The Social Medic

It's All Fun And Games Until Someone Gets Hurt... Then It's A Job

DC FEMS Considering UBER Partnership For EMS Calls

by

At the beginning of the year Washington DC Fire and EMS (DC FEMS) brought in American Medical Response (AMR) in order to off load low priority EMS calls and decrease response time of FEMS units. Although the contract is temporary, early reports indicate a high call volume for the AMR units and effectively reducing DC FEMS transport volume in half.

DC FEMS and AMRUnfortunately, it still seems to not be enough. Early response times from AMR are not up to contractual requirements and DC FEMS are still running low on ambulances at certain times of the day. Honestly, while the data is good, I think it’s way to early to be either claiming victory or raising the white flag on the concept. For that matter, the fact these are supposed to be low priority patients, response times should have a grace period as more data is collected.

Washington DC was very progressive in addressing the issue by directly contracting with a commercial company and now it appears they’re going to be taking it a step further. The Washington Examiner and NBC Washington are reporting that DC FEMS is considering using Uber to transport some 9-1-1 callers. From the report:

Over recent months, there has been an increase in the number of uninsured residents who rely on city-subsidized transportation to get to non-emergency medical appointments.

“We are working with the health department to find other ways to transport people, such as using a contract taxi cab or Uber,” said D.C. FEMS Chief Gregory Dean. “We are trying to find creative ways to try to reduce the strain on the system.”

Of course, there is an acute irony in the statement regarding uninsured residents… considering who lives at 1600 Pennsylvania Avenue and all that.

Using Uber in these types of circumstances as an alternative ambulance isn’t a terribly new or original idea. Jimmy Kimmel joked about it and then a shooting victim actually used it. Uber already has a program for mothers in labor AND babies have been named after the ride hailing app.

The use of Uber, or a service similar to it, by DC FEMS would be a first on many accounts. Of course while this is just a discussion with no solid plans of implementation, you can’t help but wonder just how long until someone actually DOES implement it.

Feel free to share your thoughts on using Uber for those non-emergent frequent fliers instead of an ambulance in the comments…

Woman In Labor Denied Ride By UBER Driver

by

ubulance_screenshotUber, the car ride-summoning service powered by a smartphone app, has been in the healthcare news for a number of reasons over the last few months. Most of the coverage has been positive, including how it’s faster than an ambulance. There have even been people who have been shot and called Uber instead of an ambulance.

The honeymoon of Uber as an ambulance alternative and the realities of servicing the ill has officially ended. Fortune.com is reporting that a NYC Uber driver refused a ride to a woman in labor, and then still charged them $13.00 for his time. From the article:

Instead of taking David Lee and his wife to the hospital, the Uber driver balked because the expectant mother retched on the sidewalk. He informed them he would lose $1,000 a day if Lee’s wife became sick in the car and, what’s more, told them no other driver would accept a woman in labor as a passenger.

An UBER Onesie
An UBER Onesie
There are two things that are relatively humorous to me about this whole thing. The first is that the driver didn’t want the woman vomiting in his car because he would lose $1,000 a day. Vomit, contrary to popular belief, is not that hard to clean up. Sure there may be a lingering scent from it, but that’s what those little green cardboard pine trees are for. Second, other Uber drivers not only accept pregnant women as passenger but sometimes they get naming rights and choose to name the baby after Uber. The company even has it’s own promotional onesie for babies born in Uber cars.

To add insult to the injury of not being deserving enough for a ride in a precious Uber, the driver also reportedly charged the couple $13.00 for his time. This is actually something that got me thinking and I think this Uber driver may be on to something that may revolutionize EMS. Could you imagine if ambulances were able to charge for their time instead of whether or not they actually transported? That is SUCH a novel idea!

Oh, wait. It isn’t.

