News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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More People Using Ride-sharing Uber and Lyft to Get to Emergency Rooms for Medical Treatment; Might Medical Laboratories Use These Ride-sharing Services?

Clinical laboratories and pathology groups that use taxicabs to pick up patient specimens and bring them to the lab now have the option of using Uber and Lyft for this service

For decades, medical laboratories have used taxicabs to have specimens picked up from one location and driven to the lab for testing. This was a way to handle STAT specimens, for example. Now, with the rise in popularity of ride-sharing services such as Uber and Lyft, a burgeoning trend has emerged where people utilize ride-services rather than driving themselves to the emergency room (ER) for medical treatment. Should clinical laboratories use ride-sharing services as well for transporting specimens?

Cost and Choice Two Advantages of Ride-sharing Services

According to the Center for Disease Control and Prevention (CDC), there are 130.4 million visits to ERs each year in the US and approximately 15% of those patients arrive by ambulance. But ambulance rides and EMT services can be costly.

According to howmuchisit.org, a website where visitors can find out how much average consumers paid for products and services around America, a trip to the ER by ambulance can range from $350 to $2,000 or more, depending on location, distance to the ER, and the patient’s insurance company.

Conversely, the cost for the same transportation by Uber or Lyft would typically cost less than $100.

So, price is one advantage ride-sharing services have over traditional ambulance rides. There are others. Patients also can choose which hospital they will be taken to for treatment. This option is generally not available via ambulance. Additionally, passengers know what the price of the trip with Uber or Lyft will be up front. Months can pass before patients receive a bill for a traditional ambulance ride.

But is it a good idea to call up Uber or Lyft instead of dialing 911 in a potentially life-threatening situation when moments count and emergency medical technician (EMT) skills can save lives?

To Uber or Not to Uber? That Is the Question

There are no statistics on the number of people who use ride-sharing services to go to the ER. However, many drivers in a chat room for Uber drivers acknowledged an escalation in the amount of requests for trips to the ER, usually for maladies such as broken bones, bleeding wounds, vomiting, or allergic reactions.

In a STAT article, Francis Piekut, who drives for both Uber and Lyft in Boston, described what he encountered when taking a call to transport a passenger to the ER. “They were burned and wanted to go the emergency room,” he stated. “I don’t know how bad it was, but I knew they were in pain really bad.” He took the individual where they wanted to go, as he would any other fare.

“I didn’t mind it,” Piekut added. “I was already there, and I know the ambulance costs a lot.”

However, other drivers in the chat room indicated they had or would refuse such service requests due to:

  • Liability issues;
  • Fear of getting blood or vomit in their car;
  • Knowing that they could not speed through the streets like an ambulance during an emergency; and
  • Apprehension about being stuck with a dead body if the passenger perished on the way to the ER.

Officially, Uber and Lyft recommend that people call 911 in the event of an emergency. In an ABC News article, Uber stated: “We’re grateful our service has helped people get to where they’re going when they need it most. However, it’s important to note that Uber is not a substitute for law enforcement or medical professionals. In the event of any medical emergency, we encourage people to call 911.”

The screen shot above taken from an NBC News TODAY video shows that some Uber drivers feel they are not required or prepared to substitute for an actual ride in an ambulance or EMT van. Click on the link above to watch the full video report. (Photo copyright: NBC News TODAY.)

Nevertheless, some emergency departments are looking at ride-sharing services to reduce their workload. Officials in Washington DC are researching the use of such services for “non-emergency, low-acuity” calls. These types of calls were responsible for nearly half of the city’s 911 calls in 2015, STAT reported.

“In our research, we found that many of these calls did not require an ambulance,” Doug Buchanan, Chief Communications Officer for the District of Columbia Fire and Emergency Medical Services (DC FEMS), noted in the STAT article. He believes it would be beneficial if people with non-emergencies used ride-hailing services instead of an ambulance. “We would love our residents to take that initiative,” he stated.

Baltimore ER physician Mark Plaster, MD, believes there should be multiple transportation options available to patients to accommodate different types and intensities of injuries.

“I would hope that no one who needed truly urgent medical attention would take an Uber,” Plaster urged in the STAT article. “If you need medical care en route, a private car is a bad idea, because you won’t have the personnel or equipment to treat you.”

Nevertheless, Plaster can see some merit in using ride-sharing services to get to the ER.

“Rideshares don’t take ambulances out of service, and not everybody coming into the ER is in a dire situation,” he stated in the STAT article. “And the ambulance can be expensive.”

