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Comment by mattmireles | Hacker News Reader

I worked 911 in NYC and LA. The incompetence of Nursing Home Staff is often quite astounding.

It was common to arrive for a call of "general illness" only to find the patient in respiratory failure or cardiac arrest with no CPR in progress.

I see this as providing a fast way for clueless staff to up-triage patients.

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Telemedicine can potentially add value in many settings, like here http://nyti.ms/1fyWXeK. What I disagree with is their misleading marketing as an alternative to 911.

For regular people, this service is like a family doctor visit on Skype. Sometimes it can be handy, but it remains to be seen how this impacts outcomes statistically. (I wouldn't use this myself.)

For healthcare facilities, like nursing homes, this is like providing a doctor on call via telemedicine. Many hospitals already do this with radiologists or neurologists for example.

What is misleading is their marketing jump from these potentially useful scenarios to advertising as an alternative to 911 for the general public, and even claiming that they are faster than 911 when in fact they are a gatekeeper to 911.

While not wanting to paint with too broad a brush, many nursing/assisted living facilities have as a first priority the avoidance or at least dilution of liability. For example, in one facility, the management, the building owner, and the nursing provider will likely be three separate business entities. I can easily imagine that "call 911" is start and end of their approach to emergencies. If the patient dies, well there are probably 10 more people on the waitlist for that room.

Absolutely. I saw this time and time again. Things that were done to minimize liability, rather than patient's best interest - and that should never be acceptable. The least reason of which is financial, but people and their families are paying four, sometimes five digits a month for places whereby anything more than taking vitals is handled by 'do nothing, call 911', all the while charging for 'round the clock nursing care'.

Yeah. Anything that can be done to limit the damage of "ignorance and/or incompetence" is always a good thing.

My pet hate is always "Do you have a history on the patient or what's been going on?" was almost invariably answered with:

a) "No, this is my first day", or

b) "No, I just got on shift"

Oh. Good.

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