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Introducing Uber Health, Removing Transportation as a Barrier to Care

301 points by coloneltcb 9y ago

mcast 9y ago
I wonder if there will be a way to pair a driver with a patient who only speaks Spanish. Health care transportation is a huge market for elderly in Miami, especially since retirement homes are taboo in many hispanic cultures.
- jamesmishra 9y ago
  (Disclosure: I am a former Uber employee.) A handful of cities already have UberESPAÑOL. I'm not certain, but I imagine that the healthcare provider's dashboard should be able to request the product if it is available at the pickup location. https://www.uber.com/drive/san-diego/resources/san-diego-uber-espanol/ https://www.uber.com/drive/san-diego/resources/san-diego-ube...
nathan_long 9y ago
> To ensure Uber Health meets HIPAA standards, we have been working hard to develop, implement, and customize numerous safeguards. The stories I've seen about employees tracking individual riders lead me to view this skeptically.
- samstave 9y ago
  Any links to these stories, I’d like to read some. I’m sure there are people at Uber who are fascinated by seeing where celebs take ubers... and can’t blame them.
  - cryptoz 9y ago
    Really? You can't blame them? For wanting to and then actually executing illegal methods of spying on someone's private life? I absolutely blame them. That's abhorrent behavior. Here are some juicy stories for you to read if you want to know the details of all the kinds of stupidity and evil it takes to invade someone's privacy like that. https://www.revealnews.org/article/uber-said-it-protects-you-from-spying-security-sources-say-otherwise/ https://www.revealnews.org/article/uber-said-it-protects-you...
    - samstave 9y ago
      I didnt say it was OK - im saying "i cant blame them"=="I understand humans, and this is not a surprising outcome from having access to that data in a company known for sexual mis-conduct, crazy ceo egoist stories and illegally accessing an employees medical records, etc etc etc" So blame was the wrong word...
- lhorie 9y ago
  HIPAA violations can cost a lot of money (up to $50,000 per record, depending on the severity level). A single incident can cost a few million dollars in fines, so there's a _very_ strong incentive to do things the right way.
- cryptoz 9y ago
  Uber executives have specifically stolen health records from a patient in order to attempt to create a media frenzy about how an Uber passenger who was raped by a driver was actually liar and a cheater. Uber executives went on a long-haul journey to insanely attempt to ruin the life of one of their customers, who had already been raped by one of their drivers, by stealing her medical documents and ridiculing her in public. No thanks Uber. There is absolutely no way I would use this service. Edit: It should also be remembered that Uber hired this driver, the rapist, as a known rapist (a recorded criminal history of being convicted for rape). Uber hired him without caring about his background or past criminal behaviour. Uber hired him with the knowledge that he could well be a rapist, since they declined to do a simple background check, presumably because it would "take too long" and they consider the occasional rape just a part of doing business. The evil behaviour and willful disregard for the safety of their normal Uber passengers - before trying to ruin their lives with deception, theft and lies - makes it 100% impossible to trust them about anything ever again, especially personal health. #DeleteUber.
  - EggsOnToast 9y ago
    I'd like to agree with your position but in the current environment I can't. Uber is a shitty company, I can get on that bandwagon and ride it to the other end of the continent. But in my country, America, this sort of service is immensely valuable to the elderly community and yet there is a dire shortage of acceptably priced choices to provide for those peoples' needs. If Uber's service is priced better than the entrenched players then I'll sign that pact with blood.
    - loceng 9y ago
      Allowing bad behaviour in order to get something cheaper is IMHO the wrong way to do things. If you want to look at why everything is so expensive, look at capitalism and all of the for-profit layers people add to cost structures - extracting value from society and adding a constant negative pressure to the quality of everyone's lives; whether the amount of extracted is reasonable or not is what needs to be looked at in each case. A certain minimum of transportation should likely be a right.
- jtmcmc 9y ago
  I would bet they have put access restrictions on these because violating hippa can be a felony whereas in general there are 0 legal requirements to restrict access to internal data to a company generally.
  - matheusmoreira 9y ago
    So if a company stores medical history data it's only required by law to prevent the data from leaking to the public? It's okay if a system administrator employed by the company has read access to people's medical records?
    - arkades 9y ago
      No. Anyone internal to the company viewing medical data without an explicit need is in violation of hipaa. But I don’t think that’s what the poster was saying.
