
Introducing Uber Health, Removing Transportation as a Barrier to Care - coloneltcb
https://www.uber.com/newsroom/uber-health/
======
callumprentice
The other side of removing transportation as a barrier to care is have the
doctors come to you. We've started using Heal
([http://heal.com](http://heal.com)) recently when the whole family was sick
with the flu and it was great. Doctor and assistant come to your home within a
2 hour window. Cost is same copay you incur at a doctor's office. We used it
several times and doctors were great. Seems like a no-brainer to not force
sick folk to travel and spread germs. Only downside really was that you don't
usually see the same doctor twice although I believe you can request by name.

~~~
notatoad
That sounds like a good plan if you have good insurance, but it doesn't sound
like a sustainable way to improve health care service to a wider population.
Doctors are a scarce resource, and having the doctor drive around to each
patient's house is not a very good use of their time.

At my Doctor's office, the doctors are scheduled for 15 minute appointments.
at an optimistic assumption of 15 minutes travel time to and from each
appointment, a model where the doctor visits each patient requires 3x as many
doctors for the same level of care.

~~~
kfriede
Cost could be minimized if the particular doctor does not have to pay for a
facility. I can't even begin to imagine what the cost per sq/ft of a generic
doctor's office is, given all the regulation and equipment requirements.
Having them mobile may remove a significant cost (though probably won't come
close to the added opportunity-cost you mentioned).

~~~
mbesto
> doctor does not have to pay for a facility

> given all the regulation and equipment requirements.

Um, so how does not having a facility, which is probably required to give
care, all of the sudden eliminate all of the equipment and regulatory
requirements? I mean, don't you think the equipment and the regulation is
probably there for a reason..?

~~~
dragonwriter
> Um, so how does not having a facility, which is probably required to give
> care

It's required for certain levels of care, but not every encounter requires
those.

------
nathan_long
> To ensure Uber Health meets HIPAA standards, we have been working hard to
> develop, implement, and customize numerous safeguards.

The stories I've seen about employees tracking individual riders lead me to
view this skeptically.

~~~
jtmcmc
I would bet they have put access restrictions on these because violating hippa
can be a felony whereas in general there are 0 legal requirements to restrict
access to internal data to a company generally.

~~~
matheusmoreira
So if a company stores medical history data it's only required by law to
prevent the data from leaking to the public? It's okay if a system
administrator employed by the company has read access to people's medical
records?

~~~
jtmcmc
sorry if i was unclear. if a company is storing medical history data that
falls under HIPPA which is serious.

If a company just has data about you that is not medical data then there is no
legal requirements as to who can have access to it internally. (So Joe's
Sprocket's has a list of everyone who has bought sprockets and their phone
numbers - anyone in the company could look at that info and there would be no
legal implications)

~~~
matheusmoreira
I see. I think I misinterpreted the "0 legal requirements" part of your
comment. It gave me the impression employees not involved in the care could
access medical data. Thanks for clarifying.

------
jamesmishra
(Disclosure: I am a former Uber employee.)

HEY! In 2016, I worked on the pilot program that was the predecessor of the
product. It was just me and an intern finding ways to modify Uber's core
dispatch and billing workflows to make workflows like this possible.

The project started attracting interest in the company, and we handed it off
to a newly-formed dedicated team for the project. They made it into a fully-
fledged, HIPAA-compliant product with a great UX.

I'm absolutely ecstatic that this launched. Although I probably can't answer
any questions about the project, since they probably had to rewrite all of my
prototype code.

~~~
BillinghamJ
Looks like it has evolved from Uber Central right? Or is it based off
something else?

------
socialist_coder
I can't even read this because of their stupid geo redirect.

It redirects me to [https://www.uber.com/de/newsroom/uber-
health/](https://www.uber.com/de/newsroom/uber-health/) which gives a 404
error.

God, I hate geo redirects. I wish you could set some "don't do geo based
redirects" option in your browser that sites would then respect.

