Ambulnz, Inc.
Can the use of disruptive technology and innovation in medical transportation really change lives? Let’s find out.
Ambulnz, Inc.
The healthcare transportation industry has not seen fundamental change in decades. Industry-wide stagnation has resulted in a pronounced lack of technology adoption by traditional ambulance service providers. This lack of technology adoption has led to a declining quality of service and a prevalent lack of transparency [1]. This backdrop has led to a frustrating and deficient experience for the stakeholders of an ambulance transport: the patient, the patient’s caregiver and the hospital or nursing home staff. Lastly, underlying these inefficiencies is an outdated hourly EMT compensation structure that further exacerbates the declining level of service.
Ambulance transportation has a huge impact on patient care and resource allocation, affecting over 20% of hospital patients. Healthcare facilities across the board experience frustration when ordering ambulances. Nurses and patient logistic coordinators within a hospital or nursing home on average spend between 20 and 60 minutes and typically make multiple calls before confirming an ambulance transport [2]. The nurses and patient logistic coordinators often need to call multiple ambulance companies and will wait on hold for extended periods of time. They also have difficulty in getting the ambulance company to commit to or keep the time frame they promised. Other wasteful practices include “no shows,” where the ambulance never arrives due to disorganization and poor communication, and “dry runs,” when the ambulance shows up and the transport has been cancelled. At a traditional ambulance service provider it is not uncommon to see 6 to 7 dry runs per day. These inefficiencies inconvenience the patient and requires the nurse or patient logistic coordinator to stay with the patient while waiting for the ambulance. The time wasted by nurses and patient logistic coordinators having to wait with patients who occupy hospital beds longer than necessary due to inefficient transportation logistics is very costly for healthcare facilities. These inefficiencies also mean that EMTs waste time that could otherwise be spent providing care to additional patients.
The evolution and growth of smart phone usage has paved the way for new and innovative business strategies using geolocation technology [1]. Historically, common industry practice for dispatchers at traditional ambulance service providers is to give a static pick-up time based on experience and intuition, which is often inaccurate and unreliable. This is very similar to how traditional taxicab companies operate, where dispatchers would produce pick-up times using a combination of intuition and experience and communicate instructions to their drivers in the field by radio or cell phone sporadically before and during the trip. Ambulnz, Inc. (Ambulnz) was founded to fix these inefficiencies by developing proprietary technology that gives control and transparency to hospital facilities and nursing homes similar to the way that Uber and Lyft provide control and transparency to their customers in the consumer ride-sharing space [2].
Ordering and/or monitoring an ambulance transport using Ambulnz’s computer-aided dispatch (CAD) software provides transparent, accurate and dynamic arrival time estimates based on real-time GPS tracking. Nurses and patient logistic coordinators are able to share this information with patients and the patient’s family, reducing frustration and patient inconvenience, while also allowing the hospital staff to more efficiently manage their labor costs and bed utilization. Ambulnz’s predictive algorithms creates routing efficiencies that drastically shorten wait times for patients and caregivers by providing reliable and transparent arrival times based on geolocation coordinates. Lastly Ambulnz’s software and operations were built to allow EMTs to be compensated based on productivity and level of service, which boosts productivity and the overall level of care.
The transparency that Ambulnz brings to the ambulance services ecosystem helps each of the various stakeholders. Ambulnz reduces the patient and the patient’s caregivers unnecessary waiting time by giving the hospital facilities and nursing homes transparency into when the Ambulance will arrive. Caregivers can stay informed about where the patient is throughout the entirety of the transport in real time using their smartphone or a web browser. Ambulnz delivers immediate benefits to nurses and patient logistic coordinators by decreasing the time and amount of calls needed to request or order an ambulance. This dramatically decreases the downtime spent waiting for the ambulance to arrive. Ambulnz is also able to provide a quicker response times by dispatching the nearest ambulance using Ambulnz’s CAD geolocation technology and internally developed algorithms.
