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Uber: Your hospital's next partner?

Earlier this fall, the "Uberization" of healthcare became a reality when the San Francisco-based startup took a big step into the world of healthcare. On Sept. 27, Uber officially partnered with Boston-based startup Circulation to help non-emergency medical patients get to their appointments on time.

Now Uber's preferred healthcare platform, Circulation launched with the goal of solving a "fairly straightforward issue," according to Circulation Cofounder John Brownstein, PhD.

"Transportation is a $6 billion cost in the healthcare system, and 4.5 million patients are late for appointments due to transportation problems," says Dr. Brownstein, who's also a healthcare advisor to Uber, professor at Boston-based Harvard Medical School and chief innovation officer at Boston Children's Hospital.

Studies have shown transportation issues affect healthcare for as little as 3 percent of the population in certain areas, but up to 67 percent in others. What's more, even the type of transportation taken can affect the likelihood of a patient arriving on time or at all. A 2012 study of low-income patients in New York City showed patients who rode a bus to the physician's office were twice as likely to miss appointments as patients who drove cars, for instance.

Uber's partnership with Circulation is one part of the ride-hailing app's growing emphasis on health system partnerships. In January, Uber joined forces with Columbia, Md.-based MedStar Health to give patients rides to and from appointments in the greater Washington, D.C. area. Lyft, another ride-booking service, embarked on a similar journey earlier this year when it teamed up with National Medtrans Network to offer seniors in New York City rides to non-emergency medical appointments. Veyo, a San Diego-based startup, recently contracted with the state of Idaho to help Medicaid patients get to the hospital.

Circulation joined forces with Uber to alleviate healthcare's transportation barrier, but the partnership wasn't easy to finesse. The companies had to ensure Circulation's platform is HIPAA-compliant and Uber's vehicles are wheelchair-accessible. Instead of the Uber consumers are familiar with to traverse across a city or get home at night, this version of Uber is specifically geared toward healthcare. "We had to utilize Uber in the way it needs to be used for patients," says Dr. Brownstein.

The collaboration resulted in a finished product that makes it easy for non-emergency patients to get to the hospital. Instead of booking the service directly from their phone, patients work with their hospital's transportation coordinator to determine a pick up — and, if necessary, return — time and location. On the day of their appointment, the patient gets a text message or phone call informing them of the make, model and license plate number of the car. From there, the patient is picked up and dropped off in time for their appointment. Uber drivers participating in Circulation's services are screened per state laws, which vary.

Circulation's platform and Uber's services are targeted toward patients — oftentimes the low-income, elderly or disabled — who don't have ready access to transportation to and from the hospital. "These are the patients who are most in need of being helped," says Dr. Brownstein. "These are the patients — potentially the sickest — who have the largest cost on the healthcare system."

Circulation's service piloted at three systems: Boston Children's Hospital, Conshohocken, Pa.-based Mercy Health System's three acute care hospitals and program for the elderly, and Nemours Children's Health System in Wilmington, Del.

The implementation at one of Circulation's pilots — Mercy Health System — is well underway only months after the two organizations began talks. "The concept was immediately embraced," says Gary Zimmer, MD, senior vice president and CEO of Mercy Health System's clinically integrated network.

Mercy had limited hospital-based transportation before working with Circulation, and it was also bogged down by a number of regulatory barriers. But because transporting patients is an integral part of Mercy's case management programs, the system — which includes three hospitals, a program for the elderly, a home healthcare agency and a Medicaid managed care plan — wanted a better solution.

"The possibility of becoming better financial stewards was a piece of [why we're working with Circulation]," Dr. Zimmer says. "There was also the possibility of adding on wheelchair-equipped vehicles with UberASSIST, as well as being able to use a modern, robust platform."

Although Mercy's patients aren't yet transported via Uber, the buzz about the service is growing. Dr. Zimmer says Mercy staff and physicians are supportive of the change, primarily due to more transparency regarding which patients are eligible for non-emergency medical transportation services under specific regulatory rules. "Our patient population is one that is below the median household income, so there are many social issues," Dr. Zimmer says. "This is a tremendous benefit to our patients."

The relationship between Uber and Circulation doesn't end there. Dr. Brownstein pointed out that the service will expand to six additional states within the coming year. After that, the future is full of possibilities, from home health services to patient discharge services. "From our perspective, we're just starting," says Dr. Brownstein.

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