NFPA Journal - January/February 2018 - 43

Can

RIDE
SHARING

highly unlikely if a ride-sharing
service is used.
According to Vincent Robbins, people experiencing
The numbers suggest that ride-sharing
services may be able to play a role in
cardiac events are just one
a broader community health care model
group that has traditionally
by reducing unneeded hospital transports
bypassed the EMS system to
by emergency medical services
get to a hospital. Robbins,
president and CEO of MONOC,
New Jersey's largest private,
non-profit ambulance service,
has over 45 years of experience
in EMS. "They often downplay
their condition to themselves,"
Percentage of all annual EMS transports
he said of these patients, who
that are for low-acuity ailments
like sprains or flu-like symptoms
are typically older adults.
"They want to think it's just
indigestion. They don't want
to believe they're having a
heart attack." Younger patients
with conditions like asthma,
The estimated number of annual
EMS transports in the United States
who believe they're able to
manage symptoms themselves
and don't want to "bother"
EMS providers, also do it, as
do elderly people afraid of the
cost of an ambulance, Robbins
Percentage of ambulance transports
said. "Emergency department
to emergency departments described
physicians will tell you there
as inappropriate or unnecessary
are a number of walk-ins who
arrive without EMS intervention, which is what they really
public's familiarity with ride-sharing
needed as precautionary treatment
technology and the corresponding user
before getting to the hospital."
interfaces can heighten its appeal as a
With the obvious dangers of using
mode of emergency transport, Montes
ride sharing as a means of emergency
said, even in cases where people should transport, why would somebody risk it?
be taking an ambulance. Over the last
From a patient's perspective, the benefit
couple of years, news outlets have
of using Uber or Lyft over an ambulance
increasingly covered the practice of
starts with the comfort and familiarity
Ubering to the ER.
of ordering one. "Ride sharing is incredBut it's also prompting a public
ibly user-friendly," Montes said. "You
response from those in the fire and
can't look on your phone and see where
emergency medical services. In April,
an ambulance is coming from, who's
Mark Becraft, a veteran paramedic
driving, or how long it'll take to get
turned fire chief in Utah, condemned
there. With these apps, you can."
the practice in an interview with a
Beyond the convenience and translocal television news station. "It's
parency, ride sharing is significantly
just unsafe," he said. "I think Uber
cheaper. Most ambulance rides cost
has its place. I just don't think it's in
between $800 and $1,200, according to
emergency medicine." Becraft gave an
Montes, while in most cases an Uber or
example: Say someone is having a heart Lyft ride will cost less than $50. A third
attack but they don't know it. Ambubenefit for the patient is a greater sense
lance personnel can figure that out, and of control, especially when it comes to
instead of going to the ER, the patient
selecting a hospital to go to, a considercan go straight to the catheterization
ation reflected in the posts that appear
lab-a timeline compression that is
on uberpeople.net. "Got a pregnant

Help?

10-40%
28m+

30-50%

lady who was in labor who wanted to
go to a hospital that was about 30 miles
away from her house because she didn't
want to have her baby at the local hospital," one driver wrote.
Officially, Uber doesn't endorse the
practice, but the company acknowledges it occurs. "We're grateful our
service has helped people get to where
they're going when they need it the
most," the company said in a statement
sent to NFPA Journal. "However, it's
important to note that Uber is not
a substitute for law enforcement or
medical professionals. In the event of
any medical emergency, we encourage
people to call 911." Lyft did not respond
to a request for comment before the
magazine's deadline.

A role for ride sharing
Despite the concerns surrounding the
practice, some EMS providers have
started to explore a system where
ride-sharing services are utilized for
non-emergency medical transport. A
number of shifts in the health care
landscape over the last decade or so
have allowed that to happen, according
to Robbins.
First, there has been a significant
increase in the number of urgent care
facilities nationwide, which often provide low-level emergency medical care
for injuries like a broken arm. EMS providers and health insurance companies
realized that transporting patients who
were experiencing non-life-threatening
conditions to these facilities was both
more sensible and cheaper than bringing them to hospitals. Once that started
to happen, some providers began
searching for an even lower-priority
subset of patients who don't require
ambulances to get to urgent care. In
many cases, that search led them to
people who were known to repeatedly
request ambulances unnecessarily-a
common and significant drain on EMS
resources.
"It became a kind of 'aha' moment,"
Robbins said. "We realized we maybe
didn't have to take these people to
urgent care centers. Maybe we could
call someone else. And we could put
our ambulance back in service to
handle the life threats and the critical
N F PA . O R G / J O U R N A L * NFPA JOURNAL

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Table of Contents for the Digital Edition of NFPA Journal - January/February 2018
