One month in: DispatchHealth on Vashon

One month into its rollout on Vashon, mobile urgent care provider DispatchHealth has seen a steady stream of islanders with a variety of healthcare needs on Vashon — providing an alternative to off-island brick-and-mortar urgent care facilities.

That’s according to data from the company shared by the Vashon Health Care District, the public taxing district responsible for hiring DispatchHealth to provide care on the island in October.

According to that data, DispatchHealth crews made 69 total visits in October (between two and three per day), with 100% of those patients saying they would recommend DispatchHealth to another person. The average patient was 57 years old.

VHCD Superintendent Tim Johnson is ebullient about the healthcare provider’s rollout. In its first month of operation, the service has also been lauded by several islanders who have shared testimonials about their positive experiences with the healthcare company on social media and letters to the editor of The Beachcomber.

“I’ve spent the better part of 10 years trying to figure out urgent and after-hours care, and the model that we ended up with is here, and it’s in many ways better than what I had been going for,” Johnson said. “We’re hoping that that is a fundamental game changer for not only quality of life, but the ability of people to maintain life on the island.”

But Vashon Island Fire & Rescue’s (VIFR) Chief Matt Vinci, joined by some VIFR commissioners, has emerged as a vocal critic of DispatchHealth’s rollout on Vashon. Vinci has alleged that DispatchHealth has, in its first month, treated islanders with certain serious conditions who instead should have been attended to by VIFR and King County Medic One crews.

In recent weeks, VIFR has launched a public health campaign, under the banner of “Don’t Wait, Call 911,” for conditions including but not limited to chest pain or discomfort, shortness of breath, stroke-like symptoms, loss of vision, bleeding control, bone breaks, severe allergic reactions, head injuries, high fevers, and major injuries resulting from falls or other accidents.

“Our heart and our mission is to ensure that patients get the right level of treatment,” Vinci said. “Dropping DispatchHealth into the middle of an established system is completely disruptive.”

According to DispatchHealth Area Operations Manager Jasmine Casey, DispatchHealth dispatchers had no calls suggesting the need for any care outside the scope of DispatchHealth’s urgent care services, nor any instances of care given outside the scope of DispatchHealth teams once in the home.

Furthermore, Johnson denies the allegation that DispatchHealth has infringed on VIFR’s work or improperly taken appointments from islanders whose conditions should have been routed to 911. Emergency and urgent care are well-defined in the medical world, he said, and DispatchHealth crews are trained professionals who know when a call should be escalated to 911 services.

“We agree that if something is an emergency, or you think it’s an emergency, you should dial 911,” Johnson said. “In fact, in our literature and our presentations, that’s kind of our lede. … Would you go to an urgent care center? If the answer is yes, then likely you’d call DispatchHealth. And if you’re wrong, they’ll tell you.”

The Beachcomber will dive into this complicated conflict in an article soon. For now, here’s the basics of DispatchHealth’s rollout.

Visiting Vashon residents seven days per week, DispatchHealth crews take a ferry over from Tacoma in the morning, and by 11 a.m. are on Vashon and ready to start seeing patients. They operate from 11 a.m. through 7 p.m., 365 days per year.

DispatchHealth is intended for the kinds of urgent care needs you’d seek care for at a brick-and-mortar location — including skin infections, urinary tract infections, coughs and colds, cuts that need minor stitches, illnesses, care for minor muscle pains, food poisoning and kidney stones. Staffed by nurse practitioners, physicians assistants, EMTs and other medical practitioners, DispatchHealth has the ability to suture wounds, administer fluids, x-ray suspected fractures and more.

Vashon residents can request an appointment by calling 253-617-4010 or visiting dispatchhealth.com/locations/wa/vashon-maury-island.

Beachcomber rides along

The Beachcomber joined a DispatchHealth team on Halloween to see one of those teams in action.

It was a brisk afternoon as nurse practitioner Christian Graves and EMT Bailey Black, two DispatchHealth providers, knocked on the door of Vashon Island home.

