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by ceejayoz 4155 days ago
I've got a medically sensitive daughter and this is a cool idea. Where does the data come from? Are you protected in situations where someone might drive to a now-closed ER?
3 comments

The data comes from http://medicare.gov/hospitalcompare/search.html

It has a pretty good amount of useful data if you're interested in searching around :).

To answer your second question: I'm not. For the V1 of the app, I'm relying on the government data being valid. However, I'm currently building an in-app feedback form that will allow users to (a) report real-time wait times if they are in the hospital, and (b) report closed ERs / incorrect addresses etc.

rtrivedi - do you have an email I can reach you on? I work for the company that helps Medicare.gov (and a lot of other govt agencies) publish their data online in machine readable formats and I'd love to get feedback from you and understand how you're using the data and potentially make the data publishers aware of this use case as well. You can reach me at mark.silverberg@socrata.com if you prefer not to post your email publicly.

Great job!

that's a very insightful comment on potential liability. it could indeed prove to be a problem in the event that the app misguides a user to a closed ER with a tragic outcome, especially in a litigious society.
I totally agree. One thing I made sure to do was make it very clear in the app (via a disclaimer) that the data is not real time and the app should not be used in emergency situations. I even tell them to call 911 whenever in doubt.

I think Health Scout is very useful but definitely shouldn't be used in life and death situations. Maybe I should make the disclaimer even more prominent...

One thing you could do AND SHOULD DO now is post your disclaimer in your app's description. LIKE RIGHT NOW!! Don't even read the rest of what I've posted. Do not pass go. Just go append your disclaimer to your App Page.

Okay, now that you've done that, good. Second, you need to put up a disclaimer screen or modal that happens on launch or viewDidLoad that requires user to agree to your terms of service/disclaimer/privacy policy in order to use the app. If they don't agree, they can't use the app. Period.

As it is now, I can access your app without seeing any messages or disclaimers on the accuracy of the information.

People can be litigious jackasses and may want to find somebody to blame for their grief or problems. With the false perception that every app makes millions of dollars, make sure you are not a target for lawsuits by at least doing the above steps ASAP.

Other than that, great job on the app!

Thanks! Will do asap and push out a new build.
Remember that you do not need to push a new build for your description changes to get updated. Those do not require approval and will go live soon after you hit save in iTunesConnect.
Your app to find Emergency Rooms nearby shouldn't be used in emergencies? I'm not convinced a disclaimer like that it's going to cover you.
I imagine the use would be, for the caregiver of a medically sensitive individual, to familiarize oneself with a new local area on arrival rather than waiting for an emergency situation.

For example: You've arrived in a new city. Open the app, see locations for ERs. Drive to each and familiarize yourself with the surroundings.

Yup, exactly. Recently I traveled to California and used the app to familiarize myself. I noticed that the closest hospital was 30+ minutes away. It was just good info even though I never really needed it.
It isn't reasonable to expect an app to replace 911.

That might not be what plays out in court, but the problem there is people aren't reasonable.

Hmm, this is a tough one. Given that it's just a different visualization on publicly accessible data, does the app have to safeguard against this in a special way? I used a disclaimer in the app, and went into detail in the privacy policy about how the app claims no responsibility to how the data is used. Do you have any suggestions as to a good way to handle these types of situations in general?
Just looking at your description in the app store, it says that it gives people the "ability to find the nearest emergency room" not that it "provides a visualization of publicly accessible data". ie. your claim in your app description is different to what your app actually does. It is natural that you want to inflate the merits of your app because you want people to download it. But that is exactly the sort of thing that will get you into trouble in court, I would imagine. (IANAL, etc).
No.

I guess advertising the locations of hospitals and what hours they are open could be less fraught than advertising emergency rooms, but I'm not a lawyer.

It's so people can plan out their visits and know what their options are in a new area.
I am also very interested to know where the data comes from. Great idea and great execution!
I want to be as open as possible about where the data comes from. It's pretty darn important to understand potential flaws in the system and I'm hoping to identify and (help) fix it.

The data comes from http://www.medicare.gov/. If you dig deep enough you'll see that the government does extensive surveys on each hospital and tries to catalog everything.

Two important deficiencies in the data that I am thinking about:

(a) Data is updated in real time. (b) There is no existing mechanism for Health Scout to help updating the gov data.

I agree the above will take some work and I intend to try through Health Scout :)

I'd suggest looking at openstreetmap for hospitals with emergency rooms. This might also give you an easy way to allow people to update the data.

OSM has http://wiki.openstreetmap.org/wiki/Tag:amenity%3Dhospital

  amenity=hospital
  name=Royal London Hospital
  emergency=yes
I've been working on this over the weekend. Due to imported data, the quality of hospitals in OSM (for the US) is pretty low. There are hundreds of doctors offices, clinics and nursing homes that are listed as hospitals.

(I've been correcting the data in my region. I have the idea to do some analysis for the entire country and incite people to clean up their areas. The Medicare dataset mentioned in this thread really makes that easier.)

Here's a query for the OSM tagged emergency rooms near me: http://overpass-turbo.eu/s/7pL (move the map and press "run" and it will update)

https://www.mapbox.com/blog/coffee-directions/ has a "coffee finder" that will give directions, but replace "coffee" with "emergency room" and it suddenly has a much greater impact.

That query works better than just looking for hospitals.

At a glance the rest look okay, but I converted one of the results into a 24 hour clinic (which is a better semantic match for urgent care than hospital+emergency=yes).

Thanks so much for this awesome app :) Multiple times in my past I've needed an app like this. If I may offer two suggestions:

- Can you show hospitals without average wait times? I just tried the app and it doesn't show me my preferred ER because medicare.gov doesn't have any wait time listed for it. That might weed out good ERs for no reason. (It's my HMO's hospital. I would travel 2 extra miles in nearly all cases for ER staff that have direct access to my medical records, the easy insurance situation, and the super easy followup with my doctors.)

- A way to search ERs by manually entering a location, not just showing the nearest. Unfortunately, my parents have a habit of calling me rather than calling 911 or just going to the nearest ER. While 99% of the time it's the ER near their home, sometimes I need to look it up. They're averse to learning any new app :(

Great ideas.

(1) I will add in the functionality to show nearby hospitals without average wait times. It seems easy enough and very useful without search functionality. FWIW, if the government doesn't report wait times, I default to the average ER wait time for your state. If there is no average ER wait time for your state, then I use the national ER wait time reported by the gov. May I ask where in the country you are located?

One thing to note, I explicitly query for hospitals within a 10 mile radius. I figure if it's more than 10 miles out, it's probably not worth the drive. Maybe I should rethink that assumption...

(2) The search functionality is definitely coming in an update. I've heard that it would be useful from numerous people.

> I default to the average ER wait time for your state.

Ahh, I did see that in the app after I wrote my comment, but that was the only thing I could think of that might affect the search results :/ I'm in San Francisco. 10 miles would cover most ERs in the city ;) but in more specific terms, the particular hospital I can't find is Kaiser SF, only ~2 miles away from me. I see hospitals 5+ miles further away in my list... so.

I wouldn't mind a view that opts out of wait times altogether too, or sort by travel time only. Most times I go it's serious enough that I rarely wait more than a few minutes, so I don't pay attention to wait times. And I definitely do a mental sort when presented with the ER a couple blocks away with the 20 minute wait, or the 20 minute away hospital with the super short wait time...