Triage 2.0: Take A Picture Of Your Ailment, Email It Your Doctor, And Avoid The ER

Sherpaa, a health care startup previously only available to Tumblr employees is now going public. With a doctor on call 24/7, you can always get care, but there’s a hitch: They’ll only see you on the Internet.

It’s no secret that the health care industry is just now starting to catch on to today’s technology. Electronic health records are slowly being adopted, but bills are still sent out via snail mail, and perhaps most irritatingly, most doctors won’t just let you send them a quick email instead of trekking into the office. There’s a good reason for this: They don’t get paid if you don’t come in. Sherpaa, a New York City-based startup, is aiming to keep patients out of the doctor’s office as much as possible—and to make sure that doctors have an incentive to answer their calls and emails.

The goal of Sherpaa, explains co-founder Dr. Jay Parkinson, is to keep overhead health care costs down for companies and improve doctor-patient relationships at the same time. That may sound contradictory, but it’s not. "Companies are spending way too much on health insurance relative to people in the youngish age population," says Parkinson. Consider: 75% of people spend less than $2,000 each year on health care, and 96% spend less than $10,000. And yet, health care is the second highest cost for companies, just after payroll.

"A company of 100 would go to an insurance broker, which would give them 20 to 30 plans in a spreadsheet, it’s confusing as hell, and they don’t have the expertise to make an educated judgment," says Parkinson.

Sherpaa cuts out wasteful spending by going to companies, analyzing their health care, and securing them a plan that is more in line with how their employees use medical services. They generally recommend a deductible of at least $2,000, and then ask companies to give employees a $2,000 debit card for health care. Whatever they don’t use goes back into the company coffers. In the end, these companies can save $2,000 to $4,000 per employee, even with the debit card.

Companies working with Sherpaa also pay a monthly fee for the startup to manage employee health. This is where Sherpaa gets really interesting: Instead of just going to a primary care doctor (or even an emergency room) when they need medical attention, members can email or call one of Sherpaa’s primary care doctors (or "guides," as the startup calls them), who are on-call 24/7. The doctors get paid a monthly salary for their extra time.

Instead of heading into the office and shelling out for a copay, patients can talk to Sherpaa doctors remotely to find out whether they need to see a doctor in person (Sherpaa doctors, in fact, only work remotely), whether they need a prescription (those can be prescribed without setting foot in an office), or whether they need a referral to a specialist (Sherpaa has 100 specialists).

If a patient thinks they need to drive to the ER for a gnarly cut, for example, they could instead snap a picture and send it to a Sherpaa doctor. The doctor could give instructions on self-care, or call one of their trusted plastic surgeons, and send the patient into the surgeon’s office an hour later. No ER necessary. Hence, the name of the service—these doctors are sherpas through the health care system.

Sherpaa currently has one doctor on call, but expects to expand to 150 to 200 New York City doctors in the future. Up until two weeks ago, the startup worked only with Tumblr; it has started signing up more business in the past few weeks.

"When you go to a company and explain to them what’s going on, within a few minutes, it’s a no-brainer for them to do it," says Parkinson. "It just highlights how much waste there is in the health care system. That’s their business model: confusion."

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  • Daniel Kim

    This is rather similar to the kind of cellphone picture/email service that some agricultural extension services use, in which a farmer can email a photo of an insect, insect damage or diseased plant and get a reply identifying their crop problem.

  • Daniel Kim

    The 'high deductible plus debit card' idea is pretty good. By reducing insured billing for small amounts of care, a company can still come out ahead, even covering 100 percent of an employee's deductible. Part of the efficiency comes from the lack of billing paperwork, though. There is an assumption that employees on such a plan will not engage in significant fraud, cutting out the expenses of gatekeepers and paperwork to justify 'medical need' and 'customary fee for service'. In the end, even with some amount of fraud, the system may still save money for a company. If it were to be adopted for government-sponsored health care, though, irregularities become political issues, and more and more layers of often ineffective oversight are added, without regard for their expense, to ensure that nobody cheats the system.

  • free2b1956

    This would be a good solution for medicaid recipients considering they somehow think that since they aren't footing the bill an er visit isn't a big deal for a stubbed toe. 

  • Daniel Kim

     It can also relieve a Medicaid user from the long waits that can be associated with those few doctors (in some regions they can be rare) that will accept Medicaid, giving them an alternative to the very expensive emergency room visit.

  • jana rade

    Well ... considering how long one has to wait at the ER ... considering how LOONG before one gets to see their family doctor ... considering that veterinarians offer similar service already and it's been working well (of course sometimes the only right answer you get this way is "go to the ER"), why not?

    Also might work well for getting second opinions, which are more crucial than one would think.

  • Stuart Wainstock

    Very interesting concept.  It will be interesting to see what the future holds for this doctor 2.0 business model.  Thanks for spotlighting this.

    Team MDWebPRo