5 ms·
InQuickER: See the ER doc in 15 minutes or less, or your ER visit is free
- tkiley 17y agoThis is my startup. 100% bootstrapped and ramen profitable. Questions and comments encouraged. Thanks for checking it out!
- dschobel 17y agoLove the idea. What are the expansion plans?
- tkiley 17y agoBecause this is such an intensely localized service, expanding the network of participating ERs is pretty much the most important thing we need to do. We've made it a turnkey implementation for low- and mid-volume ERs, and there are some fairly compelling customer service and bottom-line benefits for participating hospitals.
- ars 17y agoMy companies startup http://www.medtipster.com/ http://www.medtipster.com/ should partner with you. Unfortunately it's not up to me. We already have all the localization code, and with more hospitals I think this would work great as a module on the site. I sent the suggestion "upward", but I have no way to know if it'll go anywhere.
- prakash 17y agofantastic idea. The first ER experience I had in the US, I waited for 5 hours -- completely baffled that it was called ER.
- aaronblohowiak 17y agoTriage is the new priority queue.
- kirse 17y agoJust wait until we get socialized health-care... the wait times are going to be absolutely phenomenal.
- potatolicious 17y agoI waited about the same in Canada, in the second-worst hospital in the province for ER wait times. So... what was that with the socialized medicine bashing?
- abstractbill 17y agoThe only things I really miss from the UK (I moved to California when I was 27) are my family, and the health care.
- sanswork 17y agoI have had socialized health-care in all three of the countries I've lived in and dealt with the american solution a few times while traveling. Honestly wait times were about the same across the board. Socialized or not E.R. rooms are rarely able to cope with busy times. Socialized health care usually only means worse service for the very rich. For everyone else it's a great thing.
- ews 17y agoNever waited more than 10 minutes in Spain, Italy, Portugal, Germany or UK (and lived on all those countries for a while), had to wait 4.5 hours on San Francisco just few months ago.
- wheels 17y agoWhile I'm a fan of the German healthcare system, under 10 minutes is an overstatement. Honestly, the only time I've gotten treatment that fast was when I was covered in blood. I'd say my usual (non-critical) ER waits are closer to an hour, but still shorter in general than I had when in the US. (I've lived in Germany for 7 years now.)
- tjmc 17y agoSocialized health-care has its own problems but just from reading the comments here it seems like a better system as it routes people to the level of treatment they need. My understanding of the US system (and please correct me if I'm wrong) is that those without insurance have no other option than to attend the ER. Here in Australia you'd generally go to a GP, a public health center or have a locum come out to visit you before heading to a hospital. There are certainly still wait times, and a system like this might be able to help, but in general I think there's a much better spread of patients to the right location.
- mattmaroon 17y agoWell, good luck. I'm rooting for you because your service would be amazing. You're dealing with the most fucked up, slow-moving, ass-backward industry in the history of capitalism though, so it's going to be a really tough battle.
- patio11 17y agoI don't know about it being the worst possible industry -- government procurement or public education give it a run for its money some of the time. (I will refrain from playing the "find the common thread here" game.) Seriously, though, I hope that this startup escapes the regulatory issues and goes Big. It solves a clear problem for both patients and hospitals, will greatly increase societal welfare, and it should attract Big Bucks (TM) because of the amount of money wrapped up in the problem it solves. This page is one of the best brief sales pitches I've ever seen, by the way: http://inquicker.com/page/inquicker_benefits http://inquicker.com/page/inquicker_benefits Everything about it is great. It scans great. It directly addresses the customers' needs and makes it explicit what tangible benefits buying in will get them. I have bookmarked it so that when software vendors ask how to improve their website I'll say "Your benefits section should look like this". Best of luck.
- Adrenalist 17y agoSounds like a neat idea. You obviously have to get hospital permission/buy-in before this idea could really take off. This is a similar idea to OpenTable, the dining reservation system. Perhaps you could do (or already have done) some research to find out how that company has succeeded/failed and apply those lessons to your efforts. Online based reservation systems are a great idea, but seems like a lot of leg work is required to get it really rolling. Classic chicken/egg problem here with early adopters. 1. Add some auto-suggest features to the 'add a hospital' form. 2. Use an IP address/geolocation service to guess where I'm located and pre-populate the state for the form. 3. I tried to add my local hospital, and received a very ugly error message: ==== Internal Error There was an error processing your request. The system administrator has been notified of the problem, it will be fixed as soon as possible. Please try again later. TELEPHONE SUPPORT For telephone assistance, call our on-duty support technician at (770)-597-9185. ====
- tkiley 17y agoThanks for reporting this, it's been fixed, and we did receive your hospital suggestion. :)
- absconditus 17y agoIf you can afford to wait do you actually have an emergency? There are many other options, including clinics in drugstores, which don't burden emergency departments.
