Christine Merkel

Christine Merkel

Innovation in health service delivery: elegant solutions to transportation barriers

9 August 2017

person on their phone using map app to navigate

Innovation in healthcare delivery seems to be everywhere right now, particularly with the burgeoning market for apps.

I recently read a paper that pushes innovative delivery of healthcare into new realms.

‘Nonemergency Medical Transportation: Delivering Care in the Era of Lyft and Uber’, by Powers et al., describes collaboration between ride-sharing apps and healthcare providers, which is making headway in breaking down barriers to attendance of non-emergency care appointments.

Patients with the highest burden of chronic diseases typically have some of the greatest transportation barriers. In 2005, approximately 3.6 million individuals in the United States failed to receive non-emergency medical care because of such barriers. This ride-sharing innovation could be an important step to improving access to care and, eventually, health outcomes – particularly for elderly, poorer and minority groups.

Digital transportation services are also aiming to revolutionise travel for disabled passengers. There is huge potential to allow greater freedom and ability to travel than ever before.

Service improvements

The article describes early results from a pilot programme between a payer and Lyft, which provides a dramatically better service than the existing options of traditional taxis or livery services. It demonstrated 30% shorter waiting times and patient satisfaction of over 80%. Furthermore, it was estimated that the cost per ride was reduced by a third over the typical service. A dedicated web-based tool allows caregivers, nurses and patients to book rides and track them in real time. This means that not having a phone is no longer a barrier to digital transportation services.

Another trial, in a different area and with another care provider, used Uber. It noted no-shows being just 8% of all rides, compared with 25–50% for traditional services. Clearly, there is a significant opportunity to improve care and access, while saving costs in the long term.

There are many possibilities for such services, beyond transporting people to and from appointments. They could deliver medication, support carers in their activities, or support a wide range of other health or social services.

Digital transportation services are also aiming to revolutionise travel for disabled passengers. There is huge potential to allow greater freedom and ability to travel than ever before. Traditional transport is known to be expensive and unreliable; with digital transport services, people can book adapted cars and drivers can receive additional training.

Implementing innovation

Of course, such services will always have hiccups and more endemic issues. It is essential that drivers be provided with adequate training in the needs and challenges of these specific groups of passengers. Then there is the perennial issue of access. Many of these services are only available in urban areas, and accessible cars may not be an option in all markets.

The Powers et al. study was carried out in the United States, so may not be entirely applicable across the UK and Europe, which often have better public transport infrastructure. But tremendous barriers still exist in attending healthcare appointments – especially for people with a low income or mobility issues.

There must be better support for people with chronic diseases and underserved groups to attend non-emergency appointments. People should be helped to access readily available care, particularly those in rural populations and lower-income groups. Improved access through innovative delivery of care, such as digital transport providers, seems a simple – even elegant – solution. I think there is significant potential here; in a challenging healthcare economy, we need to think outside the box. Healthcare providers should consider collaborating with seemingly untraditional partners, to reduce barriers to care and support people to manage their health.


The opinions expressed in this blog are those of the author and do not necessarily represent the views of The Health Policy Partnership.