On-demand health: UberHEALTH and the future of healthcare delivery
Editor’s Note: Last year, Uber ran a pilot program called UberHEALTH in four U.S. cities, making flu care packages and the option to receive a flu shot available on-demand through the Uber platform. We worked with John Brownstein, PhD, Director of the Computational Epidemiology Group at Boston Children’s Hospital and Professor of Biomedical Informatics at Harvard Medical School, as well as the co-founder of Epidemico, a healthcare informatics company. Dr. Brownstein’s research on this initiative was published today in the Annals of Internal Medicine,* and he is the author of today’s post.
My career has focused on using emerging technologies to study patterns of disease, particularly how someone’s location and access to healthcare options affects health outcomes. It’s clear that while there are many barriers to effective disease prevention, lack of convenience is a major issue.
Even as the healthcare market has witnessed an explosion of health apps and sensors and the emergence of telemedicine, in-person care remains virtually unchanged, taking place in brick-and-mortar locations, requiring people to take the time to find them, schedule an appointment, and travel to and from their provider.
The resulting loss to the economy and impact on healthcare is huge: over $190 billion is spent on primary care each year, with over a billion primary and urgent care visits annually. Yet more than 50% of patients complain about trouble getting appointments within at least one week or wait times of more than an hour in the waiting room. And many patients say that doctors spend too little time with them. Convenience and access to healthcare simply haven’t kept up with the rest of the industry’s advancements. That means that many people will not receive even the most basic care, including immunizations.
To address the lack of clarity around where to get a flu shot, my team maintains tools like our HealthMap Vaccine Finder, which can help connect the public to local vaccine providers through a searchable online map.
But in exploring ways to truly change the game of healthcare access, I thought: instead of bringing the people to healthcare, why not bring healthcare to the people? With its existing logistics platform, Uber seemed a perfect candidate to help test a new model of healthcare delivery. This is how UberHEALTH was born.
In the first phase of UberHEALTH, we focused on immunization. Vaccination remains the single best option in preventing numerous diseases, yet coverage for most adult vaccination remains under 50 percent. For influenza alone, the economic cost to the U.S. is around $90 billion each year. While there are many factors behind low coverage, the delivery of vaccines remains a massive challenge, driven in part by the 31 percent of unvaccinated adults who do not have regular contact with a healthcare provider. On October 23, 2014, we launched a day-long mobile flu care package delivery experiment (including the option of a flu shot) to test whether on-demand immunization would persuade more people to receive an annual influenza vaccine.
Overall, the experiment showed an overwhelming number of requesters would not have been immunized this year, including 42.2 percent who had never received a flu shot prior to the event. Over 90 percent rated the delivery aspect of the vaccine program as important in their decision to request a flu prevention package or flu shot, with almost 80 percent considering delivery “very important.” And 95 percent of users said they would use UberHEALTH again.
It is my hope and ambition that this will be just the beginning, which is why I’m excited to join Uber as its first advisor in the field of healthcare.
Of course these efforts are not without challenges. To scale these efforts, the cost of such activities and how they are reimbursable by insurance remains to be worked out. Efforts going forward must address health disparities and populations with limited access to smartphones and network coverage.
As stated in the press:
“Uber’s on-demand vaccines offer a compelling hint at how the 21st century’s hyper-efficient logistics networks could also be vehicles for delivering better public health.”
This initial pilot project points to the potential of logistics platforms as mechanisms for disease prevention. Beyond seasonal influenza, the availability of delivery is especially exciting when considering the needs during an outbreak, where contact tracing (that is, quickly locating people that may have come in contact with an infected person) is a key public health tool. The data captured by Uber on movements of passengers could represent provide a vital resource to local, state and national public health agencies as they attempt to track potential exposures and mitigate risk to the general population. Thinking bigger, there are many examples where a mobile platform could enhance healthcare delivery ranging from urgent care visits, medical transport, drug delivery, disease screening, and home care visits.
I look forward to seeing what the future holds for healthcare on demand.
This article is made freely available to our readers via an agreement with the American College of Physicians. Website users may not distribute or post this article without written permission from the American College of Physicians. Posting or distributing article PDFs not only violates the ACP copyright, but it also could proliferate the sharing of non-authoritative versions of articles. Brownstein JS, Huston JE, Steingold L, Joyce MV. On-Demand Delivery of Influenza Vaccination. Ann Intern Med. 2015;163:806–807. doi:10.7326/L15–5169 © 2015 American College of Physicians. Used with permission.