OsteoMobile proposes training a sub-set of ride-share drivers to be certified and legally protected to transport people with, or who are recovering from, osteoporosis-related injuries.
In one proposed idea, select 'Early Response' drivers could be notified via their ride-share app of a potential osteoporosis-related injury. The closest appropriate and available driver could then proceed to the site of the incident and, using a live video-conferencing connection, have medical staff evaluate the situation and determine if there is a need for emergency on-site medical response or transport. This 'subtler', less 'public spectacle' approach could relieve the anxiety or embarrassment for an injured individual who may not understand the seriousness of their injury, or be otherwise hesitant to call for an ambulance with the attending exposure and cost.
Staff at the Washington Hospital Center in Washington, DC interviewed patients and found that, "Overall, 70% of the patients said that one reason for not seeking immediate help was that they didn't think their symptoms were serious... About 29% of the patients said they didn't call 911 because they would have been embarrassed to have emergency medical services and an ambulance appear at their home." It's important to note that this is not a gender-specific issue. As a 2010 article in USA Today states, "...failure to call 911 is not just a female problem. Many men also respond to ominous symptoms with denial... That fear of embarrassment is ingrained in all of us." -Daniel Lackland, professor of epidemiology and neuroscience at the Medical University of Southern Carolina in Charleston.
By arriving at the site of an accident quickly, OsteoMobile's 'Early Response' personnel may prevent additional harm caused by well-meaning family or friends who may be tempted to move an injured person. Additionally, the responder could provide emotional support while awaiting emergency transport or other care.
Just as importantly, during the follow-on recovery period, select OsteoMobile 'Care-ier' employees could provide ride-share transport to patients for doctor/physical therapy visits or for errands. This transport could be offered at a premium high enough to cover the inevitable additional time required for loading and unloading recovering patients. This rate would be justified by the special care and would, ideally, be covered by insurance or Medicare.
FOCUS DURING REFINEMENT PHASE
During the Refinement phase, this team will focus on OsteoMobile's 'Care-ier' ride-share services for specialized transportation during an out-patient's recovery period.
Suggesting details for hiring, training and legally protecting individuals as 'Early Responders' for potentially injured individuals is deemed out of scope for this team.
APPLICABILITY TO CHALLENGE
By providing ride-share personnel trained and knowledgeable in the transportation of individuals with OP, OsteoMobile's 'Care-iers' can help these patients avoid transportation situations which could cause additional injuries, such as, maneuvering into or out of vehicles by themselves (including buses, trains and other forms of public transportation or even the personal cars of family or friends), especially if they need to carry belongings or bulky purchases. These drivers can also assist the patient with retrieving or deploying assistive devices such as canes, walkers or wheelchairs.
The following image illustrates a possible initial contact between an OsteoMobile 'early responder' and an injured patient:
This image illustrates how OsteoMobile's specialized 'care-ier' transportation services could benefit an OP patient during their recovery period:
KEY AREAS OF FOCUS FOR THE REFINEMENT PHASE
- Determining suitability of the OsteoMobile service for individuals with osteoporosis
- Does the service address a REAL NEED?
- Will the service be EFFECTIVE?
- Will the service reach MANY osteoporosis patients?
- Is the service AFFORDABLE?
- Determining whether the service makes BUSINESS SENSE
- Building awareness of the OsteoMobile service (Develop an App prototype)
- Suggesting how hospitals and medical personnel interface with the service
- Ride-share businesses (ex: Lyft's Hitch Health and Uber Health) already offer rides tailored around healthcare. Lyft's website states that '8 of 10 patients prefer Lyft to traditional healthcare transportation'. They go on to say that this service 'helps curtail no shows' and 'reduce(s) costs by 32% on average'. This type of transportation service fulfills a need for non emergency medical transportation (NEMT). OsteoMobile takes this service to an additional level, that of handing specific osteoporosis patient needs (averaging 1.5-2 million bone breaks per year in the US). There may be other medical conditions that also would benefit from this kind of handing and it would certainly make sense to include those in this service offering as well. With respect to costs, Lyft states that they 'partner with 'the top 5 payers to provide patient rides throughout the patient journey'.
- While ride-share businesses such as Lyft and Uber have successfully folded this special service into their offering, OsteoMobile will entail additional costs. Training instructors will need to be hired or consulted and training materials specific to the ride-share service will need to be developed. This training may be centralized or conducted nationally via video-conferencing. Additionally, some vehicles may need physical modifications. This could be as straightforward as pushing front seats forward to allow additional room for rear-seat passengers. For some cars, the front passenger seat could be removed. There may be a set of semi-custom pads offered for seats to add another layer of protection, as well as padded seatbelts or other restraining devices. In extreme cases, vans or similar vehicles may be acquired by the company or its drivers to accommodate patients in wheelchairs. The costs of designing, procuring and installing these will need to be considered in the ROI for the company.
- Building awareness of the OsteoMobile service can take place on many fronts. Hospitals, doctors and medical organizations can be powerful allies and may carry literature or make recommendations explaining the service to potential patients. An OsteoMobile website can provide information, and ride-share companies can advertise the service on their sites and within their smartphone Apps. For this Refinement phase, a prototype will be developed and explored that focuses on the OsteoMobile service as it might integrate into a mock ride-share App.
- As mentioned above, OsteoMobile service information can be shared with medical professionals and organizations. Services that deliver their patients on time and safely for appointments should appeal to their basic requirements for care.
EXPLORING EXPANDED CAPABILITIES
OsteoMobile's 'Care-ier' service is described here as largely curb-to-curb, implying its value is limited to picking up, transporting, and dropping off OP-patient passengers. OsteoMobile could, however, extend its service up to the passenger's door and potentially on inside their living space.
Osteoporosis patients likely have physical challenges beyond their curb. They may need to navigate front steps and front doors. Once inside, patients might benefit from knowledgeable advice regarding rudimentary fall prevention- things that a trained observer could identify and point out.
A certain reluctance on the part of patients to invite strangers into their homes is understandable. Evidence of proper training and/or references may be appropriate. It may also be that OsteoMobile transportation services could arrange for 'curb hand-offs' to other locally-organized or community-driven caregiver organizations to provide this expanded service.
These logistical touchpoints offer OsteoMobile a growth path to expand and improve its offering, ultimately providing deeper value to patients suffering from osteoporosis.
The OsteoMobile team may explore a rudimentary 'pilot' of their 'Care-ier' service by contacting members of the local community with an understanding of the OP condition or personal connection to an osteoporosis patient and offering transportation for local errands. This will give us the opportunity to discuss OP-related issues and opportunities to improve OsteoMobile.
The OsteoMobile team thanks Mert, Emma, Delphine and the entire OpenIDEO team for their comments, suggestions and support!