Poor EMT attitude and job performance, indifference to personal appearance and ambulance maintenance, and lack of company loyalty are pervasive throughout the industry. The root causes of these behaviors are low compensation, hourly pay structure, little feedback and quality control, and lack of a career path. On average, the 241,000 EMTs in the US make only $1 – $3 per hour over minimum wage, or roughly $32,000 per year. Generally, EMTs are treated as low-level employees and most need to work two jobs to make ends meet. By compensating EMTs based on productivity and level of service, Ambulnz provides a great opportunity for EMTs who earn at or around minimum wage to increase their income by two to three times.
Although Ambulnz has pioneered a new way to provide high-quality service to the stakeholders within the healthcare transportation industry questions remain around how the company will continue to innovate in the face extreme regulation and bureaucracy that exist within this industry [3,4].
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Sources
[1] Susanna Smith. “How Can the Ambulance Industry Meet the Demand for Value-Based, Consumer-Driven Care?” Medlert Transportation Solutions, 2015. http://naemt.org/docs/default-source/community-paramedicine/Toolkit/medlert_whitepaper_050615.pdf?sfvrsn=2083c792_2
[2] Brian Powers (Harvard Medical School), Scott Rinefort (MBA), and Sachin Jain (MD, MBA). “Non-emergency Medical Transportation: Delivering Care in the Era of Lyft and Uber” Viewpoint, September 6th 2016. https://www.mfprac.com/web2018/07literature/literature/Misc/UberTransportation_Powers.pdf
[3] Jason Wallace (JD, MPH, CAC). “Ambulance industry: Guidance for intensified government oversight” January 2015. https://www.hcca-info.org/default.aspx
[4] Suzanne Murrin (Deputy Inspector General). “Inappropriate Payments and Questionable Billing for Medicare Part B Ambulance Transports” Department of Health and Human Services, September 2015. https://oig.hhs.gov/oei/reports/oei-09-12-00351.pdf
Very interesting service. I guess I never knew that hospitals or nursing homes had to find 3rd party ambulances to deliver patients to primary care providers. I just assumed that the ambulances were under the cognizant control of the hospitals. In Italy, I remember seeing that the ambulances often cannot make it to patients in time or are slower at negotiating city traffic (in Naples where the road rules are less rigid than America – and car size determines what is and is not permissible) and therefore friends and family of the patient drive erratically on the way to the hospital, honking and waving a white towel to signal distress and for other drivers to yield. As far as Ambulanz moving forward, is there sizable research data on the costs of timing errors and their impact on EMT performance and looks metrics? And if so, how can this open innovation technology be leveraged to address these concerns about EMT service that are perhaps only slightly correlated with time of arrival and overall efficiency?
Reading this I immediately thought: this seems like such an obvious, practical thing to do. It helps all stakeholders, reduces costs, and increases efficiency for all parties. Not to mention it’ll probably save lives. I’m curious to know why it hasn’t happened? Is this something that can be achieved in the next 5 years? If not, why? Great blog, Corey.
I’m so glad you wrote an article about your startup! I had so many questions when we first discussed it in person, and this article did a nice job covering the key value propositions. I’d be curious to learn how cities with traditional dispatch services manages quality control. I remember when I used a dispatch service for taxis, the dispatcher would often send my taxi to the wrong address, leading to long wait times and inefficiencies on the taxi company’s end. I could imagine the same happening with the ambulance/EMT services (with human lives at stake) and Ambulnz’s technology can help reduce that risk. Has there been any issues with the users not understanding Ambulnz’s interface and mistakenly putting the wrong address/information, or does the geolocation aspect of the app control for that?
Thank you for the insight, it is very interesting to see how you can use disruptive technological platform solutions like Uber and merge it with ambulance. Did you consider why there is such a break between the cost for taking ambulance for the patient and what is being reimbursed by the insurance versus what are the real costs for the hospital or the vendor to operate the ambulance? Will Ambulnz help in narrowing this break?
Great article and loved reading about your startup! In terms of adaptability of the UI, is there a training process for the EMT’s? Do you foresee Uber or Lyft entering and overtaking this space and what will be Ambulnz inc. relative advantage other than having a first-mover advantage?