Hospitals spend a lot of time tracking appointments and treatment plans, monitoring patients and ensuring that critical supplies are delivered when needed. With healthcare reforms and the shift to value-based care models, providers are looking for ways to cut costs while providing high-quality care. A number of digital solutions are helping them do just that.
Here are three technologies that are disrupting healthcare logistics.
Ensuring people get to and from medical appointments is a constant concern for providers and one that can end up costly them dearly. According to a retrospective study published by BMC Health Services Research, community hospitals average 62 no-shows a day, at an annual cost of $3 million. For teaching hospitals, the average rates of no-shows and late arrivals are 25% and 31%, respectively. Now, however, ride-sharing companies like Uber and Lyft are helping to alleviate this age-old problem.
For example, last January MedStar Health announced a partnership with Uber aimed at reducing the number of patient no-shows at the Columbia, MD-based health system. The collaboration is already seeing returns. With UberX, for example, the cost to the system is about 60% of the cost of a cab in DC, Northern Virginia or Maryland, Pete Celano, director of consumer health initiatives at MedStar’s Institute for Innovation, told the crowd at last month's Connected Health Conference. In addition, using an UberX means having the ability to hail a car inside an hour which reduces the chance of an appointment going unfilled.
In fact, Uber is investing in the creation of a small team at the company that will do nothing but work with healthcare providers, Lindsay Elin, director of federal and community affairs at Uber, stated at the conference.
San Diego-based Veyo is adapting advancements in consumer on-demand transport specifically for healthcare needs. The one-year-old startup currently provides rides for Medicaid beneficiaries in six states — Arizona, California, Colorado, Idaho, Michigan and Texas — and is gearing up for expansion into five or six more in 2017, Veyo President Josh Komenda tells Healthcare Dive.
With $4 billion to $5 billion a year spent getting clients to and from appointments, Medicaid is a huge opportunity for non-emergency medical transport (NEMT) companies like Veyo. “When you think about an agency that spends $20 to $30 to get someone to their appointment, it can actually pay off dividends in savings by keeping people healthier, keeping them compliant to their care, making sure that they’re getting in when they have chest pain or need to get on dialysis,” Komenda says. A 2008 study of Florida’s NEMT costs found each dollar spent on NEMT could save up to $11 in healthcare costs.
Komenda sees Veyo and companies like it as the next-generation of NEMT brokers, managing the entire needs of a health plans’ transportation benefit. Its rideshare drivers are trained on HIPAA, CPR and first aid as well as how to help people with disabilities or age-related issues get in and out of vehicles. It actively monitors for fraud, waste and abuse and tracks all vehicles in real time, allowing it to correct service failures before they happen.
Unmanned aerial vehicles are a curiosity for most Americans, but in some remote parts of the world, drones are already having an impact on healthcare.
In October, drone startup Zipline, in partnership with UPS and Gavi, began delivering blood supplies to transfusion facilities in western Rwanda where barriers to land transportation can prevent blood supplies from reaching critically ill or injured patients in time to save a life.
“Because of infrastructure deficiencies like impassible or nonexistent roads and supply chain challenges, many remote health centers across the world only receive deliveries twice a year,” the company told Healthcare Dive via email. “Zipline will make it possible for these same clinics to receive deliveries twice a day.”
Each drone, or Zip, can carry 1.5 kg of blood and fly up to 150 km round trip, dropping down low to air drop the package at a designated spot, before returning to the Nest at Zipline’s distribution center within the Central African nation. The whole trip takes about 30 minutes.
To date, Zipline has made close to 100 flights in Rwanda as it works to bring the first two of 21 clinics online. “Some of those have been test flights to map out the routes to hospitals. A smaller number of those flights have been deliveries to clinics,” the company said.
The plan is to stand up five delivery sites to start and then expand one by one to serve the remaining clinics. At that point, Zipline expects to be making between 50 and 150 flights a day.
The company plans to expand the drone delivery service to the eastern half of Rwanda in early 2017, and, from there, to other countries in Africa and around the world, including the sites U.S. Federal aviation regulators have cleared Zipline to deliver blood — Smith Island, MD, and the San Juan Islands of Washington, and Nevada.
Zipline also plans to move beyond blood to deliver medications and vaccines for HIV/AIDS, malaria, tuberculosis and other life-threatening diseases.
Since the company partners with governments, there’s no worry about reimbursement. “We’re able to make medical deliveries for about the same cost as current modes of transportation — like motorcycles and cars — just faster and more efficiently,” Zipline representatives said. “And the economic benefits of a healthier population are immeasurable."
Digital technologies are also revolutionizing the field of home health care. Mobile apps and connectivity are helping to enable people with chronic conditions and the elderly to manage their health at home while cutting costs by reducing office visits and trips to the ER or a hospital stay.
One technology that is creating buzz is voice assistants, which are designed to make digital information and services more accessible by eliminating the need for physical interaction — making them ideal for paraplegics, the blind and others who may have trouble using a touchscreen or even a keyboard. Three years ago, Palo Alto-based HealthTap launched TalkToDocs, a standalone app based on its proprietary Health Operating System. The app combines HealthTap’s extensive library of physician knowledge with artificial intelligence and a voice-activated interface.
“We’ve been experimenting with this app with users (both doctors and patients) through HealthTap Labs to learn how to provide access to people to doctor knowledge even if they cannot use smartphones or even websites,” says founder and CEO Ron Gutman.
Orbita, which provides software for home connected healthcare, recently launched the Voice Experience Designer, an offering to make it easier to create conversational experiences based on Amazon’s cloud-based Alexa platform.
What Alexa and others like Google Home have is the ability to design what a conversation should look like, says Nathan Treloar, co-founder and president of the Boston-based startup Orbita. So, for example, if someone says their pain is 7 on a scale of 10, is the advice breathing exercises or some kind of intervention? The idea to construct conversations in a way that providers can encode their care protocols into these agents.
While Orbita’s home health voice solution is HIPAA-compliant, Alexa is not—though individual skills within the platform can be designed to be HIPAA-compliant. Given the varying levels of trust people have around digital agents, Orbita is erring on the side of caution for now and does not attempt to diagnose, prescribe or treat any conditions, Treloar says. “When you cross over into that, you’re crossing over to an FDA class of software…We expect to get there, but it’s not really us, it’s more our clients. They’re cautious, and we think appropriately so.”
Meanwhile, the potential for voice voice-assisted software and other digital solutions to disrupt home health care is huge. Patients who are engaged in a solution that’s been designed for their care are more likely to adhere to their treatment and be compliant with medication. In addition, they’re likely to feel more empowered to seek care and guidance through a digital device, making it the first line of triage if something happens, Treloar says.
He sees another advantage, too. People already use their smartphones and technologies like Amazon Echo, which doubles as Alexa, to get news and weather and music. The seamless integration of home healthcare with these other lifestyle needs “kind of transforms the definition of patient engagement,” Treloar says. “I think that, by itself, is a disruptive concept.”