Ensuring that patients adhere to their medical appointments is a great challenge. Missed appointments are detrimental to the patient’s health, and is costly for the general population if the problem becomes widespread.

Studies conducted in the US showed that millions of Americans missed or delayed their trips to the doctor's office because of transportation issues. Existing literature shows that the inability to access transportation services is one of the major barriers for patients to complete their clinic visits.

Unsurprisingly, the problem is more prevalent among the low-income population as they lack the necessary means to own a personal automobile, or simply have limited access to affordable public transport.
For a challenge as formidable as this one, the tech industry appears unfazed and determined to turn it into an opportunity.

Ride-sharing as a bridge to healthcare

On 1 March, ride-sharing company Uber announces a new dashboard – Uber Health – that allows healthcare providers in the US to schedule transportation that will ferry patients on their appointment dates. The platform also allows patients to schedule the ride themselves, therefore providing a certain time flexibility.

"We want to make [Uber] accessible to patients whether they're familiar with Uber or not," says Chris Weber, the General Manager of Uber Health.

The company claims that they have an official partnership with over 100 healthcare organisations in the US "including hospitals, clinics, rehab centres, senior care facilities, home care centres, and physical therapy centres" as part of this ride-sharing program.

Uber recently announces that the company is offering ride-sharing services to help patients get to and from their healthcare providers. Photo credit: Ritchie B Tongo/European Pressphoto Agency
Uber recently announces that the company is offering ride-sharing services to help patients get to and from their healthcare providers. Photo credit: Ritchie B Tongo/European Pressphoto Agency

On the other hand, another ride-sharing giant operating in the same market, Lyft, has also endeavoured into this potentially lucrative trade in healthcare. It has entered into a partnership with various health insurers, hospital systems and medical transport services to service patients in non-emergency situations.

Lyft goes one step further to integrate its ride-hailing system into patient's electronic health records (EHR). Such integration allows Lyft to determine if the patient requires special transportation without causing additional workload to the healthcare providers.

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Promising solution or impending failure?

At first glance, the ride-sharing initiative seems promising in reducing the number of missed medical appointments – due to transportation issues without any significant clinical concerns. After all, majority of the patients travel to the clinics in the same mode of transportation.

However, a recent publication on JAMA Internal Medicine calls into question, whether ride-sharing is truly the answer to missed medical appointments.

The study looked at 786 adult patients who were allocated to being offered complimentary ride-sharing services (intervention arm), or usual care (control arm) based on the prescheduled day of their primary care appointment reminder. They came to a conclusion that there was no significant difference in missed appointment rate between the intervention and the control arm.

Speaking to The Washington Post, lead author Krisda H Chaiyachati of the University of Pennsylvania and the Veterans Affairs Medical Centre, is surprised by the results that seem to contradict previous studies conducted by the individual ride-sharing company.

“We really thought ride shares would be super convenient. We were pretty surprised, actually, it did not work out,” says Chaiyachati.

Earlier reports seem to uphold the notion that the ride-sharing programs are more efficient and cheap. Average waiting time decreases by 30%, while the average cost-per-ride has also fallen by a staggering 32.4%.

“The study results [by the Chaiyachati group] really contradicted what we’ve seen with other partners, again and again,” says Gyre Renwick, the Vice President of Lyft Business.

Lyft has also entered into a partnership with several healthcare providers to offer transportation services in non-emergency situations. Photo credit: The Associated Press
Lyft has also entered into a partnership with several healthcare providers to offer transportation services in non-emergency situations. Photo credit: The Associated Press

The issue with reputation

Besides ensuring good medical appointment attendance, securing the patient's private medical information is another pivotal element for companies like Uber to succeed. It is reported that Uber is working with a leading Health Insurance Portability and Accountability Act (HIPAA) risk-management company to ensure Uber Health adheres to the rigorous HIPAA standards.

Given Uber’s history of disrespecting privacy by spying on ordinary users using the infamous “God View” app, many are not convinced that the company will adhere to such strict confidentiality requirements unless major reforms to the company's corporate culture and ethics take place.

As with any other emerging technologies, ride-sharing actually has the potential to disrupt the healthcare market. Only time will tell if this development will be beneficial or detrimental to the patients in the end. MIMS

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Sources:
http://money.cnn.com/2018/03/01/technology/uber-health/index.html
https://www.uber.com/newsroom/uber-health/
https://www.washingtonpost.com/news/the-switch/wp/2018/03/01/uber-and-lyft-think-they-can-solve-one-of-medicines-biggest-problems/?utm_term=.b1794ff51b58
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2671405?redirect=true
https://techcrunch.com/2018/03/05/lyft-commits-to-cutting-the-problem-of-health-care-transportation-in-half-by-2020/
http://web1.ctaa.org/webmodules/webarticles/articlefiles/NEMTpaper.pdf
https://futurism.com/uber-health-doctor-rideshare/
https://www.engadget.com/2016/01/07/uber-settles-god-view-probe/
http://time.com/3595025/uber-data/
https://www.engadget.com/2018/03/01/uber-health-partnership-with-health-providers/
https://jamanetwork.com/journals/jama/article-abstract/2547765?redirect=true