      - matheusmoreira 9y ago
        I see. I don't know the details of HIPAA but that seems reasonable. What kinds of needs justify use of the data?
        wallflower 9y ago
        One example. A friend of mine who works at a hospital told me about a colleague (a nurse) who looked up her own test results since she was anxious and could not wait using her login to the main system (for providers). She got flagged in the system and reprimanded. Every access is logged.
        northern_lights 9y ago
        it's worth noting for others that this was almost certainly a hospital policy violation, not a hipaa violation. There's nothing in hipaa that prevents a person from accessing their own record (though I have heard hospital administrators try to claim otherwise).
- asabjorn 9y ago
  Uber has strong internal data access controls at this point, and any user data access need a ticket and a justification before accessing.
  - cryptoz 9y ago
    After nearly a decade of lying, cheating, intentionally breaking the laws of various countries, spying on paying cusomters, spying on other people, aggressively attacking and spying on journalists, of attempting to discredit victims of rape by Uber drivers, harassing their competition using illegal tactics and lying about it, etc, I don't care if they have "strong internal data access controls". They should have had that Day 1, they should never have lied or cheated and they certainly should not ever expect anyone to trust them about anything ever again. First, I doubt that it's true that they have strong controls. I don't trust organizations that have such a long, clear and bragging history of lying. Second, that sounds like the Titanic being unsinkable. As if I'm going to trust Uber with personal health data - they are the first group I'd suspect to try to sell that data under the table, the first group I'd expect to abuse the power, and also the first group I'd expect to suffer internal leaks or external hacks. No way I would trust this given the very recent and abhorrent behaviour of the executives at the company. Edit: Also this, > and any user data access need a ticket and a justification before accessing is not secure. Sounds to me like any user can make a ticket and create any justification they like. This is like the NSA saying "any user of our PRISM system is logged and watched" - but what happens when millions of tickets are going through? Is each one actually being carefully inspected for abuse? If Uber executives are in charge of this decision then no way do I trust it.
    - asabjorn 9y ago
      It will definitely take time for Uber to earn trust back, and it is fair that you feel the way you do. Hopefully Uber will earn your and other people’s trust through us showing over time that we continue doing the right thing. My intention here is not to go into details, which would not be appropriate for me as an engineer that doesn’t work on those aspects. I am only saying we care a lot about this.
- sudouser 9y ago
  now their creepily stalking methods will allow them to know when someone famous or a loveint is sick
atonse 9y ago
It's still taking me a while to dissociate Uber with Travis Kalanick and his army of bros, even though they seem to be trying a lot of new initiatives. Anyone have a good article on Uber's attempts to de-bro itself?
- bhups 9y ago
  https://www.politico.com/story/2018/02/28/uber-were-moving-away-from-antagonistic-relationship-with-cities-430098 https://www.politico.com/story/2018/02/28/uber-were-moving-a...
- loceng 9y ago
  Uber support still has dark patterns within it - this organization is trying to win by optimizing at all costs. I don't trust them, and worse, based on passed verified behaviour of Uber's - I feel somewhat hesitant even speaking badly of Uber in case of retaliation. We need strong whistler-blower laws with substantial pre-defined payouts to disincentive this kind of behaviour in every organization and at every level.
  - ghostbrainalpha 9y ago
    Are any of the dark patterns you are thinking of public knowledge?
- lhorie 9y ago
  I wrote about some of the changes I've seen as a new employee coming in near the end of the shitstorm: https://news.ycombinator.com/item?id=16179104 https://news.ycombinator.com/item?id=16179104
  - atonse 9y ago
    Wow thank you. I just might resurrect my account with them.
    - nugi 9y ago
      Reeally? Thats all it took?
thisisit 9y ago
So I am confused - are they going to introduce a new fleet or is it asking their existing drivers to do this? If they are going to introduce a new fleet - how is it different from a normal ambulance service?
- FireBeyond 9y ago
  I saw no explicit mention of any healthcare training on this. I realize it's more "cabulance" than ambulance (BLS - basic life support, or ALS - advanced), but still... there's probably at least an implicit assumption that there's a modicum of first aid or other training with the drivers. A whole host of potential liability issues, Uber's favorite thing to avoid.
- jtmcmc 9y ago
  I think this is aimed not at ambulances but at like all those assisted care ridership services that exist. I assume they are going to need a large fleet of improved accessibility cars though (for wheel chairs, walkers, etc..)