- Adrenalist 17y agoI'm a father of 3 and this service would have been useful on several occasions. TRUE emergencies are handled VERY quickly at the ER, but there are a lot of times when the regular doctors office is closed (holidays, weekends, after business hours) but you REALLY need to take your sick child to get medicine or whatever. We've had more middle-of-the-night ear infections than I'd care to remember. :)
- absconditus 17y agoThe drugstore clinics can certainly handle ear infections. There are also urgent care facilities in most areas that can be utilized.
- tkiley 17y agoThe key phrase here is "middle of the night". How many areas have drugstore clinics that are open at 2am?
- garndt 17y agoBetter question, what is the likelihood that a hospital near most residents are busy enough at 2am where wait times are extremely excessive that you need to use a service like this to "schedule" your visit? I would imagine that the likelihood decreases considerably during the "middle of the night" especially when taking into consideration that there are probably more hospitals that are not level 1 trauma centers and/or county run facilities and are often the busiest between 11am and 11pm.
- randallsquared 17y ago
- eries 17y agoVery cool.
- zackattack 17y agoAre you Eric Ries?
- matt1 17y agoLook at his submissions. I'm seeing a trend... :)
- eries 17y agobrilliant deduction :)
- eries 17y agoyes
- zackattack 17y agoNice to meet you. I read your blog sometimes, and just watched a video presentation you gave with Steve Blank. My name is Zack. Customer development and agile software development seem like such neat, rational concepts. I'm thinking of taking it a step further, though, and would like your opinion. I have a couple ideas for services, but they would take a couple weeks to build. Do you think it would be worthwhile to post an Ask HN thread, seeing if people express interest in paying for my potential products, before I build them? Zack
- zackattack 17y agohttp://news.ycombinator.com/item?id=629726 http://news.ycombinator.com/item?id=629726
- stevenbedrick 17y agoGreat idea! Which EHR/scheduling systems do you currently interoperate with? EmStat, Epic, etc. Alternatively, if you're not directly hooking into the ER's systems: A) What sort of workflow do you use to exchange scheduling and appointment data between your site and the ER? and B) Is it the same for each participating hospital? If not, how are you planning on scaling your operation to include more than four hospitals? I'm genuinely curious, having done some work on ER workflow analysis and modeling. I think this is a great idea, but can envision some pretty significant workflow issues on your horizon depending on how you've got stuff set up currently.
- tkiley 17y agoRight now, we're use a manual workflow; we provide patients' preregistration data to nurses and registration staff through a web interface. Direct EHR integration is my next priority. We're implementing at relatively low-volume locations (in the neighborhood of 25-35k pts per year), and so far we've used the same manual workflow at all locations without any problems, but I think we need full integration for long-term growth. I'd love to talk further by email -- can you send me a note at tyler@mystartupdomain?
- mildweed 17y agoIIRC, Emory uses Cerner FirstNet.
- cadalac 17y agoWow I think you have a great idea. We really need something like this in Canada. What are your rates? I couldn't find them on the site. Oh, and one last question: where you funded by YC?
- matt1 17y agoTo answer one of your questions... From the registration page: "Your credit card will be charged a fee of $24.99 to complete the registration process."
- tkiley 17y agoExactly. Originally, we experimented with offering this service to patients for free or for $2.99, but the hospitals were experiencing significant numbers of no-shows and bogus registrations; the $24.99 price point was actually requested by our pilot hospital as a form of data validation. If we could find another way to keep the signal-to-noise ratio high, I would love to offer this service at a lower price point.
- paulgb 17y agoHave you considered treating some of the fee as a deposit, refunded when the person shows up? Awesome job, by the way.
- mediaman 17y agoI say don't lower your price. What you want to do is segment the demand curve for ER services and slice out those who are willing to pay more to avoid wasting hours of their time. It seems lowering the price would gut your revenue but you wouldn't increase your userbase enough to make up for it (there would be a big deadweight loss of utility that patients get, but don't have to pay for -- lost revenue for you). Also, ER is an incredibly expensive thing to go through, so mentally your users may be more price-insensitive than usual--they'll bucket all the costs together in a 'big bath', so you can charge more.
