Rideshare Companies Improving Access But Training Drivers Important To Consider

Emergence of Uber and Lyft are transforming healthcare delivery, literally, but they are also leading to new questions about the training of drivers

We used to travel by car or train or taxi but the increasing accessibility of Lyft and Uber has changed the collective traveling behavior of many Americans. These businesses have now infiltrated the healthcare system, helping hospitals get people home and helping seniors and underserved populations get to appointments. Their efficiency is without question, their cost is also clearly a win for both patients and healthcare providers. Rich Smorles, 57, used to live within 20 minutes of his eye doctor but is now more than 2 hours away due to an insurance change and has difficulty driving due to his glaucoma.  “I missed a few appointments and had some issues, needed to go to hospital,” Smorles, a retired firefighter from Sullivan, Indiana said. He is now using Lyft through an IU Health program. 

In the next several years there is the potential for these companies to begin to play a bigger role in transporting people to mental health services, including those in a mental health crisis.

“I think Uber and Lyft are a microcosm of our culture – the immediacy we now crave and expect – and now we see their potential to help us get people to the right services at the right time, particularly for appointments we might miss,” says Anna Flaunders, a sociologist.

Buck Poropatich, the newly appointed head of Lyft Healthcare, told us that the company has helped lower transportation costs 32% on average. “We don’t need wheelchair-accessible vans going to pick up somebody who’s appropriate for rideshare,” he says. Lyft reports a 40% reduction in ER visits by using its fleet of drivers to bring people to doctor’s offices or outpatient visits rather than the ER. No-shows are down 73%, Poropatich says, in large part to the ease of booking these rides. 9 of 10 major hospital systems in the US have arrangements with Lyft. “Healthcare transportation doesn’t need to be so burdensome and difficult for somebody to navigate, which at times is still very much the case.”

The entry of Uber and Lyft also represents a new tool to limit barriers for those needing mental health services.  While the advent of virtual apps and telehealth visits has transformed the delivery of psych therapy, a growing number of people need care in a center or facility for higher-risk situations like anxiety, depression, or the litany of behavioral addictions to drugs or eating disorders. Having a dedicated healthcare service to take someone in a rural area to treatment or to help hospitals and doctors more quickly transport someone to treatment will likely be important as coverage of mental health continues to rise.

Rideshare-based non-emergency medical transportation like Uber and Lyft does not require any specific healthcare-related training for their drivers but driver education on identifying mental health crises and then responding to them is likely to become more important in the future.  Hospitals, insurers, schools, and consumers will need to have assurances that the transport team has at least some basic training in mental health, like how to know the difference between a heart attack and a panic attack. Both have similar physical responses and few people can differentiate.

Panic attack symptoms include chest pain, a racing heart, and sweating, which are three of the same symptoms common in those having a heart attack.

“The driver may not be trained and may simply be bringing an older adult to a doctor appointment, but what if these symptoms occur during that ride?” wonders Melissa Sampson, RN. Heart attack pain radiates to other areas of the body like the arm and neck, while panic attack pain stays in the chest.

Franciscan Health System in Indiana selected Uber as a service to transport its Medicare seniors to appointments and from hospital to home as part of its accountable care organization, according to business development director Sean Duddy.  Part of the decision healthcare organizations like Franciscan will need to make in the future isn’t just how to use transportation to reduce health disparity, but how to make sure the driver can be educated enough to recognize and respond in a crisis. 

“That might mean realizing when going to the hospital is the right decision sometimes, or understanding what to ask during a transport,” says psychologist Victoria Owens.  “We can’t just ignore the fact that if Lyft and Uber and others are going to be in contracts with hospitals and payers that part of their responsibility ought to be to train the drivers.”

Poropatich says Lyft Healthcare has a dedicated healthcare compliance team that does background checks. “We do not require additional training for our drivers,” he said but acknowledged the role his and other logistics companies can play in making healthcare, not just more efficient and affordable and part of the value-based care trend, but safer.