20
May
By Tim Rowan, Editor & Publisher of Home Care Technology Report
Do any of these things happen to you? [Rowan presents a list of reasons why patients typically miss appointments with clinicians–such as car problems, no back-up ride from friends or relatives, etc. A new division within Uber–Uber Health–is introduced. Details are provided in this article about its operations, including ease of use for patients, drivers, and operations concerned with billing for all rides. Uber’s exacting agreements with HIPAA requirements to maintain patients’ privacy are described. An example of an early adopter–Georgetown Home Care in Washington DC–is provided with details on scheduling, payment, and ease of use of the Uber Health system. The main problem of relying on home care employees who have a car is eliminated by using Uber Health, and employees’ time is spent more usefully on providing home healthcare activities.]
- A new referral comes with the message that the patient has no family or friends to offer transportation from hospital to home.
- A Medicare patient has a post-surgery checkup appointment or a non-medical client needs to get to a dentist but they are considering skipping them because no ride is available.
- A home care aide calls to cancel a week’s worth of visits because her car is in the shop.
- Mileage reimbursement is an out-of-control budget item.
A new division within Uber has been created to address all of these problems, as well as others experienced by patients of physicians and residents of assisted living facilities. Uber Health is partnering with hospitals, physicians, cancer centers, and post-acute care providers across the country to eliminate transportation as a reason for missed appointments.
We spoke with Lauren Steingold, Head of Strategy at Uber Health, a team within Uber’s San Francisco headquarters but not a separate division or company. “3.6 million people miss doctor appointments every year because of transportation issues,” she told us, “at an annual cost of $150 billion. If we can mitigate that loss, the cost of the rides themselves will become insignificant.”
Variation from personal Uber rides
Where individuals use a smartphone app to summon a driver to their current location, Uber Health is based on a dashboard installed on an office computer. A physician or other medical provider can send a driver to pick up from any location and deliver a patient to any other location, and can schedule the ride up to 30 days in advance. Uber does not charge the physician for that software. In fact, the only fee involved is the standard charge for a ride, and the driver never knows he or she was called by the phone app or the dashboard, nor that this ride is with a patient.
HIPAA Implications
Nevertheless, Uber Health decided it was best to sign HIPAA Business Associate agreements with every covered entity using its dashboard. For this, it secured the assistance of Clearwater Compliance, a Nashville-based security and privacy consultancy. CEO Bob Chaput explained that the chances of Protected Health Information becoming available to Uber drivers and its San Francisco-based staff is slim but that the company chose to take a conservative approach.
“Uber was apparently the first organization to ever request a meeting with the Department of Health and Human Services Office for Civil Rights,” Chaput laughed. “OCR officials were taken aback. ‘You want to come here and talk to us and you haven’t been accused of anything yet?’ they responded to Uber.” The meeting was productive, convincing Uber to establish the BA policy and to ensure that drivers only get the patient’s first name, which disappears from the driver’s smartphone immediately after the ride.
“The program entered a beta test phase on July 1, 2017, with over 100 healthcare organizations using it through the end of February,” Ms. Steingold related. “After making enhancements and optimizations based on eight months of feedback, we released it to all healthcare organizations on March 1.”
Pricing and reports
Uber sends a monthly invoice to its direct customer, the healthcare organization, covering only the cost of the rides. There are no fees to the patient or surcharges to the direct customer. Most organizations cover ride costs from their existing transportation budget. An Assisted Living Facility might bill the cost of a ride back to a resident.
With each monthly bill comes a detailed report of every ride, including the patient’s name, pickup and dropoff addresses and times, the cost, and who made the ride request. “Organizations find these reports extremely valuable,” Ms. Steingold added, “because they are much easier than compiling mileage reimbursement forms or trying to get information from random taxis.”
Alternative to employee vehicles
There is at least one home care early adopter, Georgetown Home Care in Washington DC, which had been a beta test participant. “Georgetown is excited about Uber Health because they came to realize that their in-home caregivers do not need to have a car,” Ms. Steingold explained. “We’ve heard the same report from other organizations as well. They tell us their home care aides and clinicians can do more visits per day because there is no time wasted navigating and they can do paperwork in the car. The common problem of vehicle breakdowns causing missed visits is completely eliminated.
Additional details and contact information are available at uberhealth.com
©2018 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only.editor@homecaretechreport.com