- GavinMcG 9y ago
  Ambulances are necessary for a few reasons. The obvious ones are acute illness or trauma, where a life threat could develop emergently. Another significant segment of ambulance traffic is psychiatric, where direct monitoring is needed even if there's no likely medical intervention. And another segment is for bariatric or non-ambulatory people. But this service doesn't seem to be for people who need to be transported so much as for people who need transportation. That is, the target for this service isn't the person who has a medical issue that needs to be addressed in transport. It's for people who need a transport and whose destination happens to be medical in nature. That's why it seems to be marketed primarily to medical providers rather than patients, with the benefit of a reduction in missed appointments and an increase in efficiency. If there is a new fleet, then, it's likely that the vehicles would have none of the medical equipment that ambulances do. (Though maybe they'd have more leg room, or a stool to help people in, or other minor accessibility considerations.) I'd also expect that drivers would be specially trained in HIPAA, and probably in recognizing imminent life threats so that they could call 911 in case someone was trying to use them as an ambulance.
DanBC 9y ago
One thing they could do is coordinate with English NHS Trusts and the "Crisis Care Concordat" to talk about conveying people who are mentally ill, who need to go to hospital, but who don't need a fully stocked ambo. They'd have to make sure it was free at the point of delivery to the patient. They'd have to have good governance (so, actually doing background checks) and have better training for drivers. But a non-medical (more normal) conveyance to hospital is probably something many people want.
- gaius 9y ago
  Absolutely not, while Uber flaunts their noncompliance with TfL et al they should not receive a single penny of taxpayer’s money - and there’s the matter of them dodging employer’s NI thereby directly undercutting the NHS too.
  - DanBC 9y ago
    Wait til you find out how much Priory Group or Virgin already get for treating NHS patients.
    - gaius 9y ago
      Yes Branston is tax-dodging scum like the rest of them. If Fred The Shred got his knighthood revoked then so should he.
vinceguidry 9y ago
Non-emergency healthcare transportation is a pretty big market that can't be served well by taxi companies. You may not have noticed the ubiquitous branded vans which drive around large cities ferrying seniors around. They're operated by numerous small-to-medium companies. I'm sure there's a few large regional companies at it as well. Uber has probably already disrupted that industry in a large way. I'd be quaking in my boots right now if I made my living doing this.
callumprentice 9y ago
The other side of removing transportation as a barrier to care is have the doctors come to you. We've started using Heal (http://heal.com http://heal.com) recently when the whole family was sick with the flu and it was great. Doctor and assistant come to your home within a 2 hour window. Cost is same copay you incur at a doctor's office. We used it several times and doctors were great. Seems like a no-brainer to not force sick folk to travel and spread germs. Only downside really was that you don't usually see the same doctor twice although I believe you can request by name.
- homero 9y ago
  How do you deal with patients keeping the doctor there for an hour? Drives taking an hour in between? It's nice and I'd love it, but I can't see how it's feasible against an office where they can see 6 patients an hour. Great pricing however. Is it really $99 total? That's cheaper than driving and a copay.
  - callumprentice 9y ago
    In my experiences, they're in and out pretty quickly. I didn't feel rushed but certainly not the mellow chit-chat I've experienced in the past when I visit my regular doctor where I used to live. My cost is $20 per visit for the copay - I guess they bill the insurance company in the same way as if you'd gone into the practice.
  - dragonwriter 9y ago
    > Is it really $99 total? $99 is the cost with no insurance; with insurance they bill and you pay your normal copay. $99 is probably less than their average reimbursement. > That's cheaper than driving and a copay. If you have really high cost of driving, have poor insurance, or are comparing it to average urgent care copays instead of primary/specialist office visits (IIRC, copays for primary average around $25 and specialist around $40; $60-75 seems improbably high transport cost for most people to drive to a doctor, even with non-free parking), sure. But unless appointment availability is really high, it's going to be higher latency, on average, than urgent care, and in any case it seems necessarily to be less well equipped than most urgent care facilities (meaning you are more likely to need to go somewhere else and be seen after your visit when using it as an urgent care.)
thingschanged 9y ago
These healthcare companies make a huge amount of money billing insurance companies and medicare, so I imagine at some point its profitable for them to pay for the transport of the patient back and forth.
mountainofdeath 9y ago
Looks like they are trying to tap into the goliath pile of cash that is Medicare by offering better service with the same billing structure. Most of the companies in this space are either regular taxi companies or fly-by-night transportation "companies" because of how easy the money is.
juanmirocks 9y ago
I'm extremely excited and happy for any possible innovations that may save lives / improve our health, even if just a little.
