NATION
THE SUMTER ITEM
SUNDAY, JANUARY 18, 2015
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Now you can book a trip to the ER on your smartphone TRENTON, N.J. (AP) — It’s like OpenTable for medical appointments. No waiting weeks to see a dermatologist. No sitting for hours in the emergency room. No frantic calls to find a family doctor with openings. Online services such as ZocDoc and InQuicker are enabling patients with non-lifethreatening conditions to schedule everything from doctor’s office visits to emergency room trips on their laptops and smartphones — much like OpenTable users do with restaurant reservations. Hospitals and doctors increasingly are subscribing to the services to simplify appointment scheduling for patients who dislike waiting on hold and are comfortable doing everything from shopping to banking online. With most of the services, booking is as simple as going to a website, entering a zip code and the kind of care needed and checking available times. Patients can get a doctor appointment within a couple days, even if they’re new patients. And the services say most patients are seen within 15 to 20 minutes of their appointment, and when an ER backs up, patients with reservations are texted to come later. “I truly believe talking to people on the phone to schedule doctors’ appointments will be something of the past very soon,” says Natan Edelsburg, a New York resident who has made 10 doctor appointments through one of the biggest on-
line medical appointment booking services, ZocDoc. Doctors and hospitals are using such services to attract and retain patients as the health care landscape keeps getting more competitive. With the nationwide proliferation of urgent care centers and pharmacy clinics open on nights and weekends, patients have more convenient options than ever before. The booking websites also are a way for hospitals and doctors to try to please patients at a time when they face new financial incentives to do so. Starting this year, the Affordable Care Act, which requires most Americans to have health insurance, increases or reduces the Medicare payments hospitals receive each year based on patient satisfaction and quality. That can have a significant impact: Medicare, which covers Americans 65 and older and others with disabilities, pays for 43 percent of hospital patients’ care. A similar program for doctors starts next year. “I don’t think you can compete in our medical practice marketplace without being a ZocDoc participant,” says Dr. Bobby Buka, a New York dermatologist who gets about 15 patients a week from ZocDoc.
EASY BOOKING The services, which are free for patients but usually charge $200 to $300 per doctor a month, are benefiting from the focus on making scheduling easier for patients.
AP FILE PHOTO
Keanya Swaby, right, a patient access employee in the emergency room at Jersey City Medical Center, inputs information for Michele Marion, 44, into a computer at the hospital in Jersey City, New Jersey. Marion, who was suffering from severe stomach aches, was quickly admitted into the hospital with the help of her daughter, Shawanda Marion, who made an appointment using the hospital’s mobile phone application. ER Express, an Atlanta startup, books reservations for more than 150 ERs and urgent care centers in nearly 30 states. It served more than 40,000 patients in 2014, up 300 percent from 2013. Meanwhile, ZocDoc, which is based in New York, has more than 6 million patients per month making appointments for dentists, family doctors and 40-plus types of specialists in more than 2,000 cities. ZocDoc was started in 2007 by Cyrus Massoumi, who was frustrated trying to get care after his eardrum ruptured during a long flight and he had to wait four days to see an ear specialist. “We think everyone in America will be booking online eventually,” Massoumi says. InQuicker had a similar origin. It also was founded by someone who had some experience with the hassles of scheduling medical appointments. Tyler Kiley, who’d
spent lots of time in ERs growing up because his mom was an ER nurse and his dad a hospital administrator, started it in 2006. He says he’d seen lots of unnecessary waiting, so he created software for online check-ins. Growth surged after current CEO Mike Brody-Waite joined in 2010, bringing his marketing expertise: InQuicker now serves 224 hospital ERs, 517 doctor practices, 126 urgent care centers and some other medical providers. The Nashville company scheduled 302,000 appointments in 2014, up more than 80 percent from 2013, and its revenue was $7 million. Revenue is projected to reach $15 million this year, says marketing chief Stacie Pawlicki.