Clinical Laboratories Use Taxis to Transport Specimens

Ride-sharing services were originally established to improve on the cost and availability of taxicab services. Apparently, their faster service versus a traditional taxicab also makes them a desirable option for some individuals who need to get to an ER. But before you call Uber or Lyft to go to the ER, know that they are not prepared for true emergencies and your life could be on the line.

Clinical laboratories and pathology groups, on the other hand, have been using taxicabs for the delivery of lab specimens for decades. It is likely, then, that services like Uber and Lyft will soon be used for the transportation of lab test specimens, as well, and will continue to be utilized into the future.

—JP Schlingman

Related Information:

For a Trip to the ER, Some Are Opting for Uber over an Ambulance

Expert Warns: Take Ambulance Instead of Uber or Lyft to ER

Why Many People Are Turning to Uber over Ambulances in Emergencies

Why I Used Uber Instead of an Ambulance

Why some people are calling Uber instead of an ambulance to get to the ER

Uber to the ER?

$164 Per Mile: Surprise Ambulance Bills Are a Growing Problem and Difficult to Avoid

Lyft Plans to Expand to 100 More US Cities in 2017

Lyft vs. Uber: Just How Dominant Is Uber In the Ridesharing Business?

HIE Use Rises along with Adoption of EHRs, but Full Interoperability Remains Elusive for Hospitals, Physicians, Clinical Labs, and Pathology Groups

The majority of the nation’s hospitals and physicians now use electronic health records and most of these EHR users are already exchanging clinical data with regional HIEs

Pathologists tracking the adoption of EHR systems by hospitals and physicians will be interested to learn that, according to the federal government, more than 80% of hospitals and 50% of physicians now use these products. It is also reported that growing numbers of providers are exchanging data with health information exchanges.

Clinical laboratories and anatomic pathology groups have a big stake in these developments. Medical laboratory test data is an essential component to every patient’s permanent health record, which is why it is important for every lab to have interfaces with the HIEs serving their communities and regions.
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Medical Scribes Move Outside the ER to Help Clinicians in Other Healthcare Settings Make the Switch From Paper Charts to EHRs

Scribe-assisted physicians say their productivity is back to normal after plummeting with connection to an EHR and have time to spare

One unintended consequence of the federal program to encourage hospitals and physicians to adopt and use electronic health record (EHRS) systems is the creation of a new category of healthcare worker. Today, a growing number of hospitals and medical groups are hiring medical scribes.

Medical scribes are trained individuals who document physician-patient encounters in real-time while a physician is examining the patient. Dark Daily was one of the first to call attention to this new healthcare profession. Medical scribes got their start several years ago working in emergency rooms (ER) to help increase ER physician productivity [See Dark Daily: Adoption of EMRs Creates Demand for New Healthcare Job of ‘Scribes’].

Now, thanks in part to $15.5 billion in federal funding under the American Recovery and Reinvestment Act of 2009, medical scribes are assisting physicians outside the ER. They can be found with doctors making hospital rounds and in medical practices, entering patient medical data into EHRs while physicians are examining or interacting with patients, noted a report published in Modern Healthcare. (more…)

Hospitals Take Steps to Drive Down Medical Errors in Their Emergency Departments

Clinical laboratory managers are often part of the ER’s process improvement team

Hospital emergency rooms (ER) across the country are intensifying their focus on improving patient safety  and reducing errors. The cost of malpractice lawsuits filed after errors in emergency rooms is a major reason why growing numbers of hospitals are initiating formal programs to identify and eliminate the source of errors and wrong care provided to patients.

It probably won’t surprise most pathologists and clinical laboratory managers to learn that diagnostic errors are one significant source of malpractice claims that result from care provided by hospital emergency rooms, which can often be chaotic and overcrowded. Recently, The Wall Street Journal reported that a large percentage of medical errors in hospitals—and the resulting malpractice suits—occur because of mistakes in the emergency room. Studies of closed claims show that 37% to 55% of the malpractice suits are attributable to diagnostic errors. (more…)

Adoption of EMRs Creates Demand for New Healthcare Job of “Scribes”

Clinical pathology laboratories may soon handle lab test orders entered by scribes on behalf of physicians

Along with the growing adoption of electronic medical record (EMR) systems comes robust demand for a new healthcare job: scribes! That is a bit ironic, since many advocates of EMRs believed that physicians would do the primary entry. In fact, the acronym CPOE (computerized physician order entry) was coined to describe this process.

The trend of hiring scribes to interpose between physicians and EMRs is an unanticipated consequence of wider adoption of EMR and EHR (electronic health record) systems. Wider utilization of scribes will directly affect clinical laboratories and pathology groups, because the scribe generally becomes the individual to place orders for clinical laboratory tests at the direction of physicians and track receipt of the lab test results into the EMR.
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