Location-based technology connects patients with doctors

August 6, 2014 by Bill Toland, Pittsburgh Post-Gazette

Uber's and Lyft's taxi-like services are built to get you to where you want to go. But what if you're too sick to go out?

The same location-based app technology that drives Uber and Lyft may have a fix for that, too.

Pager, which launched in May, is an app that allows patients to order a house call from a physician, using their smart phones. The service is available on a limited basis in Manhattan and Brooklyn, but it could spread to other cities by 2015.

The technology for the app was designed by Pager co-founder Oscar Salazar, who was an engineer on the team that built Uber's on-demand ride-share technology. Mr. Salazar left Uber in 2010, then helped two other entrepreneurs raise $3.5 million in investment capital for Pager.

"We do share some of that (Uber) DNA," said Toby Hervey, marketing director at Pager. "Our doctors come to you. It's on demand."

The start-up and many others in health care see a pendulum that is swinging away from hospital-based care and primary care clinics, toward "convenience care." That's a category that includes episodic treatment at urgent care clinics, but many health care visionaries believe that the most convenient care of all takes place in a person's home, by way of email, video conferencing, remote health monitoring and, now, house calls.

Insurers want it that way, trying to drive episodic care away from emergency rooms, where treatment is most expensive.

And, increasingly, patients want it that way, too. They don't want to call ahead and schedule an appointment, and they certainly don't want to sit in a waiting room.

"It's all of the patient care and none of the bureaucracy," Mr. Hervey said, explaining the appeal of Pager for both the patient as well as the 20 physicians who are now part of the Pager network. Most of them, he said, are current or former ER physicians.

New York is a natural starting point for the service - population is dense, and because of sky-high real estate prices, urgent care clinics aren't as ubiquitous in Manhattan as they might be in a city like Pittsburgh.

The "house" calls - in Manhattan there are few houses, so Pager is hoping to see apartment calls, office calls and even some hotel calls - cost $199 during the day shift, and $299 during evenings and weekends. Doctors keep about 80 percent of the fees, and Pager keeps the rest.

The expense of the visit is reimbursable by most health insurance plans, Mr. Hervey said, meaning a patient can turn in a receipt and file a claim after the fact. Eventually, Pager hopes to negotiate reimbursement rates directly with insurers, so insured patients would be responsible for only a co-payment at the time of treatment.

The technology works like this: You feel ill. You open the Pager app, and the doctors who are on duty appear on your screen. You pick a doctor, and within five minutes he or she calls you to determine if you need an in-person visit, which happens within an hour.

"More physicians than not are resistant to change," Jasper Schmidt, Pager's lead medical provider, said. But as more consumers begin demanding convenient care options, "medicine is going to have to accommodate that trend."

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