~~~
autotune
Unfortunately this happens on the backend, for instance as a built-in feature
of a CDN or DNS routing based on your IP, so the only real way around it is to
use a VPN that'll let you switch countries and show a different IP address
when browsing the web. It's not like a user agent string that can be modified
or anything like that.

~~~
netsharc
[https://developer.mozilla.org/en-
US/docs/Web/HTTP/Headers/Ac...](https://developer.mozilla.org/en-
US/docs/Web/HTTP/Headers/Accept-Language) . Browsers send them.

But nah, let's be too clever and offer localized content based on IP! No
localized content? Enjoy the 404!

------
vinceguidry
Non-emergency healthcare transportation is a pretty big market that can't be
served well by taxi companies. You may not have noticed the ubiquitous branded
vans which drive around large cities ferrying seniors around. They're operated
by numerous small-to-medium companies. I'm sure there's a few large regional
companies at it as well.

Uber has probably already disrupted that industry in a large way. I'd be
quaking in my boots right now if I made my living doing this.

------
SkyPuncher
It looks like Uber is looking to put the cost onto the provider. I think it
could make sense for large health organizations, but I see it being an issue
extending down to the chain.

I'm curious what adoption among patients will actually look like. A provider
in Philadelphia tried providing their patients with free rides and found that
a free ride made absolutely no difference whether patients missed their
appointment.

[https://www.reuters.com/article/us-health-ridesharing-
missed...](https://www.reuters.com/article/us-health-ridesharing-missed-
appointment/free-lyft-may-not-help-poor-people-keep-doctor-appointments-
idUSKBN1FS2SF)

~~~
troycarlson
I believe a missed appointment will cost the provider more than the cost of a
ride. Also, I believe CMS reimburses for non-emergency medical transportation,
which may include Uber Health.

[https://www.cms.gov/medicare-medicaid-coordination/fraud-
pre...](https://www.cms.gov/medicare-medicaid-coordination/fraud-
prevention/medicaid-integrity-education/downloads/nemt-booklet.pdf)

------
ProAm
I would never trust Uber with anything sensitive, health related or remotely
private after their history of stealing medical records to attempt to cover
one of their drives rape. [1]

[1] [https://www.recode.net/2017/6/7/15754316/uber-executive-
indi...](https://www.recode.net/2017/6/7/15754316/uber-executive-india-
assault-rape-medical-records)

------
olivermarks
Meanwhile, 'Passengers Who Call Uber Instead Of An Ambulance Put Drivers At
Risk Sick people are increasingly using ride-hail to get to the emergency
room, putting drivers in an uncomfortable position and a potentially tricky
legal bind'

[https://www.buzzfeed.com/carolineodonovan/taking-uber-
lyft-e...](https://www.buzzfeed.com/carolineodonovan/taking-uber-lyft-
emergency-room-legal-liabilities?utm_term=.raexWaeKn#.dcMKLXvEq)

~~~
BoorishBears
I was in a digital health hackathon a few weeks ago and one of the ideas
pitched was Uber for hospital visits.

One of my first thoughts, and one of the risks people couldn’t get over, was
if a person isn’t so sick they don’t need an ambulance, why doesn’t a normal
Uber work?

The natural assumption is people who have no business getting in a car with
someone else would be the ones to use it the most.

------
cheath
As someone who struggles to get my Grandmother to doctors appointments and, as
a result, she has high cancelation rates - I think this has the opportunity to
be an incredibly valuable two-sided market.

\- Doctors are incentivized to have fewer cancelations and help get their
patients to and from appointments.

\- People get to the doctor more often and have better care.

Uber is easy to hate on, but this seems like a societal net-positive. Good for
them.

------
tgb
Maybe I'm the only one who uses spacebar to mean "scroll down" (I find it very
convenient), but I'm certain that _no one_ uses it with the intent to open a
giant search bar that obscures the article.