WIN-WIN-WIN Doctors and hospitals say the services help attract new patients. At Northwestern Lake Forest Hospital outside Chicago,
assistant ER director Dr. Steve Edelstein says ER Express sends about 40 patients a month to his ER and the hospital’s nearby Grayslake Emergency Center. A quarter are new patients, and he says those tech-savvy customers “are generally more likely to have credit cards and good insurance” than others. “It’s been nothing but a benefit,” Edelstein says. Jersey City Medical Center and its two urgent care centers rolled out InQuicker two years ago, and use grew quickly. Together, they draw roughly 300 patients a month — 70 percent of them new patients — through InQuicker and their own www. healthstops.com site. “It’s helped a lot with patient satisfaction,” says operations chief Kirat Kharode. His ER’s average wait to see a doctor is 35 minutes, versus 15 or less with a reservation.
ROLL CALL WASHINGTON (AP) — Here’s how area members of Congress voted on major issues in the week ending Jan. 16.
HOUSE HOMELAND SECURITY BUDGET Voting 236 for and 191 against, the House on Jan. 14 approved a $39.7 billion fiscal 2015 appropriations bill (HR 240) for the Department of Homeland Security that was coupled with GOP amendments to negate executive orders by President Obama on immigration policies. Charles Dent, R-Pa., said the bill “fully funds ... Customs and Border Protection and its 21,370 agents, who provide not only security at our northern and southern borders, but also at our many ports of entry where goods come and go from all over the world.” Referring to the immigration amendments, Rosa DeLauro, D-Conn., said, “The fact that the majority chooses to gamble with homeland security, of all budgets, is troubling, to say the least. At a time when we face a higher terrorist threat, these tactics are potentially deadly.” A yes vote was to send the bill to the Senate, where it faces a 60-vote hurdle to advance. VOTE H-1 slugged HOMELAND Voting yes: Mark Sanford, R-1, Joe Wilson, R-2; Jeff Duncan, R-3; Trey Gowdy, R-4; Mick Mulvaney, R-5; and Tom Rice, R-7 Voting no: James Clyburn, D-6 Not voting: None DEFUNDING OF ‘DREAMERS’ PROGRAM Voting 218 for and 209 against, the House on Jan. 14 adopted a Republican amendment to deny funding in HR 240 for the Deferred Action for Childhood Arrivals program, which President Obama established by executive order in June 2012. Under DACA, more than 500,000 undocumented aliens who were brought illegally to the U.S. as children and see America as their only home — so-called “dreamers” — have received temporary work authorization and two-year reprieves from the possibility of deportation. This amendment would kill the program by effectively preventing renewals of DACA status and barring new enrollees. Tom Marino, R-Pa., said DACA “has become a magnet for drawing children from Central America, further putting thousands of children’s lives at risk ... .” John Conyers, D-Mich., said the amendment “is anti-immigrant and anti-family. This is a vote to deport ‘dreamers.’” A yes vote was to adopt the
amendment. VOTE H-2 slugged DREAMERS Voting yes: Sanford, Wilson, Duncan, Gowdy, Mulvaney and Rice Voting no: Clyburn Not voting: None DEFUNDING OF IMMIGRATION ORDER By a vote of 237 for and 190 against, the House on Jan. 14 amended HR 240 (above) to effectively kill an executive order by President Obama that is now giving temporary relief from potential deportation to more than four million undocumented aliens who are parents of U.S. citizens or permanent legal residents born before Nov. 20, 2014. To qualify for the program and receive work authorization, these individuals must have lived in the U.S. for at least five years, pass criminal background checks, submit biometric data, establish that their child was born by the date of the order and agree to pay fees and taxes. Bob Goodlatte, R-Va., said the amendment would defund an “unconstitutional power grab” that “threatens the separation of powers between Congress and the executive branch and violates (the president’s) obligation to take care that the laws be faithfully executed.” Luis Gutierrez, D-Ill., told Republicans, “The fruits of your action today will cause only anger and outrage and the mobilization of an immigrant community throughout this nation that will be the death knell of the future of your party as a national institution.” A yes vote was to adopt the amendment. VOTE H-3 slugged ORDER Voting yes: Sanford, Wilson, Duncan, Gowdy, Mulvaney and Rice Voting no: Clyburn Not voting: None GOP IMMIGRATION AMENDMENTS Voting 184 for and 244 against, the House on Jan. 14 defeated a Democratic motion that sought to strip HR 240 of its GOP-sponsored immigration amendments while increasing by 1 percent the 2015 budget for “fusion centers” located in each state. Already funded at $300 million in the bill, these centers help law enforcement at all levels of government coordinate and analyze information on terrorist threats. Steve Israel, D-N.Y., said the bill with its immigration measures “goes too far. For the first time in history, they are holding our security hostage to the politics of immigration.” Trey Gowdy, R-S.C., said the bill “is not a fight between Republicans and
