It Turns Out that Uber Is the Uber of Healthcare

^{Images have been cropped and resized. Courtesy of Uber.}

How many wide-eyed entrepreneurs have compared their health-tech start-up to Uber? A handful did so last year, though that number probably falls short of the actual total. The inspiration for likening a business to Uber may come from a few places: dreams of widespread disruption, a commitment to on-demand, or even the inclusion of an app. (More cynically, building a link to Uber could be a savvy branding decision.)

But now the health-tech space can scrap those comparisons and any that might one day come. That’s because, as it turns out, Uber is the Uber of healthcare.

The company’s announcement yesterday that it’s entering the healthcare space through an initiative called Uber Health was all it needed to claim the sometimes-sought-after and other-times-despised title. Uber health will partner with healthcare organizations to “provide reliable, comfortable transportation,” using a dashboard through which clinicians and their colleagues can schedule rides for patients, caregivers, and staffers. In beta, the program has been used in more than 100 hospitals, clinics, and other medical groups.

The big idea: Transportation is a problem for healthcare, and millions of people miss appointments every year because they don’t have a ride. Uber wants to change that.

Uber Health, however, is not merely an extension of a ride service. John Nosta, the lightning bolt behind the digital-health think tank NOSTALAB and a member of Google’s health board, tells Healthcare Analytics News™ that Uber Health is an engine that will drive transportation into the care continuum.

“We’ve never done that before,” he adds. “We know that compliance is a major problem, and we spend an extraordinary amount of money on making sure people take their pills. But there’s also a level of care compliance that is mediated by transportation, by getting to the doctor—and somehow this has been taken out of the care equation.”

So, no longer will the care continuum consist only of stages like diagnosis, treatment, and medication adherence, or the things that providers traditionally oversee. Like the emergency department or even the assisted-living facility, the backseat of a cab is now tied to healthcare.

By proxy, Uber at large is taking on a role in the care continuum. It’s not the first tech sage to expand its reach into some corner of healthcare. (Amazon, anyone?) But the move represents another area through which disruptive Silicon Valley forces might change how healthcare functions in the United States.

His tech credentials aside, Nosta understands the particular problem that Uber Health hopes to solve. Once upon a time, he was president of Perth Amboy, New Jersey’s volunteer fire squad, for which he served as a paramedic. He was the person who drove the ambulance, meaning he saw the stressed emergency services system and the “critical need” for medical transportation. Uber Health, he says, could relieve some of that burden.

Then, of course, there are the patients who never enter an ambulance at all—and, consequently, don’t get to the doctor’s office or hospital and don’t receive care. Uber cites figures claiming that there are 3.6 million of these people in the country, which contributes to a 30% no-show rate. The people who lose the most are “vulnerable populations,” like the poor and patients with chronic disease. “The primary determinant of good care,” Nosta notes, “is getting good care.”

The fact that riders don’t need a smartphone makes Uber Health all the more accessible. Instead, they may receive a phone call or text message to confirm a trip. Researchers have already demonstrated that not every tech-centric health transportation effort works, but bridging the tech gap could help this project.

Uber Health strays from typical Uber, in that healthcare professionals arrange the rides on behalf of their patients. The company says the tech service complies with the Health Insurance Portability and Accountability Act (better known as HIPAA), and healthcare organizations will be billed for the rides. Each detail further cements Uber Health’s role on the care continuum.

As a result, the initiative could result in new knowledge and better outcomes for patients, Nosta says. Still, much remains unknown about the possibilities and potential effects of this new setup. “My feeling is that the insights that could be derived from Uber Health are around optimizing care, and even looking at outcomes might be extraordinarily insightful and clinically important,” he adds. Like clinical trials that control for variables like transportation, Uber Health could provide stronger structure to healthcare, Nosta says. And who knows what improvements—or challenges—that might yield?