~~~
kakarot
Space scrolls for me just fine.

~~~
tgb
Odd - I just Chrome, Firefox and Edge and all have pull up search boxes when I
scroll with space.

------
dayjah
What might not be super clear to most folks is that this is one of the last
areas that medallion owners make bank. Typically, in many US cities local taxi
operators have deals with the govt to ferry the elderly around. So this in
effect is uber putting the final nail into the taxi company coffin. I've
spoken to taxi drivers which have resisted switching to the gig economy
because they made enough from this government tie up to not have to move; I
guess that all changes from here on out.

------
foobarbazetc
This already exists. It’s called paratransit.

E.g.: [http://www.sfparatransit.com/](http://www.sfparatransit.com/)

Trained people who can handle mobility and disability needs.

It’s unclear where the gulf is between people who just book an Uber to go to
the doctor (which seems to be all this is, just arranged by the provider
themselves instead) and services that have trained professionals transporting
people.

------
dsr_
Every bit of Uber's history says that they are willing to bend rules and
ignore ethics in favor of expanding their business. They aren't interested in
protecting the public, their employee-contractors, or their employees. All of
this is well-documented in stories discussed here on HN.

Why would anyone trust them in any aspect of healthcare?

------
JustAnotherPat
I would imagine disabled and old people would use this the most (people who
use Acess-A-Ride in nyc for example), but obviously this means vehicles would
have to be accessible to them, and how can you guarantee that with Uber using
shady contractors who have to maintain their own vehicles?

------
neuro_imager
(Physician here) I am so pleased that competent technology companies (Google,
Amazon and now Uber) are entering the healthcare space. I really heope this
portends the demise of the overcharging, outdated garbage (such as EPIC) that
passes for healthcare IT at most hospitals.

------
juanmirocks
I'm extremely excited and happy for any possible innovations that may save
lives / improve our health, even if just a little.

------
Dowwie
Those with acute renal failure (kidneys) largely need to go to and from a
dialysis center a couple of times a week. Dialysis is an exhausting, lengthy
process. Once the treatment is finished, a patient really is not fit to drive
yet many do for the sake of cost. Driving after dialysis is like DWI. It isn't
safe for anyone on the road.

If Uber Health can provide affordable transportation services for dialysis
patients, it is providing a life changing service that is sorely needed. This
is a great idea and I hope that the service succeeds.

------
yalogin
How is this different from regular Uber? Will it be billed to my insurance? If
so Uber has found a brilliant way to charge 10 and 20x rates for regular Uber
rides.

Sorry, I am very skeptical when it comes to healthcare offerings.

------
atonse
It's still taking me a while to dissociate Uber with Travis Kalanick and his
army of bros, even though they seem to be trying a lot of new initiatives.

Anyone have a good article on Uber's attempts to de-bro itself?

~~~
loceng
Uber support still has dark patterns within it - this organization is trying
to win by optimizing at all costs. I don't trust them, and worse, based on
passed verified behaviour of Uber's - I feel somewhat hesitant even speaking
badly of Uber in case of retaliation. We need strong whistler-blower laws with
substantial pre-defined payouts to disincentive this kind of behaviour in
every organization and at every level.

~~~
ghostbrainalpha
Are any of the dark patterns you are thinking of public knowledge?

------
mountainofdeath
Looks like they are trying to tap into the goliath pile of cash that is
Medicare by offering better service with the same billing structure. Most of
the companies in this space are either regular taxi companies or fly-by-night
transportation "companies" because of how easy the money is.

------
mcast
I wonder if there will be a way to pair a driver with a patient who only
speaks Spanish. Health care transportation is a huge market for elderly in
Miami, especially since retirement homes are taboo in many hispanic cultures.

~~~
jamesmishra
(Disclosure: I am a former Uber employee.)

A handful of cities already have UberESPAÑOL. I'm not certain, but I imagine
that the healthcare provider's dashboard should be able to request the product
if it is available at the pickup location.