Democrats” or “over immigration reform. This is a fight over whether this branch of government will ever find the courage to stand up for itself.” A yes vote was to adopt the motion, which, had it prevailed, would have immediately amended the bill. VOTE H-4 slugged IMMIGRATION Voting yes: Clyburn Voting no: Sanford, Wilson, Duncan, Gowdy, Mulvaney and Rice Not voting: None FINANCIAL DEREGULATION Voting 271 for and 154 against, the House on Jan. 14 passed a bill (HR 37) that would weaken or repeal several rules for banks and private-equity firms that stem from the Dodd-Frank financial-regulation law, which Congress enacted in 2010 as its main response to the global financial collapse of 2008-09. Republican sponsors said their bill would promote economic growth and help small businesses. The bill gives institutions such as Wells Fargo, Citigroup and JPMorgan Chase two additional years, until 2019, to comply with a prohibition on their investing taxpayer-insured deposits in the risky instruments known as collateralized loan obligations. In addition, the bill softens Securities and Exchange Commission registration requirements for private-equity firms that function also as broker-dealers. The bill also would ease SEC requirements on disclosures that companies must make about the worth of company stock they offer as part of employee-compensation packages. Jeb Hensarling, R-Texas, said, “Much has been said about Wall Street versus Main Street. This is about Main Street jobs. The U.S. Chamber of Commerce, the Independent Community Bankers Association and the American Bankers Association all talk about how this will help.” Stephen Lynch, D-Mass., said that in 2008, he witnessed “the harmful impact that lack of regulation had on hardworking families. ... Many pension funds today continue to suffer and are on the brink of collapse because of the reckless policies that were observed during that time by many of our major banks.” A yes vote was to send the bill to the Senate, where it faces a 60-vote hurdle to advance. VOTE H-5 slugged FINANCIAL Voting yes: Sanford, Wilson, Duncan, Gowdy, Mulvaney and Rice Voting no: Clyburn Not voting: None COMPANIES THAT ASSIST TERRORISTS Voting 183 for and 242 against, the
House on Jan. 14 defeated a Democratic motion to HR 37 that would prohibit regulatory relief in the American financial system for state sponsors of terrorism or any company that has been convicted of assisting a terrorist organization. Seth Moulton, D-Mass., said, “Reasonable people may disagree on the merits of this bill, but we should all be able to agree that those who support terrorists and state sponsors of terrorism should never use our financial system to their benefit.” Jeb Hensarling, R-Texas, said “there are numerous bad-actor provisions already within our federal securities law. So, with the possible exception of the unconstitutional power grab of our president in granting amnesty and possibly allowing new bad actors to enter our country, I think that (this) motion to recommit is probably largely irrelevant.” A yes vote was to adopt the motion, which, had it prevailed, would have immediately amended the bill. VOTE H-6 slugged COMPANIES Voting yes: Clyburn Voting no: Sanford, Wilson, Duncan, Gowdy, Mulvaney and Rice Not voting: None SENATE KEYSTONE XL PIPELINE The Senate on Jan. 12 voted, 63 for and 32 against, to advance a bill (S 1) that would authorize construction of a Keystone XL Pipeline leg between the Canadian border and Steele City, Nebraska. This set the stage for debate on amendments to the bill, which gives federal approval to the pipeline for moving Canadian tarsands crude to the Texas Gulf Coast. John Hoeven, R-N.D., said, “Canada’s (oil) production is continuing to grow. And if we build the infrastructure, we can make sure that we control that energy — North American energy security.” Maria Cantwell, D-Wash., said TransCanada, the pipeline owner, “knows they are not going to be successful in getting this oil from Alberta across British Columbia out to the Pacific because the people of British Columbia do not want it. So, of course, why not come to the United States?” A yes vote was to advance the bill. VOTE S-1 slugged KEYSTONE Voting yes: Lindsey Graham, R, and Tim Scott, R Voting no: None Not voting: None © 2015, Thomas Voting Reports Inc.