Tiempo: making non-emergency care easier to reach
A platform concept giving undocumented and uninsured New Yorkers clinic wait times and same-day appointments, designed around privacy and trust.
Our team started from one question: how might we strengthen connections between NYC immigrants and their local healthcare systems? It was personal. Each of us thought of a mother or grandmother who immigrated, from the Dominican Republic, China, Spain, and Vietnam, and navigated care in a new country. Our guiding line was "No one should wait on health. Nadie debe esperar por la salud."
What Tiempo does
Tiempo helps people seek last-minute, non-emergency care on their own schedule. It shows wait times for public clinics and federally qualified health centers (FQHCs), and, through collaboration with clinics, lets people book same-day appointments.
Estimating a wait
Our proposed wait-time estimate combined three inputs for each clinic: a week of historical patient arrivals, aggregated by hour and day; the clinic's expected throughput per hour; and current activity, including same-day bookings made through Tiempo and walk-in visitors. Multiplying the expected queue by the typical visit length gives an estimated wait.
We mapped that data to Epic's FHIR APIs: EpisodeOfCare.Read for start- and end-of-care times, and Appointment $find, $book, and Appointment.Read for scheduling, refreshed weekly from participating clinics.
Early validation
We spoke with clinics at the Weill Greenberg Center. An ophthalmology clinic told us, "This would be useful for our walk-in patients. Our clinics would consider using this." An oncology clinic noted that walk-in patients often wait a long time for care.
Designed for trust
Many people Tiempo is meant to serve are wary of technology that collects their information and might be linked to their citizenship. So we designed it to be free, confidential, and built only for the community it serves, with privacy safeguards from the start. We planned Tiempo as a nonprofit, funded by donations, grants, and foundation partnerships rather than revenue from users. Our team motto: "Rather be tied up in calls and not strings."
We also drafted an ethical risk assessment covering data-use and business associate agreements; FDA, CMS, cybersecurity, and IP considerations; and usability experiments with users and clinics.
Where it stood
Tiempo was a concept and prototype, not a deployed service. The roadmap went from design lock to data agreements with clinics, a pilot launch, and continuous improvement. The wait-time estimate was a proposed method and had not been validated against real clinic data.