[https://www.uber.com/drive/san-diego/resources/san-diego-
ube...](https://www.uber.com/drive/san-diego/resources/san-diego-uber-
espanol/)

------
robk
This just doesn't scale. Babylon Health here in London is using machine
learning to do more of the triage in app. That's the only way to narrow the
pipeline early with any form of scale.

------
thingschanged
These healthcare companies make a huge amount of money billing insurance
companies and medicare, so I imagine at some point its profitable for them to
pay for the transport of the patient back and forth.

------
DanBC
One thing they could do is coordinate with English NHS Trusts and the "Crisis
Care Concordat" to talk about conveying people who are mentally ill, who need
to go to hospital, but who don't need a fully stocked ambo.

They'd have to make sure it was free at the point of delivery to the patient.
They'd have to have good governance (so, actually doing background checks) and
have better training for drivers.

But a non-medical (more normal) conveyance to hospital is probably something
many people want.

~~~
gaius
Absolutely not, while Uber flaunts their noncompliance with TfL et al they
should not receive a single penny of taxpayer’s money - and there’s the matter
of them dodging employer’s NI thereby directly undercutting the NHS too.

~~~
DanBC
Wait til you find out how much Priory Group or Virgin already get for treating
NHS patients.

~~~
gaius
Yes Branston is tax-dodging scum like the rest of them. If Fred The Shred got
his knighthood revoked then so should he.

------
Brajeshwar
This is interesting. About 2 years ago, I emailed or perhaps filled up their
contact form that it would be a good idea to do this for India. India
road/traffic condition is so bad and there is no formal/official importance
given to Ambulances. If Uber taxis can serve as on-demand ambulances-esque
services when needed, it will likely save a lot of lives.

------
908087
Among the companies I'd trust with anything related to my health or associated
data, Uber ranks right next to Equifax.

~~~
jackietreehorn
This is pretty much my sentiment. Uber is basically a company that has engaged
in illegal, unethical, and reckless behavior over and over and over again. Not
exactly the type of company I want involved in health care. On the plus side
the inevitable HIPPA violations will (hopefully) carry some teeth and maybe
force Uber to change finally.

------
wk2jkhkjdfglsl
Its a really nice idea, but will the cost not be passed on to the consumer in
the form of inflated health insurance premiums? The health industry already
stupidly too expensive in the US. Is having Uber suckling on the heath
insurance teat a good thing?

~~~
nugi
You are light grey, but this is a huge point. Insurance preimums are almost
untennable right now. This will slowly raise them for everyone.

------
thisisit
So I am confused - are they going to introduce a new fleet or is it asking
their existing drivers to do this? If they are going to introduce a new fleet
- how is it different from a normal ambulance service?

~~~
GavinMcG
Ambulances are necessary for a few reasons. The obvious ones are acute illness
or trauma, where a life threat could develop emergently. Another significant
segment of ambulance traffic is psychiatric, where direct monitoring is needed
even if there's no likely _medical_ intervention. And another segment is for
bariatric or non-ambulatory people.

But this service doesn't seem to be for people who need to _be transported_ so
much as for people who _need transportation_. That is, the target for this
service isn't the person who has a medical issue that needs to be addressed in
transport. It's for people who need a transport and whose destination happens
to be medical in nature. That's why it seems to be marketed primarily to
medical _providers_ rather than patients, with the benefit of a reduction in
missed appointments and an increase in efficiency.

If there is a new fleet, then, it's likely that the vehicles would have none
of the medical equipment that ambulances do. (Though maybe they'd have more
leg room, or a stool to help people in, or other minor accessibility
considerations.) I'd also expect that drivers would be specially trained in
HIPAA, and probably in recognizing imminent life threats so that they could
call 911 in case someone _was_ trying to use them as an ambulance.

~~~
Tyrek
Given our current understanding of Uber's business model, do you really think
that 'specially trained' drivers are going to be subject to more than a
powerpoint presentation or two?

~~~
GavinMcG
To be honest, it doesn't take much training to understand those two things.

------
brokenmachine
Who needs ambulances when we have Uber!!

