Author: Graciela Hasbun

Attached is our App prototype mock up

SJHS app mock up

Attached is our business Canvas

 

Presentation4

Subject- What is the story about?

• Our ideation process trying to come up with a solution for transportation issues for low income patients in  SJHS

Goal- What do you want to achieve with this story

• Present a viable and suitable solution and prototype

Audience

• SJHS administration and offices of community outreach

Before – what does your audience think, feel , know, want, before they have experienced your story

• Gallery Day
• details on the problem
• About the class
• Failed solutions
• Want
  • solution
  • cost effective
  • no liability or legal issues
  • not alot of required man power or capital

set the scene – what do you need to introduce?

• process used
• ethnography
• guiding principles
• trends
• immersions
• past failed attempts

make your point

• solutions
• how it fits needs
• how its integrated into existing system
• babysitting
• rewards

conclusion

• who it helps
• how to move forward
• cost
• reduction of missed and skipped appointments

After

• a sense of hope
• desire to look into it more
• desire to pass along ideas
• excitement about future

 

Idea 1: Mobile App/ Scheduling System 

Summary of Idea: Idea 1 consists of a system utilizing both an app/website as well as a receptionist/ transportation coordinator. The system will begin when a patient first schedules an appointment. The receptionist will ask if they have a Smartphone. If yes, the receptionist will ask if they would prefer to get text message and use an app or to receive a phone call. If no, it will automatically be a phone call. A few days before the appointment there will be a confirmation text or call. With the text, the patient will confirm the appointment and answer if they need transportation help. If yes, it will direct them to a webpage or an app in which they can enter all of the relevant information such as appointment time, pickup location, insurance information, budget, number of passengers, etc. The app will put out all of the relevant transportation options including cost and duration of trip and the patient will select and schedule the method of their choice. If the patient does not have a smartphone or does not choose to use the app, a phone call will be made and a receptionist or transportation coordinator will enter the information into the system and book the transportation. Patients will also receive a push notification or automated phone call the morning of their appointment reminding them of their pickup time and method of transportation.

Consider the Setting: We believe that it would be beneficial to first show our rough idea of our prototype to experts and staff such as Michelle, Geoff, Receptionists and Care Coordinators. Given that this is a system that would be used by SJHS and their staff, the input from the people running the technology would be the most beneficial in helping us modify and tweak our prototype to best fit SJHS needs. We would also want to talk to someone in the IT department about systems integration. After the app is created, we would then test it on users.

Define What to Test: We would test the ability for the app to effectively schedule and book transportation services. We would also test to see if the SJHS staff is able to use the system and integrate it into their current system and daily work. In doing so, we will be able to discover the effectiveness of our overall prototype system. It is important for us to determine if this system could work with the SJHS administrative staff before going any further because if it cannot work with the administrators then it will not be able to work for the patients themselves.

Define Feedback Activities: Our first order of business is to get into contact with the stakeholders that we have already interviewed. Feedback from stakeholders such as Geoff would be extremely useful because these people have already worked to solve the current transportation problems. Furthermore, talking with Michelle is crucial because she will be able to tell us whether or not our prototype would work on a large scale with the many offices of the SJHS. Lastly, we must meet with more receptionists and volunteers because they will be the ones who would actually be using our service in their day-to-day work. In talking with all of these stakeholders, we will be able to make changes to our idea, and ultimately come up with the best possible solution to the transportation problems at hand.

 

Idea 2: Uber Partnership 

Summary of Idea:

Idea 2 involves St. Joseph Health System developing a partnership with Uber.  While prices associated with Uber may be a concern, the flexibility and readiness that Uber provides will have enough of a positive impact that SJHS will overcome its current transportation problem.  Some barriers to developing such a partnership include billing; while Medicaid patients are covered for transportation in most situations, the amount organizations are reimbursed varies between states.  Another issue is the fact that SJHS patients and clients may not have the ability to readily access technology such as smartphones used to request Uber rides.  The benefits that having clients use Uber affords healthcare organizations outweighs these barriers, and there are even ways to overcome these barriers.  At the following URL, https://tinyurl.com/n4rthzp, a healthcare expert discusses the various ways organizations have undertaken partnerships with Uber and Lyft to overcome problems with transportation.  There is an opportunity for SJHS to give patients access to requesting Ubers on their website or through phone calls with receptionists.  Our team will conduct further research into the intricacies of billing regulations and any other liabilities or other issues associated with SJHS partnering with a transportation company such as Uber.