- telegraph 17y ago
- edw519 17y agoNice. You may want to consider a Google maps mashup centered on my location. If the hospital(s) I know aren't participating, this would be easier to use than a drop down box.
- tkiley 17y agoGreat idea! Right now we have a fairly small network of participating hospitals (3, to be exact), and engaging visitors who aren't in our current service area is a bit of a trick. I'll pass this one along to the designer for our next revision.
- thorax 17y agoFrom what I understand, there are a number of hospitals that can do some measure of call-ahead scheduling for ERs. What would prevent you from asking about each hospital policy and at worst doing a Twilio automated call to the number if they choose that one? At worst your automated message would get hung up on, and you'd tell them that it could not be processed and tell them to go there directly. At best, you win because the ER staff hits the right keys for your automated message. Or they agree to do a full agreement with you.
- matt1 17y agoWhat an ambitious, innovative idea--nice work. I don't understand (even after looking at the How it Works page) is how it works. Since you can't predict what types of injuries that are going to come in that are more critical than yours, how can you gaurantee an appointment time?
- tkiley 17y agoThe short answer: we can't. Sometimes, we miss the guaranteed appointment time. However, we do everything we can to ensure that our predictions are accurate, and we do everything we can to ensure that the patient experience is still as smooth as possible if we're wrong. At this point, we have a 99.9% success rate with that guarantee: less than 1 out of every 1,000 patients has requested a write-off of the bill.
- JimmyL 17y agoCan you expand on this a bit - for example, do you come up with the appointment times based on your own models, or does the hospital update your system to say "well, we're having a light day, so most people can get in two hours after they send us their triage info, regardless of what comes up." I also wonder if you could talk about the incentives you use to get hospitals to sign on to your program - while you're adding value, you're also costing them staff time. Do you pass on a portion of the $25 to them, or is the idea that they will make up the cost by having more people come to them and thus getting more volume? Lastly, have you considered partnering with insurance companies to offer this service as part of a premium's offering? All-in, great idea you have - this is the kind of health care innovation we need.
- byrneseyeview 17y agoInteresting. Actually, this is a good way to separate two of the crucial functions of health care: actually fixing medical problems, or demonstrating serious concern and sympathy for someone's medical problems. A person interested in the first can use inquicker; someone more interested in the latter can still bustle off to the ER and pace around, or something.
- jacoblyles 17y agoAwesome, meaningful, useful startup. Congratulations. I hope you are successful and expand to my area. My friend spent 4 hours in the ER on his birthday to get some stitches. This would have been a huge help.
- danw 17y agoI'm not sure I comprehend this. Isn't it the role of the emergency services to prioritise your visit? If you're critical you'll get seen, otherwise you wait. If you're capable of shopping around for the best appointment time then shouldn't you be seeing a GP instead?
- tptacek 17y agoThis service doesn't bypass triage. It just puts your name and info on the triage list and allows you to wait from home instead of taking up space in the waiting room. The hospitals are (apparently) intensely involved in this process.
- tkiley 17y agoBingo. Most patients fall into the general "low-acuity" category, which means that they are essentially seen in the order in which they arrive at the ER; this is the default case in our system. However, the ED caregivers do have the ability to change it.
- Feynman 17y agoNifty idea -- I work for a Hospital with California's largest ER, and several ERs in other hospitals owned by the same company. Unfortunately, I'm having a hard time seeing something like this working in our environment (for a variety of reasons). However, I CAN see how this could be killer for small Urgent Care clinics. I can't tell you how many times I'd love to just go on a website and see what the wait times are for all my local urgent cares -- and then reserve/travel to the one I can get in quickest. Nice idea, clean design... really cool. Best of luck with it.
- tptacek 17y agoReal quick: SIFR for typography not a win. I'm not some crazy paranoid, but I block Flash by default because it kills my browser.
- invisible 17y agoJust for a note as to my experience, there should be a "relinquish" or "Cancel" when setting up an appointment. I clicked next step and it booked my time temporarily. Ten minutes later it'll be open, but if you're releasing this you're going to want to allow us curious folks to cancel out.
- invisible 17y agoAlso, it looks like it booked the SOONEST appointment rather than the one I requested. In the "When" row I selected 10:30PM and it said on the next page 11:15AM was what I had selected.
- tptacek 17y agoA killer idea. Every friend of mine that has had kids echoes my experience, which is that you end up going to the ER way more than you expect to --- your primary care pediatrician sends you there any time the answer to an "is it serious" phone call is "maybe". If this scales, it will let me pick which of 4 local ER's I'm going to go to based on wait time. I'd pay $50 a visit for that. I'd subscribe to a service like this simply in anticipation of needing it eventually. Good luck.