The problem is that ambulances are reimbursed on a fee for service model. The service an ambulance actually renders is primarily transportation, the whole clinical patient care aspect is a sidenote when reimbursement is involved. Without actual transportation, the largest payor in healthcare will not provide you reimbursement. Since the largest payor in healthcare won’t do it then the other payors generally follow suit. You may be wondering why you can’t just bill the largest payor and then go after them for the money, right? That’s because the largest payor happens to be the United States Government through it’s Medicare and Medicaid programs. There are some instances where services do recover funds for doing RMAs, but those are rare when you look at the big picture.

While I am against the refusal of service (especially since Uber is going to be one of the ways that healthcare costs are curbed from a transportation perspective) I am definitely pro-charging for time.

Baby Named Uber After Ambulance Fails To Arrive Or Deliver

by

An UBER Onesie
An UBER Onesie For UBER Born Babies
The Times of India is reporting that an expectant mother needing to get to Safdarjung Hospital used Uber when, after repeatedly calling, she was unable to get an ambulance. On the way to the hospital she began giving birth in the back of the car. The driver, Shahnawaz, used towels and drinking water in a bowl to aid the delivery. Once delivered the driver finished the trip, helping the new mother and baby into the hospital via stretcher.

The woman and her family have asked Shahnawaz to name the child. He is expected to name the baby Uber, after the company that he works for who has afforded him this unique (for a cab driver) opportunity.

The use of Uber in medical emergencies is not unheard of. Just last month a man called an for an Uber car instead of an ambulance after being shot. The company even has a policy of providing Uber-birthed babies with a free onesie.

Back in September a baby was born in the back of an Uber outside the Lincoln Tunnel while on the way to Lennox Hill Hospital in New York City. New York City has had a number of ambulance response time issues, making Uber a more timely service provider for (very) soon to be mothers.

Man Shot Calls Uber Instead Of Ambulance

by

A man in Grand Rapids, Michigan was shot. Instead of calling 9-1-1, he summoned a Uber driver to take him home. According to WZZM 13:

On most days, passengers tell Uber driver David Heinicke where to go. However, on this particular ride he had a suggestion for the passenger.

“(I) tried to get him to go to the hospital, he would not do it, refused to do it,” said Heinicke. Heinicke says he received a call to pick up the 20-year-old man. “Looked like a handkerchief or something tied around his leg, trying to stop the bleeding. You could see right into his leg and the big crease down his pants where something had obviously hit him in the leg, and he later told me he had been shot by a .22 pistol.”

However, despite the obvious injury, the man only wanted a ride home.

ubulance_screenshotWhat makes this interesting is that this isn’t the first time Uber has been used for medical services. Within the last six months Uber has been reported as faster than an ambulance, the company launched mobile mobile flu shot clinics, and was declared the winner of Mobile Integrated Healthcare. Is a Jimmy Kimmel like Ubulance that far off???

Uber‘s model has something many ambulance agencies would love to have. They have a database with their customers information and method of payment. Payment gets processed when the service is rendered. While I don’t believe Uber will be able to convert medical services to its company, I do believe that an ambulance agency with the correct vision would be able to utilize Uber‘s technology to disrupt how ambulance service is delivered in their community. Couple the technology with a Mobile Integrated Health program that allows the user to choose an ambulance or a single provider, and I think you will see a huge change in the way healthcare is delivered in that area. Including Surge Pricing for non-emergency transports and discharges home will force facilities to include transportation in their discharge planning.

Of course, there would be many obstacles to this model that would need to be overcome. Namely the Center for Medicare/Medicaid Services that would not honor such price changes or provide the immediacy of payment. If the government was honestly interested in providing better healthcare to the population, then they would look to allow a program such as this. Surge Pricing would serve as an incentive for both ambulance services and hospitals to do better, as opposed to the current model of delivering punitive action in the form of decreased revenues that will only cause service to suffer.

The man in Grand Rapids, Michigan who was shot was convinced to go to the hospital… and yes… he went via Uber.