Sebastiaan Foppema is CEO and general manager of instED, a mobile health care provider that provides emergency care to patients who would otherwise wind up in the emergency room. The service, launched in Massachusetts in 2014, expanded into Rhode Island earlier this year.
Available to people who are covered by health insurance through Commonwealth Care Alliance, another Massachusetts-based provider that moved into the Ocean State in 2021, instED offers care for acute illnesses, chronic conditions and injuries.
Foppema explains how the service works and whether he expects to make new hires in Rhode Island.
PBN: When did instED begin operating in Rhode Island, and approximately how many people are eligible for the service?
FOPPEMA: instED officially began operating in Rhode Island at the beginning of 2022 and is currently available to individuals who are enrolled in Medicare Advantage or Medicare Special Needs health insurance plans through Commonwealth Care Alliance.
While we are still very new in Rhode Island, instED was founded in 2014 and is well-established as a leading provider [of] in-home urgent care services. Just last year in Massachusetts, instED paramedics completed more than 4,400 in-home visits in response to the urgent care needs of more than 2,100 patients, resulting in approximately $6.1 million in medical cost savings.
As we build our presence in Rhode Island, our goal is to partner with additional local insurers so that we can make our service available to as many Rhode Islanders as possible. As someone who has lived here in Rhode Island for the last 20-plus years, I was particularly excited to have the opportunity to work on this expansion – and I am looking forward to the next steps!
PBN: Does instED have a brick-and-mortar Rhode Island location? If so, were any jobs created here?
FOPPEMA: We have secured office space in downtown Providence. Additionally, our paramedic partner, Cataldo Ambulance, has established a base location in the Providence area. As we grow our Rhode Island operations, we expect to add nurses, nurse practitioners, physicians and administrators over time.
PBN: If need be, can instED paramedics take patients to hospital emergency departments in the same way that “regular” emergency responders can?
FOPPEMA: Our goal is to help patients avoid unnecessary, expensive trips to the hospital. An estimated 67% of patients who are admitted to emergency departments across the country do not actually need to be there. Especially for individuals with significant or chronic health needs, these avoidable trips to the hospital can take a toll on patients’ mental health and put them at risk of catching “something else” while they’re in the hospital. Our care model aims to provide these patients with a safe, convenient and comfortable way to request and receive the urgent care they need, without needing to leave their homes.
By design, instED paramedics do not transport patients to the hospital. When we receive a request for an in-home visit, our team quickly connects with the patient to conduct an assessment of their medical needs and determine whether they can be seen and treated in their own homes. From there, a specially trained team of medical professionals determines the patient’s best course of care, and if appropriate, an in-home visit will be conducted by instED paramedics within a few hours of receiving the patient’s request. During that assessment, if it is determined the patient requires immediate attention in a hospital setting, we engage 911 to dispatch a Rhode Island EMS [emergency medical services] provider to the patient’s home.
PBN: For months, Rhode Island health leaders have been asking residents to visit the emergency room for real emergencies only, in order to alleviate overcrowding caused by recent COVID-19 variants. With that in mind, has there been any thought on expanding instED’s availability?
FOPPEMA: The impact the COVID-19 crisis has had on local hospital systems is one of the primary reasons we made the decision to expand instED’s scope outside of Massachusetts. Our service is a tried, tested and proven way to reduce the strain on local emergency departments, while ensuring individuals with significant needs are able to continue receiving the urgent care they need in their own homes.
Our technology platform, instED Now, accepts patient requests on an always-on, 24-hour basis, and our instED paramedic teams are currently equipped to conduct in-home urgent care visits from 10 a.m. to 10 p.m. every day, 365 days per year. If there is a need to expand our operating hours to serve more Rhode Islanders, we will certainly pursue it.
PBN: What are some of the most common conditions and health issues that instED responds to?
FOPPEMA: InstED’s network of highly trained paramedics and medical professionals respond to and treat a wide variety of symptoms, including acute illnesses – abdominal pain, shortness of breath, COVID-related symptoms, anxiety, depression and more; chronic conditions – congestive heart failure, migraine headaches, asthma, behavioral health and more; and injuries – burns, basic wound care, fall assessment and more. More than 82% of instED visits in 2021 resulted in the avoidance of an emergency department visit or an inpatient admission. instED’s patient satisfaction is consistent and impressive with an NPS [Network Promoter Score] … well above 90.
Elizabeth Graham is a PBN contributing writer.