Consider the Setting: We are not innovating a product necessarily, but rather creating a new relationship between SJHS and Uber.  SJHS employees will have a general awareness of Uber’s technology, yet we could certainly role play as SJHS clients looking for a ride and reveal how efficient Uber is.  We feel it would be beneficial to pitch our idea to SJHS at one of their facilities.  With access to multiple departments, we could discuss the complexities of billing with SJHS employees who would be involved.  We could also have a few SJHS volunteers join the meeting, so they could gain a better understanding of what it would look like assisting people arriving at the hospital in Ubers.

Define What to Test : We need to test our idea in two ways.  First, we need to assess the likelihood of SJHS patients using Uber after a partnership had been developed.  Through our research we are confident that clients would use Uber.  Secondly, we need to test how SJHS employees adjust to a partnership with Uber.  Employees in charge of billing with Medicaid and Medicare patients will take on a slightly different role since adjustments would need to be made when billing for patients who used Uber.

Define Feedback Activities: We will assess feedback from patients’ point of view and SJHS employees’ perspective.  We will plan to visit different SJHS facilities and ask patients whether they used Uber.  If they answer yes, we will ask how they felt about the experience.  We will also develop a survey to be passed out to patients, possibly in the Emergency Room or in the lobbies of different facilities.  Finally, we will conduct several meetings with SJHS employees throughout the next few months after establishing a partnership with Uber. This will allow us to assess the functionality of the new partnership from SJHS’s perspective.

Idea 3: SHJS Shuttle Service 

Summary of Idea: Idea 3 involves SJHS purchasing at least two vans to provide patients complimentary rides to and from their appointment in specific drop-off/ pick-up zones. To request a ride, patients would either call or visit the hospital website. Patients would be required to give their name, location, and number of people they are riding with. Shuttles would go to designated drop-off/pick-up locations based on the database of SJHS’s clients in the Mishawaka area. Approved volunteers could drive the shuttles and be in constant communication with a dispatcher for every drop-off and pick-up.

 

Consider the Setting: This idea would best be shared in a meeting with team members, Michelle, Geoff and SJHS staff present. It would be best to go over logistics and the big picture plan with Geoff and Michelle who can add valuable input with their expertise and experience. Once the idea is approved by SJHS, we would meet with the IT department to go over updating their website so that users can request rides online.

 

Define What to Test: Would clients use shuttle service? What kinds of clients would use it? How do we make the service convenient to patients and resource efficient to the organization? How do we approve volunteer drivers? Where will the startup money come from? Does SJHS have a flexible budget that will enable this program to work?

 

Define Feedback Activities:

We would start out by administering a survey to see how many patients are interested in utilizing this service. In doing so, we will be able to identify whether or not our idea is feasible in the first place. From a financial aspect, we will need to meet with SJHS administrators that deal specifically with managing system budgets. This will allow us to determine if our idea is financially doable and if there is any room in the budget to fund the start of the program.

 

 

Guiding Design Principles
Design Goal	A solution must be sustainable from a financial and social perspective People who face transportation problems cannot be defined as one specific demographic All users must be treated uniquely because there are many reasons why someone may lack access to transportation A solution must be flexible in order to cater to the needs of each specific user Functionally, solution must be able to deliver patient from point A to point B and back in an efficient and timely manner
User Perceptions	A solution to the transportation challenges of low income patients is very significant to their well being Patients often miss appointments due to lack of transportation and a solution would highly increase their health, the population health and well being The user wants the service to be cost effective as well as time efficient The service needs to be flexible in order to accommodate patients with children, work schedules as well as the need to stop other places to pick up prescriptions etc. There are no aesthetic aspects involves, but the vehicles should have minimal labeling as patients might not want to advertise to neighbors and others that they have transportation issues.
Problems, Needs, Opportunities	Problem- With such a large and diverse client population, SJHS struggles to provide transportation effectively to each of their clients Problem- It is difficult to provide a standardized transportation service that accommodates each patient’s unique needs Need- It appears SJHS will need to initiate a partnership with another organization to provide transportation Opportunity- utilize another organization’s vehicles for efficiency and to lower the burden on SJHS Opportunity- develop a partnership with a private company that provides personalized transportation for some type of compensation
Functional Attributes	A flexible service that can accommodate all kinds of patients and has transportation hours that work with different patient’s life schedules Standardize high quality of transportation service Transportation service needs to be  able to help those patients who are immobile and perhaps in need of slight medical service just to leave his/her residency Transportation schedule must have times for patients who have work hours Understand that most of the target patients are elderly which means that there may need to be taught how to use certain technology if the transportation service uses an application or phone call system
Constraints	This project will be confined to only St. Joseph Health System patients and services.   It will be confined to low income patients and patients with transportation issues. There are funding and staffing limitations as SJHS does not currently have a budget for transportation or receive federal funding. SJHS does not currently have any transportation capital such as vans or cars to use. There are legal limitations and liability issues as it pertains to using volunteers and assisting patients. This project must be able to handle a large capacity of patients with variable volume.

