In recent years, more and more attention is being paid not just to the medical aspects of a person’s care, but to those social factors that have an inordinately large impact on the care journey.
These social determinants of health include things like zip code, access to healthy foods, community resources, family life, schooling and more. But one of the most important of these is transportation.
A person’s transportation needs have a critical impact on the ability to comply with a medical care plan. When an individual doesn’t have immediate access to a car, they are no longer self-reliant when it comes to making scheduled and impromptu appointments, including physician’s visits, rehab or therapy sessions, pharmacy trips, and more.
A lack of access to transportation isn’t as troublesome it once was, though, at least for hospitals willing to dedicate resources to solving this dilemma. Thanks to improvements in care management technology and processes, it’s possible to eliminate the barriers to health that would typically arise from immobility. Here’s how -
Partnering with Ride Shares
The advent of app-based services like Lyft and Uber are a godsend for health systems that have systems in place to enable partnerships with these companies.
Patient discharge quickly grows complex when a patient suffers from a lack of transportation or doesn’t have family members capable of bringing them to a post-acute facility or their home.
In the past, it was commonplace for hospitals to enlist ambulances for costly rides across the city or the state. Now, however, many of those same rides are capable of being fulfilled with ride share services.
Health systems across the country have begun to establish partnerships with the Lyfts of the world in order to get patients transported to their post-acute spaces. The drivers get explicit instructions to drive directly to those facilities and the hospital or the insurer pays the cost of that ride.
The benefits are clear, not just in terms of patient health but in terms of expense. Although it might seem like a costly endeavor once you factor in the number of patients who may need to make use of those services, those costs pale in comparison to the potential penalties assessed or reimbursement lost if the patient is readmitted to the acute facility within the 30-day window because they failed to pick up needed medication or were unable to attend a crucial follow-up visit.
That’s why ride share partnerships don’t just begin and end with the initial discharge. We’re seeing hospitals partner with these services (and, it should be noted, local cab companies as well) to assist patients for 30, 60, 90 days at a time (and beyond). That way, not only is the patient all but guaranteed to reach their initial destination without trouble, but they’ll have an easy means of traveling back and forth to the variety of appointments they may have scheduled.
The ease with which it’s now possible to schedule a ride is something we take for granted, but this would have been an arduous process for any case manager to keep track of even five years ago. With a tablet or phone set up to coordinate with these services, scheduling pick-ups can take seconds. What’s more, the patient can even be brought in the loop, shown how to use the app (if they don’t already know) and be allowed a certain degree of monitored control. This helps them gain a sense of independence that can play a positive role in their eventual recuperation or recovery.
The role of the pharmacy has traditionally been played by a local grocer or drugstore. But that’s transforming dramatically even as we speak.
Right now, we’re seeing insurers and the big name retailers (think Aetna and CVS) in the pharmacy space begin to offer direct delivery of drugs that the individual would have previously had to drive for or tasked someone else with picking up. These businesses are developing partnerships with some of the very same transportation services we mentioned up top, scheduling medication pick-ups and drop-offs that can be delivered on schedule to the patient in need.
That’s not to mention the advent of direct-to-consumer deliveries wherein an individual with a regularly refilled prescription is able to fill that drug over the phone and have the item mailed directly to them. As a result, the patient never has to worry about running out of medication as long as they or their care team monitor volume and schedule refills accordingly. It is prescription on demand, and it wouldn’t have been possible without the ongoing revolution in transportation.
Another way to get around the transportation obstacle is to do an end-around transportation entirely.
Telehealth has been invaluable for those cases where a patient just wants to check in with a doctor to relay basic symptoms. Maybe they don’t have access to transportation, are miles away from the nearest medical facility or maybe they just don’t have time to meet in person with their family physician. Insurers and health systems have begun to offer telehealth services in place of urgent care and other in-clinic visits, creating an affordable means of connecting with a healthcare professional and getting needed assistance.
Virtual care is perfect in situations where a person may just need a simple prescription, for example, or some quick advice on how to mitigate the side effects of a known condition. By eliminating the need for a middleman, e.g. transportation, patients are freed up to seek care without having to worry about how they’re going to get to their care provider.
The same also goes for post-acute patients. Thanks to wearable technology, remote monitoring devices, and messaging apps that rely on the internet of things, it’s possible for patients to immediately contact a social worker, case manager, nurse, or any other healthcare professional on their care team. Conversely, it’s possible for these persons to reach out to patients directly if they feel like an intervention or a check-in may be necessary.
It should be noted that telehealth certainly can’t fill the needs for all types of care. That’s why partnerships with ride shares and other services will remain critical, even as telehealth and remote monitoring services become more prevalent.
Finally, hospitals can benefit from looking more closely into community-based transportation partnerships that they previously may have ignored.
Because of the increased importance placed on the social determinants of health, we’re seeing organizations that have traditionally been viewed as charities or community resources now being looked upon as extensions of healthcare entities.
Hospitals can and should coordinate with Meals on Wheels-type services to ensure that patients in food deserts or who might struggle to stick to a dedicated health regimen get the items they need to embark upon the healthiest care journey possible. They can work with services that take seniors and others who need assistance on day trips under the supervision of caring staff. They could even schedule regular visits with therapy animals at post-acute facilities their patients frequent.
This is a great time to be in healthcare, because we’re getting to witness some of the leading minds in the field get creative about how they approach care. This more holistic approach to the patient’s wellbeing has already brought promising results.
I’m excited to see what comes next as the transportation challenges of today turn into solutions for the patient tomorrow. Transportation can prove to be an obstacle, but it’s one that can be easily overcome with the right attitude. We’re seeing case managers take care planning to a whole new level, and I can’t wait to see where we go next.
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