- delano 17y agoThis is a great service but it seems unfortunate that it has to exist at all. The health system in Canada isn't ideal (or the Netherlands where I am now) but having to check emergency room wait times has never even occurred to me.
- jdminhbg 17y agohttp://www.torontosun.com/news/canada/2009/05/03/9330606-sun.html http://www.torontosun.com/news/canada/2009/05/03/9330606-sun... 'Down a hospital hallway, a row of stretchers line the wall near the nurse's station. On one of them is an elderly woman who's in pain. She has been waiting for four hours to get into a room with a bed, but there isn't one available. This is happening nearly every day in hospitals across the province and the GTA," said a nurse with 22 years of on-the-job experience.'
- deleted 17y ago[deleted]
- delano 17y agoThat's fair. I should have been more accurate since Canada is a gigantic country. My experience is based on living in Vancouver and Montreal (although I went to a hospital in Toronto on one occasion and waited only 30 minutes).
- Titanous 17y agoThis is extremely common in my area (Ottawa/Gatineau). In fact, people travel the ~40 minutes to my small town where we have a relatively new hospital, and use our ER.
- bestes 17y agoYou might be watching too much TV. Nothing happens quickly in a real ER.
- calambrac 17y agoGreat idea, but why focus on the ER in your branding? The question that the end user has is "How can I get treatment for this health problem as soon as possible, without having to wait around in a waiting room"? It seems like the way that you're answering this could easily be extended to clinics and urgent care centers, couldn't it? Also, I echo the calls for a map-based or local-search interface.
- tptacek 17y agoBecause from a pure marketing perspective very few people have the problem of having horrendous waits at clinics, but tens of millions of people have had the experience of waiting 3-5 hours in an ER waiting room.
- calambrac 17y agoI've personally had horrendous waits in clinics, urgent care centers, and ERs. I've also had really quick experiences with an ER. I'm not saying I'm typical, I'm just saying that my personal experience is such that your point never would have occurred to me. But even granting your point, you can still market against that experience without implying that you only schedule people for ERs. Right now I imagine that this site gets most of its business from people who call the ER directly, and then the participating ER tells them about the site (I could be totally wrong about that, though). Going forward, though, I would think that way that this is going to be used is that a user will know they need treatment, go to the site (find it via a search engine, whatever), look for the treatment facility that satisfies some mix of 'near', 'soon', and 'perceived ability to treat my problem', and put their name down. If there's a marketing hump to get over, I would think it would be snagging people who are coming from a search engine or via some route other than having the ER send them there directly. It seems like the perception that this is just for ERs is more a problem in this sense - I'd personally be less likely to use it if I thought it wouldn't include nearby clinics in the list of places I could sign up for.
- JimmyL 17y agoWhat this service does, if I'm reading this right, is bypass the stage where you talk to a triage nurse - you're triaged based on what you report is wrong with you, as opposed to what a nurse sees is wrong with you. Do you have any mechanisms in place for two-way communication between the hospital and the people booking appointments? Specifically, I'm thinking about situations where a series of individually minor symptoms may collectively indicate something major is going on, but that a layman wouldn't know. Like let's say that I go on your site and see that I can get an appointment at an ER in three hours, so I book that because I'm feeling slightly off. My symptom description seems innocuous enough - went for a walk in the countryside, right arm is tingling a bit, small red bump on my leg, etc. - but to someone trained in medicine they indicate that I've been poisoned by some sort of tick, and I need treatment ASAP, as opposed to in three hours. Is there a way for the nurse who processes this reservation into the hospital to call me and say "screw the booking, get here now!"?
- tkiley 17y agoYes, we do have the capacity to reprioritize patients based on symptoms. Patients who reserve a treatment time online are responsible for their own health until they arrive at the ED, but we do give the ED caregivers the capacity to communicate with the patient early on if they deem it prudent; this feature is generally used in the sort of situations you describe, where the patient's condition may be more serious than he or she realizes.
- cscott 17y agoTalk about contributing to the public health problem in our ERs. Emergency medicine in the US is in a horrible state. Overcrowding is one of the primary reasons. See: http://www.ama-assn.org/amednews/2009/01/19/prsb0119.htm http://www.ama-assn.org/amednews/2009/01/19/prsb0119.htm One of the primary reasons for the large influx of patients is the diversion of primary care visits into the ER for non-urgent matters. A booking system that encourages non-urgent care visits to the ER as opposed to other urgent care options does nothing to help this. As other commenters have mentioned, the problem with overcrowded ERs from a patient perspective where they have a potentially emergent case is NOT in the middle of the night - it's during the day, where other options (including primary care and urgent care facilities) are available. Emergency medicine should not be treated in the same convenience form-factor as other consumable goods, and applying this approach is socially irresponsible in the big picture.
