offered something more robust than just putting a bandage on people,” says Riddleberger. Once the founders knew they had both a viable and valuable service, they were ready to raise capital; at that point, they changed the name to DispatchHealth.
Pivoting after the Pilot
Though the company still operates with the fire station to take its low acuity 911 calls, today, DispatchHealth has moved upstream with its service. By partnering with healthcare systems, independent living and senior facilities, these providers have been given another option beyond going through the 911 system. “The number of baby boomers entering Medicare is exploding and these seniors typically have multiple co-morbidities, as well as being on many medications,” says Riddleberger, who also shares that these individuals are frequently acutely ill, which drives up healthcare costs.” The company has found their niche in lowering those healthcare costs for all parties concerned, by helping healthcare systems treat these individuals in their home versus experiencing the trauma of a hospital or emergency department visit. For patients, convenience of in-home treatment combined with quick and easy access summoned by phone, through the website or through the DispatchHealth iOS or Android apps.
Riddleberger and Prather caught the early and prevailing wind of mobile acute care delivery. In 2015, the Wall Street Journal published an article, “Startups Vie to Build an Uber for healthcare,” in which the company and two other early startups in the space were featured. As the only service of its kind in Colorado, the company set itself apart from competitors initially with its successful integration with the 911 system, as well as Centura Health’s nurse advice line -- CenturaConnect. Since then DispatchHealth has established insurance contracts with all the major payors, including Medicare, Medicaid and TRICARE, as well as all the commercial entities. “We also offer an acuity of care where we can provide treatment for roughly 70 percent of what your typical emergency department can treat, including capabilities like IV medications, lab testing, suturing, stapling, Foley catheter placement, feeding tube replacements and more,” Riddleberger comments.
Challenges to Care Delivery
Although the company has treated more than 2,000 patients since 2014 and has racked up roughly two million dollars in cost-savings across all its channels, such success wasn’t without its challenges. Creating a new brand also presented an education hurdle for both consumers and clinicians. Company executives had ongoing discussions with the public to aid understanding around what DispatchHealth treats and to explain the difference between a mobile acute care house call versus a concierge service. For clinicians, the company had to provide specific education around its value. “We are like a tool in your box that can be leveraged so that you are more successful when taking on risk-based contracts,” says Riddleberger.
Another challenge is one Riddleberger says all providers and healthcare technology companies face — interoperability. Making DispatchHealth calls part of a patient’s overall health record involves many steps because he says many providers still primarily use traditional fax for communication. “We do bundle up our notes in an HL7 feed that providers can accept, but the vast majority of folks aren’t ready for that.” DispatchHealth is already ahead of the game and is ready to provide those clinical notes and care plans digitally and securely so they can be made a part of the patient record.
As soon as the company started to develop the technology, they reached out to Datica. “We are a small team and wanted to develop fast, but do so from a security perspective. It’s been wonderful for us to continue to iterate and push out product rapidly and securely,” says Riddleberger. “We look forward to expanding our partnership and leverage interoperability on the whole data integration that will be asked of us in the future.”
While the company further aligns with Centura Health, one of its most valued partners, the company is also evaluating different markets outside of Colorado. Riddleberger says those markets will be based on strategic partnerships, whether that be a payor, health system or other provider groups with a focus on value-based care.
Learn more at dispatchhealth.com.