EHR integration leads to 4,000 rides in the first six months

Roundtrip’s complete EHR integration creates a data-sharing repository for healthcare providers and its area transportation options, including Lyft, wheelchair, stretcher, and insurance-paid rides, to better understand how patients access healthcare.

Overview

Contra Costa Health Services (CCHS) serves as the public health system for Contra Costa County, California, and is the largest department in the county’s government, employing more than 4,250 individuals. CCHS is an integrated system of various health care services, including a medical center, and a health plan for approximately 200,000 people who call Contra Costa County home. The system works in partnership with patients, cities, and diverse communities, as well as other health, education, and human service agencies. CCHS encourages creative, ethical, and tenacious leadership to implement effective health policies and programs to anticipate and address community health needs.

Challenge

In the state of California, Whole Person Care (WPC) is a statewide waiver pilot program aimed at improving health outcomes and reducing the utilization of high-cost services among vulnerable Medicaid recipients. As one of 25 participating pilot jurisdictions, CCHS formed a local pilot program named “CommunityConnect.” CommunityConnect is a holistic case management program that identifies and addresses patients’ social needs that are not traditionally met by the health system. There are approximately 12,000 people enrolled in CommunityConnect with over 100 direct service staff. Each patient is assigned to a primary case manager, who may have a background in one of seven different disciplines, and who works with the patient over the course of a yearlong enrollment on unmet needs, including transportation.

For a large geographical area, almost the same size as Rhode Island, there are limited public transportation options in Contra Costa County, especially if you’re trying to make your way from one side of the county to the other. With rising housing costs, suburban poverty, and rising economic inequality in the San Francisco Bay area, many people have been forced to move further away from areas where traditional services have been clustered. Because of these factors, over one-third of the enrolled population of CommunityConnect has an identified transportation need.

Before Roundtrip, CCHS’s traditional workflow was to provide taxi vouchers as well as public and paratransit vouchers to meet their transportation needs. These paper vouchers were applied to get people to medical appointments, the food bank, the DMV, and various other social needs. But the high costs of the taxis and their lack of reliability were straining CCHS’s resources without meeting the patient or case manager’s needs. The process was a significant administration burden with disproportionate staff time dedicated to tracking the delivery and requests of the taxi vouchers, and CCHS was only aware of the problems in ride delivery if the patient took the initiative to share what could have been better.

Solution

CCHS has been using Epic as its electronic health record (EHR) for seven years. The CommunityConnect program required additional types of care settings within Epic, which ultimately resulted in a comprehensive record for patients throughout the system. Roundtrip capitalized on CCHS’s innovative relationship with Epic to create a simple, integrated solution for Case Managers to book transportation for patients straight out of Epic.

Impact

1. A Quicker Way of Booking Transportation for Administrators

Prior to Roundtrip, employees were challenged by the burdensome and disjointed transportation booking process and had no way of evaluating patient satisfaction with their transportation. Roundtrip led to increased efficiency, freeing up staff time to better serve patient needs. There are a few key ways Roundtrip delivered a boost in employee satisfaction:

• User-friendliness drove positive user adoption rates. Roundtrip’s integration with Epic automatically pre-populates patient information to streamline the ride ordering process. By enabling CCHS to use Roundtrip directly from their EHR, Roundtrip has made ordering transportation a piece of cake.
  1. 1. 1. There are currently 164 Roundtrip CommunityConnect users at CCHS.
        2. We’ve done over 4,000 rides in the first six months:

• New access to in-depth insights has helped improve the patient experience. Roundtrip has increased patient satisfaction from 4 (on a 1-5 scale) to an average of 4.66 in the first few months since launch. Where data was once disparate, CCHS now has real-time access to several different data points through Roundtrip:
  1. 1. 1. Number of rides per patient
        2. Level of transportation needed
        3. Patient ride satisfaction scores and feedback

With this information available, CCHS is taking proper steps to improve the patient experience and streamline patients’ compliance with healthcare visits.

• Reduction of administrative burdens for staff (measured by week over week call volume).  Roundtrip is now integrated right into the workflow that the case management team at CCHS uses every day, removing the administrative burden and giving back hours of time that was originally spent trying to coordinate rides over the phone. Case managers at CCHS can operate at the top of their licenses and focus on what matters most, while letting the Roundtrip Navigation Center be 24/7 on-call support. In the first three months, Roundtrip has handled over 3,500 calls about transportation coordination that would have otherwise been handled by the case management team at CCHS.

2. A more cost-effective way of providing transportation

Previously, through the taxi voucher program, CCHS was spending an average of $40 per taxi ride. Through Roundtrip, CCHS now averages $32 per ride across a range of vehicle options for all patient needs. While Roundtrip offers multiple levels of transport to CCHS, all rides that are now rideshare in replacement of the taxi voucher program saves the company an average of 20%, approximately $15,000 per month.

3. Growth and Expansion of the Program

Since launching with Roundtrip in March of 2019 for Community Connect, CCHS has experienced a compound monthly growth rate of 190% in ride volume. Because of this success with Community Connect, Roundtrip and CCHS expanded into the Contra Costa Health Plan in July 2019. After expanding with parts of the health plan in July, there was a 57% increase in ride volume by the end of August. Here are early insights gathered on the success of the launch at Contra Costa Health Plan:

• Cost savings: 42%
• Member Satisfaction Score: improved to 4.6 (the former process was rated a 4 and Rideshares (Uber/Lyft) were a 4.5 by our survey respondents)
• Weekly Call Volume: ~50 calls weekly go to the Roundtrip Navigation Center instead of the CCHP Transportation team

Looking Ahead

The ultimate goal of this partnership is to maximize the connections throughout the entire county systemwide. With successful expansions from CommunityConnect to the Contra Costa Health Plan, our next planned expansion under consideration is into the inpatient space. Here, Roundtrip will assist Case Managers in scheduling transportation for patients being discharged from the hospital. Both CCHS and Roundtrip are excited about the capabilities of data and this unique partnership to better serve patients’ transportation needs and create healthier communities.