Uber partners with startup to take patients to the doctor

Uber has partnered with a technology startup to provide patients with nonemergency transportation to a handful of hospitals. The move is part of a pilot program designed to reduce missed doctor's appointments for low-income, elderly or disabled patients.

Circulation, the startup, uses a HIPAA-compliant digital platform that connects Uber with patients, care and transportation coordinators, and healthcare providers.

It will be piloted at Boston Children's Hospital in Massachusetts, Mercy Health System's three hospitals and elderly-care program in Pennsylvania, and Nemours Children's Health System in Wilmington, Delaware.

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"Unlike other new offerings that are stand-alone systems to dispatch on-demand vehicles, Circulation's platform integrates with our internal systems, as well as with ride providers like Uber,” Gary Zimmer, SVP and CEO of the Clinically Integrated Network at Mercy Health System, said in a news release. “It's much more efficient for our transportation coordinators.”

The partnerships highlight the ongoing trend of hospitals and healthcare providers trying to do more to lower extraneous costs while seeking out innovative ways to improve patient care.

Lyft, an Uber competitor, has a program to transport senior citizens to nonemergency doctor's appointments. In January it announced a partnership with the National Medtrans Network to provide 2,500 rides per week in New York City. Like the Uber/Circulation program, the Lyft partnership doesn't require that patients own a smartphone. Instead they can use an online requesting service or contact a healthcare provider.

A 2005 study estimated that 3.6 million people do not receive nonemergency medical care because they don't have access to transportation, according to a JAMA viewpoint published in September. The viewpoint also said that patients with a high burden of chronic diseases are more likely to struggle with getting transportation to a doctor's appointment.

“A no-show? That's a cost to the system,” said Dr. John Brownstein, chief innovation officer at Boston Children's Hospital, and one of Circulation's co-founders. “There's [also] a downstream impact on the patients.”

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Hospitals already pay for nonemergency transportation for some patients. Other patients, primarily those covered by Medicaid, often have access to taxi vouchers. However, Brownstein described the taxi voucher programs as difficult to track and ripe for abuse.

The U.S. government spends an estimated $2.7 billion on non-emergency transportation each year. An analysis of roughly 182,000 patients receiving dialysis and who were relying on a car service found that they were more likely to miss their appointments, according to the same JAMA viewpoint.

Patient who miss routine appointments can end up in the emergency department or the hospital, both of which are much more costly ways to care for a sick patient.

But experts have raised a number of questions about whether the Lyft and Uber programs. They ask whether spending on transportation services will instead go up and whether rural communities will continue to remain underserved.

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“Older, sicker patients may prefer a slower ride, or a helping hand in and out of the car, which are activities that are at odds with the financial incentives for transportation network company drivers,” wrote the authors of the viewpoint. “As these programs expand, it will be important to rigorously monitor patient experience and to provide this information to transportation network companies.”

This hasn't stopped the companies from making expansion plans. Circulation plans to roll out its service in six additional states in 2016 and is working on developing a consumer version of the platform. It is also considering ways to use Circulation to improve the hospital discharge process, Brownstein said.

The startup was founded by Brownstein, a healthcare advisor to Uber and a professor at Harvard Medical School; Robin Heffernan, CEO of Epidemico, a population health informatics firm; Jared Hawkins, director of the informatics innovation program at Boston Children's Hospital, a Harvard-affiliated hospital; and Leerom Segal, CEO and co-founder of Klick Health.