Johnson County Mental Health is kicking off a new, novel approach to patient transportation that could make it a model for other public health agencies across the country.
Clinicians have identified simply getting to an appointment as one of the biggest barriers for mental health patients to access the care recommended for them. In a partnership with researchers from Dartmouth College and UnitedHealthcare, the county is taking part in a pilot program study that will explore whether on-demand transportation services will increase patients’ access to treatment and lead to reduced costs and improved outcomes. The study will also explore whether consistent interactions with the person providing the on-demand transportation can help improve patient compliance with care recommendations for a variety of conditions.
People with a history of significant mental health issues often have comorbid physical conditions that need treatment as well. A patient with schizophrenia or posttraumatic stress disorder may also suffer from diabetes or heart disease, for example. Through the pilot program, the drivers tasked with transporting the patients will be trained to asked questions to ensure they understand the instructions they may have gotten from a doctor at a recent appointment. The drivers will communicate with clinicians if and when they get a sense from a patient that there may be confusion about instructions they received at their appointment.
UnitedHealthcare contributed $150,000 to the program to underwrite the cost of the cars and drivers. Plan CEO Kevin Sparks said the collaboration will provide the company a chance to see whether the intervention of a trained driver could head off potentially serious health issues for patients before they spiral out of control. Having a comfortable ride to a doctor appointment may reduce missed appointments among patients who would otherwise be forced to use public transportation, Sparks said. And the program also gives clinicians an opportunity to hear questions and concerns from patients they may not get otherwise.
“In addition to handling the transportation elements, we have the opportunity to hear whatever sort of feedback the patient may have to what they learned or didn’t learn [at their appointment],” Sparks said.
Suken Shah, MD, an associate professor at Cornell Medical College who will be examining data from the year-long program as part of the Dartmouth research project, said Johnson County’s existing ride-providing program made it an attractive model for the study.
“We’re looking for innovative ways to provide health care delivery,” Shah said. “The goal is to change the model of transportation… If we can integrate transportation into the care delivery model, if it’s easier to get that transportation and build it into the relationship, can that not be a barrier to care?”