By GREGORY ZELLER //
Call9, a Silicon Valley startup and Y Combinator star, has relocated its doctors-on-demand service for nursing homes to Long Island, with a planned push into dozens of other states that welcome the cloud-based alternate 911 service.
The system immediately connects a user to an on-call emergency physician via video chat, allowing the doctor to assess a patient’s condition and talk on-site personnel through basic medical procedures as necessary.
The company said its service reduces doctor-to-patient time from an average 64 minutes to less than 60 seconds.
Call9 also distributes mobile emergency kits to customer facilities, including an electrocardiogram machine, an ultrasound device and necessary equipment to perform on-site laboratory tests.
Data from these sources is uploaded instantly to the cloud, giving the remote physician a clearer picture of the situation; if necessary, the doctor can summon an ambulance with a single keystroke.
The startup, which exploded out of California mega-incubator Y Combinator last spring with a celebrity lineup of angel investors, is looking to go national fast. But New York was the most fertile place to plant the seed, according to Chief Medical Officer and Westbury native Timothy Peck, who cofounded Call9 with CEO Celina Tenev, a Stanford University-trained postdoctoral fellow, and CTO XiaoSong Mu, a Stanford computer-science graduate.
Peck – a Harvard University-trained emergency physician who earned his MD at the NYU School of Medicine – noted new Empire State telemedicine laws that took effect this year as the primary reason Call9 planted its flag 3,000 miles from its Palo Alto base.
There are currently 29 states with telemedicine parity laws, meaning Medicaid and private health insurers must pay for telemedicine services just as they would for in-person medical services. New York officially joined the ranks in January, one year after parity laws were approved by the state Legislature.
With a ready supply of nearby investors, new laws set to reshape the telemedicine landscape and Peck’s personal connections, New York was the perfect place for Call9 to debut its services, which it did last summer.
“We set up shop here before anybody else, in anticipation of those law changes,” Peck noted. “We were willing to take a loss and maybe not get compensated at the same rate we could in some other states where they already had parity laws, in order to start serving New York nursing homes before other providers jumped in.
“It was a good space to walk into and show our value.”
That brought Call9’s “clinical operation team” to Long Island. The transient workforce, comprised mostly of engineers, jets in monthly from California – the company leases a house in Huntington to accommodate them – to install and evaluate, then returns to HQ and incorporates new functionalities.
The company wasted little time showing its value. Call9 went live in July at Central Island Healthcare, a 202-bed Plainview skilled nursing facility, and on a quiet Sunday morning just days after Call9 activated, a patient complained to staffers of stomach discomfort.
The attendants engaged the doctor-on-demand system and reached Peck, who happened to be the doctor on call. He evaluated the short-of-breath patient and walked a nurse through an EKG – something the nurse had never done before – and quickly determined the patient was having a heart attack.
Peck immediately summoned an ambulance – actions that may have saved the patient’s life and certainly showcased Call9’s intent and promise, according to the chief medical officer.
“There was already a lot of hype about us,” Peck noted. “And then right away, we saved someone’s life.”
By November, Call9 had expanded to the St. James Rehabilitation & Healthcare Center and now has contractual relationships with Oyster Bay Manor and Harbor House, a nearby assisted-living facility also owned by Manor owner Rachel Dombrowsky.
It also has connections – “anywhere from contract negotiations to signed letters of intent,” Peck said – with several other regional facilities, including assisted-living centers in New York City.
It’s precisely the rapid start worthy of a wunderkind of the Y Combinator, the California-based accelerator Fortune dubbed “a spawning ground for emerging tech giants.”
A breakout hit of Y Combinator’s spring 2015 cohort, Call9 attracted angel investments from actor Ashton Kutcher, San Francisco 49ers great Joe Montana, Gmail creator Paul Buchheit and Ali Rowghani, the former Twitter COO, ex-Pixar CFO and current Y Combinator partner.
The promising angel round was followed by a Series A that lifted Call9’s operating capital to $10 million and pointed the telemedicine firm toward Long Island. Since saving that patient in July, Call9 has also proved its worth in other ways, primarily by reducing unnecessary hospital visits.
Four out of every 10 patients Call9 physicians evaluate are in need of immediate attention and wind up going to the emergency room, and the benefits to those patients are obvious. But the value of sparing those other six patients from unnecessary hospitalization cannot be overstated, according to Peck, who referenced Centers for Medicare and Medicaid Services studies showing 45 percent of hospital admissions and two-thirds of ER visits stemming from nursing homes are avoidable.
“Preventing those other six from ever going to the hospital is a huge value proposition to our stakeholders,” Peck said. “We’ve shown an avoidance rate at 60 percent. That’s pretty good.”
As it prepares to expand into other states – there will soon be 32 with telemedicine parity laws, Peck noted – Call9 is already introducing some hefty technological upgrades. With 20 emergency physicians at the ready and at least one on call at all times, the company has rolled out “parallel” services allowing remote doctors to see multiple patients, in multiple facilities, at the same time.
That’s “unique in telemedicine,” according to Peck, and will allow Call9 to move quickly into larger assisted-living facilities. Such forward thinking, he added, is essential for a company functioning in a space that’s in regulatory flux – another reason progressive New York was the ideal location for the Silicon Valley startup to get busy.
“Long Island has been very friendly to us,” Peck said. “The people here know what it is to move fast. There’s a good mesh between fast-moving innovation and the way people think here.
“Now the pieces are in place and we’re ready to move fast across region,” he added. “To say the least, Long Island has been a good experience for us.”