New York, NY (PRWEB) October 19, 2009
New York, NY (PRWEB) Emergency room utilization continues to rise and is expected to surge even higher this flu season given the heightened awareness surrounding H1N1 and the seasonal flue. As patients continue to neglect primary health care the medical house call is becoming more and more common. The primary care medical house call could replaces non emergent visits to emergency rooms,and save the system the high cost of an ER visit. The typical ER visit can cost upwards of $700 in NYC whereas a medical house call usually costs less than half that amount. It is estimated that only 6-10% of all ER visits are actual emergencies. That means over 90% of patients use the ER for routine and urgent care needs.
Older generations may recall the old-fashioned house call that was once common, that practice seems to be gaining popularity once again. The latest company to join the medical house calls arena in NYC is a company call Metro Medical Direct. Nurse Practitioner Raymond Zakhari founded the company. "Metro Medical Direct is a non-retainer concierge style web-based primary care medical house calls practice. Patients request services online through a secure patient portal. I arrive at their home, office or hotel and deliver the care they need. I can even arrange for home x-ray, ultrasound, EKG and blood drawing," said Raymond Zakhari, NP. Also, established patients of the practice can utilize the virtual office visit, which consists of email consultations and web-cam follow-up visits. Some insurance companies have started reimbursing for these tele-med services according to Med Fusion based in Cary, NC. The main clients of the practice have been busy professionals with insurance utilizing their flex spending accounts, and individuals with high-deductible health plans with health savings accounts.
According to the Centers for Disease Control & Prevention, hospital emergency room use has risen 36% during the past decade. It is the insured, not the uninsured, population that is responsible for most of the visits, according to an October 2006 study published in the Journal of American Medical Association. Patients are going to the ER for all kinds of conditions--most of which do not require emergency care. With doctors' offices scheduling appointments for routine matters and physical exams 2-3 weeks in advance, patients often seek emergency room care because they perceive no alternative.
Manhattan based Metro Medical Direct is partnering with local mom-and-pop pharmacies in an effort to help them remain competitive amidst the arrival of retail clinics to build its client base. Patients of Metro Medical Direct utilize a secure patient portal (MetroMedicalDirect.com) which allows them to ask questions, request refills, referrals, pay their bills, and request appointments without being placed on hold or having to explain personal problems to various office staff. The typical house call lasts about 40-60 minutes, and after each visit patients get a personalized podcast, video stream or email reviewing the diagnosis and treatment plan. Text messaging is also used for quick questions and updates. Patients like knowing that they can access their PCP from anywhere they can get an Internet connection. Now with the use of e-prescribing patients can have their medications waiting for them at their local pharmacy or delivered. Mr. Zakhari says he "wants the focus to be on primary care" and as such has "created a fee structure where subsequent visits cost less than the initial consultation."
Metro Medical Direct also provides treatment for occupational injuries, and sick visits on location reducing the incidence of sick days. "It's the same thing as a home visit. The care is the same." Mr. Zakhari, NP tells of one occasion he saw "a patient at his desk job on Wall Street for a hang over due to a night of birthday celebrating. The new 30 year old had his blood drawn and got an IV infusion of vitamins, thiamin, and magnesium like he would have gotten had he gone to an ER. He was functional just a bit dehydrated. He was an established patient so the visit cost him $350. He paid online with his FSA card. The whole thing was done behind a closed door in a conference room. My background of ICU, EMS and battlefield nursing makes me feel comfortable practicing just about anywhere."
According Mr. Zakhari, NP "If we do a comparison, there will be fewer X-rays and other tests than in the Emergency Room because oftentimes the patient is not known to them, and this in turn drives up cost."
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