Sure, you can use Sever-Sent-Events, but a Websocket would be sufficient too (and probably works in more places, no less).
Especially since pusher is a third party service and it's probably using
(or is able to use) websockets as a transport for that push anyway?
Pusher uses a web socket. Pusher is cheaper when comparing against running our own dumb pub/sub server.
Rails 4 will support SSE, however we're not riding that edge as there were existing solutions to the problem.
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I think this covers most realtime problems without having to code that much, let alone a secondary server/service to handle the problem, we outsourced it, were happy.