As healthcare has evolved, the logistics surrounding patient care have gotten exponentially more complicated. That’s partially because, thanks to the evolution of payment schedules that penalize providers if their patients are readmitted 30, 60 or even 90 days beyond the initial date of discharge, hospitals are increasingly responsible for outcomes long after patients leave their sight.
This has led to a variety of care management platforms and hospital personnel tasked with one goal: keeping the patient on track with their care plans so that all the work put in at the acute level isn’t undermined the moment the patient steps out the door.
Hospitals are necessarily concerned about the role they’re being asked to play in their patients’ lives because it puts them in a position they’re not accustomed to or equipped for. Providers can’t only worry about care; they have to worry about social determinants of health that compromise optimum recovery, the patient’s ability to make appointments and stick to a medication schedule and the familial support the patient has in place.
There’s one particular logistical challenge that is impacting the modern healthcare space, transportation.
Here’s a scenario that I’m sure case managers or providers around the country are intimately familiar with: The patient has received acute care, they’ve recovered and a facility has been lined up to provide post-acute care for their specific needs. Unfortunately, the patient has no means of getting to their next destination.
What should typically happen in this scenario is the provider contacts a non-emergency medical transportation (NEMT) provider to schedule a pickup and drop-off. There’s just one problem: The availability of NEMT services in most areas throughout the United States (and in other countries, for that matter) ranges from inconsistent to nonexistent. In addition, cost, quality and reliability of those services can vary greatly.
The problems are remarkably similar in both metropolitan and rural areas. In each environment, the facilities must compete for limited resources. Cities have many more prospective services, but they also have more hospitals seeking to schedule pickups and drop-offs. Rural areas, on the other hand, may have only one transportation option, and that service could be covering hundreds of square miles.
Either way, the inability to schedule and monitor this activity is a big issue in modern healthcare, one that’s costing hospitals money and compromising optimum patient care. In fact, one study found that 1.2 million bed-days were lost in England from 2013-2014 alone. What that means is millions of patients remain in hospital beds, consuming resources and prohibiting others who need care from having the benefit of that bed -- all due to transportation challenges.
And it’s more than just bed capacity or throughput that is at issue here. Patients who remain hospitalized longer than necessary also stand a greater chance of contracting additional hospital-acquired conditions that directly and adversely affect patient outcomes.
But there’s a way to minimize these kinds of patient bottlenecks, technology.
Increasingly, acute care facilities aren’t leaving the successful discharge of patients to chance. Instead, they’re turning to software in order to manage the proper transportation of their patients to post-acute facilities or back home.
Ride hailing companies have already gotten in on the act. Uber Health and the healthcare arm of Lyft Business are making their solutions available to patients to ensure those with minor medical needs but who lack transportation are able to make it home safely and get to their appointments on time.
But some patient needs go beyond this, and software companies are stepping up to fill these gaps as well.
Ambulances are expensive for patients and hospitals alike, and they’re not the ideal method of transport for any patient not undergoing a true emergency situation. In these instances that fall somewhere between medical emergency and a perfectly healthy patient, a hospital needs to be able to contact the NEMT providers that have been designed to accommodate specific patient needs.
With an app that connects hospitals to these providers, it’s possible to quickly schedule pickup and drop-off, getting patients with unique medical issues where they need to go and reducing the amount of time they must remain in a hospital bed they don’t benefit from anymore. My company offers such an app through our partnership with Acuity Link, a comprehensive communications and logistics management platform.
The software applications available work like this: A hospital employee, typically a case manager or a discharge specialist, signs up as a user for a nominal fee and is then connected to a large network of transportation providers, each with their own specializations, fees and coverage areas. Have you gotten a ride from Uber or Lyft for personal use? Imagine that but for medical transportation.
The hospital user can filter by the patient’s unique needs to see all the NEMT providers in the area who are qualified to meet those needs. Then, they can contact those providers to inquire about a pickup, specifying the time they need the patient to be moved and when and where they need to be dropped off.
Patients’ progress can also be tracked in real-time. Back-end analytics tied to every pickup also prove valuable when evaluating existing contracts with existing NEMT providers -- from ambulance companies to taxi services and ride share agencies.
The many issues being tackled by hospitals in the modern health care setting are well outside the comfort zone of most providers, and transportation is no different. The good news is IT vendors are stepping up with solutions to accommodate organizations of all shapes and sizes, setting care providers up for success no matter what obstacles come their way.
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