Graves comes from a brick-and-mortar urgent care background and has done family practice as a Registered Nurse (RN) ranging from neo-natal ICU to end-of-life care. Black has worked in Emergency Medical Services (EMS) in upstate New York for her college campus and hopes to attend medical school after working and learning in the field with DispatchHealth.

This was their first call of the day, and wearing face masks and toting packs of medical equipment, the duo got to work. They knew what to expect because they’d been briefed about their patient, a six-year-old girl, from Dispatch’s system inside their car.

Graves and Black are what your typical DispatchHealth team looks like. The duos consist of a nurse practitioner or a physician’s assistant accompanied by an EMT, with the supervision or consultation of an emergency room physician when needed. The teams can diagnose, treat and issue prescriptions, draw blood and have access to mobile X-ray machines that fit in their vans.

The duo introduce themselves, chat with the girl and set up their gear — which includes a portable internet source, their tablet and laptop computers, a stethoscope, and blood pressure band. They confirm insurance and identification and together start taking the girl’s vitals, including her oxygen, heart rate and blood pressure, listening to her lungs as she breathes.

In between exams, the girl runs back to her room to show the employees the costume she plans to wear for Halloween. She talks to Black and Graves about favorite colors, Christmas gifts and arts-and-crafts projects.

So far, so good: “All those numbers look good. They make me happy,” Graves tells the girl.

But, Graves explains to the family: “I do hear some coarse sounds in her lungs … (and) her tonsils are extremely swollen, so I definitely think it’s [a] bacterial [infection].”

So Graves starts looking up antibiotics for the little girl. She already has a list of the girl’s allergies, so she knows which medicines to avoid. But to be safe, she asks the family for more details on the girl’s medicinal history.

Graves finds the winning antibiotic, places an order with Vashon Pharmacy, and instructs the girl’s family how to make sure their young patient keeps getting enough oxygen.

“Today, she looks wonderful,” Graves tells the family as the duo gets ready to depart.

A few minutes later, Graves and Black are out — a successful 45-minute visit in the books.

It was something of a dream visit, the two said afterward.

“She was alert, she was able to participate, able to have fun, she cooperated throughout the whole visit,” Graves said. “The family was aware of her health history and everything. That’s all very helpful. And that’s not always the case with some of the patients that we do see elsewhere.”

They said that their care on Vashon has tended to be for slightly healthier people than they see around their home base in Tacoma. They also see more kids and more cold or flu cases.

That’s because the Dispatch crews are more frequently sent out to facilities like retirement and adult family homes on the mainland, she said, where patients are more likely to have severe and chronic health conditions, or are unable to leave their houses. On Vashon, though, they’re treating many people who would otherwise be driving into a physical urgent care clinic — were one available out here.

Being in someone’s home is great, Graves said, because people tend to be more at ease. It also lets providers see what medications they’re taking, get a glimpse of their routines and lifestyle, and bring up things that might feel embarrassing for patients to bring up at the clinic — like getting help in paying for food or utilities.

“Nurse practitioners and physician assistants have a huge scope of practice, and so can make really fantastic decisions, and perform really fantastic care,” Black said. “And they’re really well versed in knowing when we need to go to the emergency department.”

The following insurance providers are in-network for DispatchHealth, according to the company: Aetna, AgeRidge Advantage, Alignment Health Plan, Anthem/Amerigroup, Asuris Northwest Health, Bright Health, Cigna, First Choice Health Benefits Admin, Government Employees Health Association, Humana, Kaiser Permanente PPO (First Choice), MultiCare Connected Care, Northwest Physicians Network, OptumCare, PacificSource Health Plans, Physicians of Southwest Washington L.L.C., Premera Blue Cross, Providence PACE, Regence BlueShield and United HealthCare.

The district has also pledged to cover the cost of caring for the uninsured. (See Healthcare District budget story, page 1.)

A previous version of this story inaccurately described the nature of after-hours visits by DispatchHealth. A quarter of the visits in October occurred on weekends or after 3 p.m. on weekdays, which is after DispatchHealth’s business hours. However, their established operating hours on Vashon are 11 a.m. to 7 p.m. This story has also been updated with information from DispatchHealth Area Operations Manager Jasmine Casey.