• Article
  • January 8, 2019

Removing Barriers to Care with a Transportation Service

Circulation program helps patients and families access care, one ride at a time.

"Necessity," as Greek philosopher Plato is believed to have said, "is the mother of invention." John Brownstein can relate. When he and the innovation team at Boston Children's Hospital looked to address the estimated 3.6 million patients across the U.S. each year who miss at least one medical appointment, it was clear something must be done.

"When you look at no-show rates for appointments, (patient) transportation represents a real barrier," says Brownstein, Ph.D., chief innovation officer at Boston Children's. "We consider this to be one of the really important social determinants of access to health care."

Like Uber for health care

To address this problem, Brownstein co-founded Circulation, an on-demand ride-ordering service tailored to health care providers. Billed as the "first customizable, patient-centric digital transportation platform," Circulation aims to improve patient outcomes by eliminating transportation as a barrier to health care.

The premise is similar to consumer ride-sharing services like Uber or Lyft. Hospitals, medical clinics and even health plans can use the Circulation platform to arrange rides for patients. Circulation matches the ride request with transportation from its network of providers, including specialized medical service vehicles.

The service accommodates rides to and from scheduled appointments as well as upon hospital discharge. Hospital staff manage the process through the platform, and patients are notified via text or phone call with status updates on their transportation.

Another benefit: reduced costs

Brownstein says more than 100 health care systems representing thousands of facilities are currently using the Circulation platform and are seeing benefits beyond those enjoyed by patients. Circulation says member institutions can save up to 70 percent on patient transportation costs compared to traditional health care transportation models—and reports appointment no-shows are down 68 percent on average. 

"If you can reduce cost and improve patient satisfaction at the same time, that's one of those rare opportunities in health care—that's not the norm," Brownstein says. "Usually, when you start to add new digital offerings, you're adding cost to the system; if you can bring in tools that are essentially reducing cost, that's massive." 

Positive reception fuels expansion

Brownstein says feedback to the Circulation platform has been overwhelmingly positive and is prompting the company to build out its transportation network to help fuel possible expansion into other areas of need for health care systems, including prescription delivery, employee transportation and in-home care.

"It has really struck a chord with this idea that just by solving this one piece—that wasn't really a health care delivery-specific piece—you could reduce costs," Brownstein says. "And, at the same time, increase patient satisfaction with the obvious long-term benefits of patients coming to their appointments."

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