Estimates are that more than three million people miss healthcare appointments each year due to transportation issues; that is true for patients with clinical lab test orders who never visit a patient service center

Patient no-shows, missed appointments, and rescheduling impact not only clinical laboratories and pathology groups but the entire healthcare community in lost time and wages. So, critical is scheduling that patient portal and electronic health record (EHR) developers focused first on implementing those technologies before moving on to billing and other aspects of health information technology (HIT). If patients don’t arrive at their appointments on time, everyone loses.

Thus, Internet and smartphone application (app) developers continue to refine and improve their scheduling software. Now, other companies outside of traditional healthcare also are capitalizing on this opportunity.

One such innovative company is Uber, a San Francisco-based transportation service company created in 2009 that enables people to order a local driver pickup via a free smartphone app. Last year, Uber began collaborating with MedStar Health, the largest healthcare provider in Maryland and Washington, DC, to help address the issue of missed appointments.

Getting Patients to Their Appoints is Half the Battle

An article in the Washington Business Journal noted that estimates place the cost of missed healthcare appointments as high as $150-billion per year in the US alone. And research published by the Journal of the Transportation Research Board suggests that up to 3.6-million people miss or delay appointments annually due to transportation issues. These exorbitant costs, combined with the necessity for patients to receive timely care, are compelling healthcare providers to develop innovative strategies to deal with missed appointments.

All of this is of interest to clinical laboratories, because a substantial number of patients who get medical laboratory test orders from the physicians never come to a patient service center to have their specimen collected. Not only does this mean that the patient (and his or her physician) won’t get the needed lab test results, but it means that the lab loses the opportunity to be paid for performing the tests that were wanted by the patients’ physicians.

“Half our battle is getting the patient to the appointment,” stated Pete Celano, Director of Consumer Health Initiatives for MedStar Institute for Innovation, Healthcare Dive reported. Celano, along with other representatives of the Uber/MedStar Health collaboration, spoke at the Connected Health Conference last December. Lindsay Elin, Director of Federal and Community Affairs at Uber and Daniel Hoffman, Chief Innovation Officer for Montgomery County in Maryland, joined Celano in discussing their shared experiences and insights with the collaboration during a session titled “Cities That Promote Health.”

“For patients who can afford it, we say ‘Please uber if and as you want to,’” Celano stated. “It could be less expensive to go to Georgetown University Hospital for example on an uber from most places than to park there, if we even have parking spots available.”

Uber/MedStar collaboration may be especially beneficial for patients with disabilities

The Uber/MedStar collaboration may be especially beneficial for patients with disabilities who want to use the Uber to get to healthcare appointments. The Uber Accessibility website features a host of helpful instructions and tools to get patients started using Uber. (Photo copyright: ABC News.)

In the past, MedStar utilized local taxi services to diminish the amount of missed appointments. Celano stated that such services could be cost-prohibitive, cumbersome, and unable to meet the needs of patients who required assistance. Now, Internet technology, such as smartphone apps, can be used by providers in innovative and clever ways to improve the patient experience.

That’s the thinking behind encouraging patients to request an Uber driver for transportation to medical appointments. The pick-up is easily requested through a free smartphone app. Healthcare providers may also arrange and manage transportation for patients who do not own a smartphone. Patients also can order an Uber driver online by selecting the Uber icon on MedStar’s homepage.

The Power of Going Door-to-Door

The partnership has been successful. Celano stated that the cost of an Uber trip is about 60% of the cost of a cab in the DC area and patients can arrange for a car inside an hour time frame. MedStar also can cover the Uber transportation fee for patients with medical and financial needs.

“People ask me how it’s going and I say it’s all about the power of going door-to-door,” Celano stated in the Healthcare Dive article. He added that keeping scheduled appointment times can result in better outcomes for patients as well.

A CrossChx report titled, “The Cost of Now Shows” notes that the most common reasons for patients to miss scheduled appointments are:

  • Lack of transportation;
  • Amount of time between scheduling and the actual appointment;
  • Emotional obstacles; and
  • Believing that medical professionals do not respect patients.

Elin stated that other healthcare providers have expressed interest in utilizing Uber for patient transportation and that Uber has established a team to work solely with healthcare providers. Additionally, Uber’s uberASSIST program trains drivers to work with riders who may require specialized attention, such as senior citizens and the disabled.

“We firmly believe [that] with partnerships with healthcare providers, senior centers, [and] transit agencies we can do even more and reach more people,” Elin stated.

Taking Proactive Steps to Better Patient Care

The Uber/MedStar collaboration shows how internet technology and smartphone apps can be used by healthcare providers in clever ways to improve patient experience. Additionally, it should be understood as a market development that shows how a healthcare provider, attempting to deliver integrated care, recognizes that it must take proactive steps to get certain patients with chronic diseases to their appointments to manage them proactively and help prevent an acute event.

Clinical laboratory leaders should see this story in both dimensions. And then use those insights to identify how they might collaborate with high-tech companies to deliver lab services in different ways that help achieve better patient outcomes.

—JP Schlingman

 

Related Information:

‘It’s Door-to-Door’: MedStar, Uber Detail Partnership’s Progress

Insight: Tackling Healthcare’s Costly Problem of Missed Appointments

Why MedStar Health Just Teamed Up with Uber

Accessibility at Uber

Cities That Promote Health

MedStar Health Pays for Patients in Need to Get Uber Rides to Appointments

Cost-Effectiveness of Access to Nonemergency Medical Transportation: Comparison of Transportation and Health Care Costs and Benefits

Multi-channel Smartphone Spectrometer Enables Clinical Laboratory Testing Quickly and Accurately in Remote Regions