Ambulance Victoria Mercedes paramedic at St Kilda Junction, 2013 by LiamDavies

“Ambulance Victoria Mercedes paramedic at St Kilda Junction, 2013” by LiamDavies

An hour or more wait in the reception area. A rushed 15 minutes with the doctor or physician assistant. Exorbitant bills tied to minor care in the emergency room.

Whether by TV tropes or first-hand experience, these are the flaws many westerners associate with their country’s healthcare infrastructure. Despite the efforts of entire industries, the complexity of healthcare makes its inefficiencies particularly difficult to solve.

These are the same types of inefficiencies that sparked a dramatic change in the taxi and hotel industries, giving rise to Uber, Airbnb, and an entirely new type of commerce known as the sharing economy.

Can the same combination of technology and on-demand services be applied to the healthcare industry? Does such an ethos even have a place where the commerce of healing is concerned?

A growing number of physicians and consumers are saying yes.

The Uber for Healthcare is a House Call

Emergency room care is expensive, and in a significant portion of the time, unnecessary. According to a 2010 study published in Health Affairs, between 13.7 and 27.1 percent of all emergency room visits in the US could be treated at alternative locations, like urgent care clinics, which would save over 4 billion dollars.

However, if the patient has children, the logistics of a drive to the urgent care clinic — or to receive help at all — become more complex. Urgent care clinics don’t answer the question of convenience, and could still be a huge drain on the consumer’s most important resource: time.

Here, like in other industries, the appeal of the on-demand aspect of the sharing economy is obvious, which is why a handful of startups are cautiously vying to do for urgent care what Uber has done for car rides.

And consumers’ appetite for on-demand healthcare services isn’t limited to North America. In the UK, consulting firm 365 Response has received some 500,000 in funding from the Department of Health to develop Healthcab.

Unlike many on-demand platforms, Healthcab reaches beyond elective visits — like for a high fever or sprained ankle — and looks to better support patients with serious renal conditions who need transportation to and from their appointments. From their mobile phone, users could book transportation provided by England’s National Health System, vet possible drivers based on their credentials, and track the vehicle’s movements.

360Response.org

360Response.org

Notice the similarities with ride-sharing services?

Pager, a New York City company, actually uses Uber to transport the healthcare professionals at a cost of $200 per urgent care visit. Heal, a similar service provider operating in Los Angeles, San Francisco, and Orange County, charges a flat fee of $99 per visit — regardless of how long the doctor spends with the patient.

The fees associated with these visits aren’t covered by insurance companies, but that doesn’t seem to be a deterrent for consumers.

So far, both parties seem to benefit: consumers get medical attention without having to leave their home and providers keep patients out of the emergency room.

All of the startups in this space employ licensed care providers (usually a combination of doctors, physician assistants, and nurses) who want to make more money during their off hours — much in line with the way many on-demand employees make their services available through these mediums to supplement their income.

Marketing, Data, and Risk in On-Demand

The value proposition for on-demand services — whether in healthcare, ride sharing, food delivery or what have you — is essentially the same. Users get to outsource a task from the convenience of their phone, thus saving a great deal of time.

This same brand positioning has become ubiquitous, with “the Uber for [insert industry here]” becoming an all too common elevator pitch for on-demand startups. But despite the repetition (or just lack of creativity) in marketing, the value to consumers is quite real.

Everything from around the house tasks (Handy) to food delivery (GrubHub and tons of others) can now be outsourced through a phone, or at the very least through a web application.

For healthcare, there’s a bit of an interesting twist both in marketing as well as in risk. Instead of simply claiming to be the Uber for healthcare, house call apps can play on a more nostalgic appeal: the return of the house call and a re-emphasis on the doctor-patient relationship.

That promise has a much stronger appeal on an emotional level, but the risks associated with an on-demand healthcare platform are much more substantial as well.

For example, many healthcare systems now seek to centralize patient data in a particular medical software, which is great in theory, but hazy when contractors who may or may not work on the same platform as the patient’s usual provider enter the care process at random.

Doctor taking notes on an iPad by NEC Corporation of America, Flickr

Doctor taking notes on an iPad by NEC Corporation of America, Flickr

This can result in significant confusion as well as data breaches arising from poorly constructed applications or data transfer policies.

Additionally, where low-quality contractors in other industries may result in cold carry-out or poorly painted trim, in healthcare, these on-demand workers have a significant role to play in the health of their patients.

So is “Uber for healthcare” really happening? Yes, though at a slower pace than other industries. There’s a great deal to be figured out, but that’s not so uncommon in an on-demand world.