Guiding Principle 1:  Make Transportation Resources Known to Me and Easy to Understand  

Insights:

Improve Marketing	Improve Simplicity	Make Resources known to SJHS Staff and Patients	Make Resources Bilingual
“There is not enough marketing for the resources available and when people find they have a problem they often don’t know where to look for a solution” Obi Madukoma, Care Coordinator Population Health On Lack of Technology to research resources :“Most of my clients do not even have cell phones and if they do they are flip phones” – Kaley Kubiac, Transportation Coordinator Riverbend.	Due to Medicaid restrictions, A lot of the burden to schedule transportation sits on the patient who might be unable to do so or not know how to do it. Obi Madukoma, Care Coordinator Population Health	“ People and staff in house don’t know about the resources. There is a communication gap” Obi Madukoma, Care Coordinator Population Health,	“Some inefficiencies arise when there is a language barrier between the patients and the center’s workers.” Erik,  Volunteer Receptionist at the Sister Maura Brannick Health Center

Guiding Principle 2 : Make Transportation Services Flexible 

Insights:

Make it flexible as appointments often run behind schedule	Make it flexible in case I have to bring children with me	Make it flexible in case I have to pick up medication or other necessities on the way home	Have late night and weekend hours
“Scheduling one single ride might take 7 separate phone calls and conversations” Kaley Kubiak, Riverbend Transportation Services	“I usually walk, which is more difficult carrying 3 kids and I’m 9-months pregnant.” Kate, client at Mishawaka Medical Center “All my kids go to different schools…every day is different.” Laura, client at SJHS Mishawaka Medical Center’s Pediatrics	“While REAL Services does transport patients, our transportation services operate within a very specific time frame which leaves some patients without transportation help.” Julie, Director of Client Services at REAL Services, Inc	In a phone interview with Michelle Peters, Director of Community Health and Wellbeing for St Joseph’s Health Systems, she mentioned that South Bend transpo lacks in weekend and late night routes.  The current routes also do not go to all of the SJHS facilities.

 

Guiding Principle 3 : Make it time efficient and Cost Efficient 

 

Make it cost efficient for Patient	Make it cost efficient for Organization	Make it as time efficient as possible
“Uber requires a credit card. I don’t have a credit card” -Kate, client at Mishawaka Medical Center “I think we spend around $550-600 on transportation a month” -Laura, client at SJHS Mishawaka Medical Center’s Pediatrics	“Patient no-shows can be very costly..up to $300” –Geoff Zimpelman, Population Health “Volunteers could do more to assist transportation” -Rob, SJHS Volunteer	“I’ve been waiting one hour for the Medicaid shuttle” -Kate, client at Mishawaka Medical Center “1.5 hour bus ride is usually around a 20 minute drive” -Geoff Zimpelman, Population Health

 

Guiding Principle 4 : Create continuity for patient transportation within all medical offices and facilities 

Insights:

Improve communication between all offices	Find one company, like uber, that will be certified by medicaid throughout all regions	Lessen criteria to increase amount of people who can utilize services
“Nothing is centralized. Each clinic and office does different things and they don’t work together on things such as transportation” –Obi Madukoma, Care Coordinator Population Health	“Medicaid will cover transportation costs for its patients, but this can get complicated because only certain cab companies are certified to pick up patients. Depending on where you live, there may not be a viable cab company to use.” -Ranae, Receptionist at Family Medical Office	“Various organizations will provide transportation for patients, but each organization will only deal with people who meet specific criteria.” -Geoff Zimpelman, Population Health

 

Guiding Principle 5 : Solution needs to work on a large scale and handle large influx of volume

Insights:

Use Resources Efficiently	Standardize Method of Transportation	Frequent and Flexible
“With many different services currently being offered, it is important for SJHS to make sure that certain resources are not being unnecessarily duplicated.”   Geoff Zimpelman, Population Health	“A transportation service that provides ‘door-to-door’ transportation would work best to accommodate all kinds of patients with varying levels of functionality.” Julie, Director of Client Services at REAL Services, Inc	“Transportation must be able to accommodate different patient’s schedules and availability for doctor appointments.” – Erik,  Volunteer Receptionist at the Sister Maura Brannick Health Center