JustAnotherPat 9y ago
I would imagine disabled and old people would use this the most (people who use Acess-A-Ride in nyc for example), but obviously this means vehicles would have to be accessible to them, and how can you guarantee that with Uber using shady contractors who have to maintain their own vehicles?
tgb 9y ago
Maybe I'm the only one who uses spacebar to mean "scroll down" (I find it very convenient), but I'm certain that no one uses it with the intent to open a giant search bar that obscures the article.
- kakarot 9y ago
  Space scrolls for me just fine.
  - tgb 9y ago
    Odd - I just Chrome, Firefox and Edge and all have pull up search boxes when I scroll with space.
- SilasX 9y ago
  I confirm what you're seeing on Firefox with Vimium -- very annoying. Site designs from 20 years ago are, sadly, more usable most of the time.
- steveadoo 9y ago
  If you click on the article spacebar starts scrolling again. Weird.
neuro_imager 9y ago
(Physician here) I am so pleased that competent technology companies (Google, Amazon and now Uber) are entering the healthcare space. I really heope this portends the demise of the overcharging, outdated garbage (such as EPIC) that passes for healthcare IT at most hospitals.
deleted 9y ago
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SkyPuncher 9y ago
It looks like Uber is looking to put the cost onto the provider. I think it could make sense for large health organizations, but I see it being an issue extending down to the chain. I'm curious what adoption among patients will actually look like. A provider in Philadelphia tried providing their patients with free rides and found that a free ride made absolutely no difference whether patients missed their appointment. https://www.reuters.com/article/us-health-ridesharing-missed-appointment/free-lyft-may-not-help-poor-people-keep-doctor-appointments-idUSKBN1FS2SF https://www.reuters.com/article/us-health-ridesharing-missed...
- troycarlson 9y ago
  I believe a missed appointment will cost the provider more than the cost of a ride. Also, I believe CMS reimburses for non-emergency medical transportation, which may include Uber Health. https://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaid-integrity-education/downloads/nemt-booklet.pdf https://www.cms.gov/medicare-medicaid-coordination/fraud-pre...
- omarforgotpwd 9y ago
  That makes a lot of sense. The medical providers just need the patient to show up to bill insurance. What does it matter to pay $10, or $20 if you’re bringing a patient in for a $700 service. Not only do you lose the $700 in revenue the utilization of your capital assets decreases (wasted time) which means your fixed costs (rent, debt, fixed payroll, medical equipment, etc) are spread across fewer appointments meaning your net margins are shrinking and you’re either becoming less profitable or raising your prices. Some people may think this is wasteful but I can see how there might be a positive ROI on offering Uber rides if it really makes a difference in getting patients to show up on time.
socialist_coder 9y ago
I can't even read this because of their stupid geo redirect. It redirects me to https://www.uber.com/de/newsroom/uber-health/ https://www.uber.com/de/newsroom/uber-health/ which gives a 404 error. God, I hate geo redirects. I wish you could set some "don't do geo based redirects" option in your browser that sites would then respect.
- autotune 9y ago
  Unfortunately this happens on the backend, for instance as a built-in feature of a CDN or DNS routing based on your IP, so the only real way around it is to use a VPN that'll let you switch countries and show a different IP address when browsing the web. It's not like a user agent string that can be modified or anything like that.
  - netsharc 9y ago
    https://developer.mozilla.org/en-US/docs/Web/HTTP/Headers/Accept-Language https://developer.mozilla.org/en-US/docs/Web/HTTP/Headers/Ac... . Browsers send them. But nah, let's be too clever and offer localized content based on IP! No localized content? Enjoy the 404!
- netsharc 9y ago
  Geo redirects... they make me furious! I remember reading in the Google Forum from an American who flew to Kuwait (War contractor?) and when they loaded up Google on their laptop, it's in Arabic. They were furious...
908087 9y ago
Among the companies I'd trust with anything related to my health or associated data, Uber ranks right next to Equifax.