- tptacek 17y agoYour argument is that on-site ER wait times are an effective deterrant for frivolous ER visits. They aren't: they impose costs on both legitimate and illegitimate visits. That cost is also imposed randomly: currently, your ER wait is luck-of-the-draw. If you want to solve the ER overcrowding problem, you should do it directly, by adding a surcharge (over and above the one that already exists) for nonessential ER visits. There's no rational reason to force people to sit in a crowded ER waiting room. Meanwhile, a retail interface to the ER scheduling systems that already exist is more likely to help than hurt overcrowding, because it will route patients to the least crowded ER in their area.
- stevenbedrick 17y agoThe problem with the surcharge idea (and lots of other market-oriented solutions to health care problems) is that, under our current system, market forces don't really apply in the same way that they apply to, say, items in the grocery store. Very few people going to an ER are paying out of pocket: many don't have insurance[1], and will either not pay for their visit or will negotiate some sort of payment plan at a reduced rate with the hospital. And, of course, those visitors with insurance don't care what the hospital ends up charging their insurance company- that's the whole point of insurance. This is, of course, especially true during emergency or urgent care situations. [1] To the extent that emergency room overcrowding is due to people without other health care options (i.e., the un- and under-insured) using ERs as their primary care facilities, surcharges really won't help: by definition, these are people who can't pay for medical care... so adding additional surcharges probably won't have much effect on their ER utilization.
- nerdburn 17y agoAwesome :) Glad to see this taking off Tyler. Nice to see my new design on there. PS. Center the layout ;)
- rickharrison 17y agoI liked this design. I've been looking for a designer for some work. Could we get in touch? Email is in my profile
- iamelgringo 17y agoSo, I've been an ER nurse for the last 15 years. I run the Hackers and Founders Silicon Valley meetup, and I love to support startup ideas. It's extremely rare that I don't support a startup idea or give it a fair shake. This is a spectacularly bad idea. I can unequivocally say without a doubt that if you pursue this service, someone will die. Why? Because I've seen it happen. Part of my job as an ER nurse is to triage patients that come in. Triage involves sorting through the dozens of patients that come in every night, and decide who can wait and who cannot because they have a life threatening emergency. People having symptoms of a heart attack move to the front of the line. People who ate a bad taco and have the shits get seen on a space available basis. That's the gig. I sort patients: sort_by_acuity([bad taco, bad taco, bad taco, heart attack, runny nose, cough, gun shot wound, ear infection, headache, headache, headache, stroke, headache]). I've been doing this job for 15 years, and I have seen plenty of triage mistakes that can change people's lives for ever. I've made a few myself. You care for thousands of patients a year, you're going to drop a ball every now and then. But, I have a lot of experience doing this, and I have a lot of knowledge and very good instincts on when someone is very ill. Patients do not have that knowledge and I would never trust your customers to make that decision when life and death is on the line. This is why ER's are almost universally abysmal at judging how long it's going to take to be seen by the doctor. The same team that is taking care of your earache at 3am or helping you get stitches after you cut your finger on your computer case, is the same team that can crack your chest open and do open heart massage on you after a thug sticks a knife in your heart. We take care of bladder infections and dying babies, sometimes right next door to each other at the same time. ER's are built for safety, not speed or even convenience. The fact that in the US, they are primarily the only type of physician that can be seen 24/7 without an appointment is an unfortunate effect of our health care system. But, we have to care for the sickest patients first, and you can never predict when the next ambulance is going to roll through the door. So, ER's suck at estimating wait times. But, you will, eventually see a doctor. Now, I understand that you have a disclaimer that says that people should call 911 for Emergencies, and that they will not use your service for life threatening emergencies. I don't think that's not going to keep you from getting sued when Uncle Bob dies of his massive heart attack that he though was a bad burrito and put his name on your waiting list. That's also not going to help you sleep at night thinking about how you might have prevented Uncle Bob's death. I'm not trying to flame you. I'm really not trying to be nasty. I'm just trying to communicate what a big, big, huge mistake I believe this application is. Please, shut it down.
- ivankirigin 17y agoEmergency services: there in minutes when seconds matter.