- jackietreehorn 9y ago
  This is pretty much my sentiment. Uber is basically a company that has engaged in illegal, unethical, and reckless behavior over and over and over again. Not exactly the type of company I want involved in health care. On the plus side the inevitable HIPPA violations will (hopefully) carry some teeth and maybe force Uber to change finally.
dsr_ 9y ago
Every bit of Uber's history says that they are willing to bend rules and ignore ethics in favor of expanding their business. They aren't interested in protecting the public, their employee-contractors, or their employees. All of this is well-documented in stories discussed here on HN. Why would anyone trust them in any aspect of healthcare?
- deleted 9y ago
  [deleted]
yalogin 9y ago
How is this different from regular Uber? Will it be billed to my insurance? If so Uber has found a brilliant way to charge 10 and 20x rates for regular Uber rides. Sorry, I am very skeptical when it comes to healthcare offerings.
jamesmishra 9y ago
(Disclosure: I am a former Uber employee.) HEY! In 2016, I worked on the pilot program that was the predecessor of the product. It was just me and an intern finding ways to modify Uber's core dispatch and billing workflows to make workflows like this possible. The project started attracting interest in the company, and we handed it off to a newly-formed dedicated team for the project. They made it into a fully-fledged, HIPAA-compliant product with a great UX. I'm absolutely ecstatic that this launched. Although I probably can't answer any questions about the project, since they probably had to rewrite all of my prototype code.
- BillinghamJ 9y ago
  Looks like it has evolved from Uber Central right? Or is it based off something else?
dayjah 9y ago
What might not be super clear to most folks is that this is one of the last areas that medallion owners make bank. Typically, in many US cities local taxi operators have deals with the govt to ferry the elderly around. So this in effect is uber putting the final nail into the taxi company coffin. I've spoken to taxi drivers which have resisted switching to the gig economy because they made enough from this government tie up to not have to move; I guess that all changes from here on out.
ProAm 9y ago
I would never trust Uber with anything sensitive, health related or remotely private after their history of stealing medical records to attempt to cover one of their drives rape. [1] [1] https://www.recode.net/2017/6/7/15754316/uber-executive-india-assault-rape-medical-records https://www.recode.net/2017/6/7/15754316/uber-executive-indi...
cheath 9y ago
As someone who struggles to get my Grandmother to doctors appointments and, as a result, she has high cancelation rates - I think this has the opportunity to be an incredibly valuable two-sided market. - Doctors are incentivized to have fewer cancelations and help get their patients to and from appointments. - People get to the doctor more often and have better care. Uber is easy to hate on, but this seems like a societal net-positive. Good for them.
olivermarks 9y ago
Meanwhile, 'Passengers Who Call Uber Instead Of An Ambulance Put Drivers At Risk Sick people are increasingly using ride-hail to get to the emergency room, putting drivers in an uncomfortable position and a potentially tricky legal bind' https://www.buzzfeed.com/carolineodonovan/taking-uber-lyft-emergency-room-legal-liabilities?utm_term=.raexWaeKn#.dcMKLXvEq https://www.buzzfeed.com/carolineodonovan/taking-uber-lyft-e...
- BoorishBears 9y ago
  I was in a digital health hackathon a few weeks ago and one of the ideas pitched was Uber for hospital visits. One of my first thoughts, and one of the risks people couldn’t get over, was if a person isn’t so sick they don’t need an ambulance, why doesn’t a normal Uber work? The natural assumption is people who have no business getting in a car with someone else would be the ones to use it the most.
wk2jkhkjdfglsl 9y ago
Its a really nice idea, but will the cost not be passed on to the consumer in the form of inflated health insurance premiums? The health industry already stupidly too expensive in the US. Is having Uber suckling on the heath insurance teat a good thing?
- nugi 9y ago
  You are light grey, but this is a huge point. Insurance preimums are almost untennable right now. This will slowly raise them for everyone.
robk 9y ago
This just doesn't scale. Babylon Health here in London is using machine learning to do more of the triage in app. That's the only way to narrow the pipeline early with any form of scale.
foobarbazetc 9y ago
This already exists. It’s called paratransit. E.g.: http://www.sfparatransit.com/ http://www.sfparatransit.com/ Trained people who can handle mobility and disability needs. It’s unclear where the gulf is between people who just book an Uber to go to the doctor (which seems to be all this is, just arranged by the provider themselves instead) and services that have trained professionals transporting people.
Brajeshwar 9y ago
This is interesting. About 2 years ago, I emailed or perhaps filled up their contact form that it would be a good idea to do this for India. India road/traffic condition is so bad and there is no formal/official importance given to Ambulances. If Uber taxis can serve as on-demand ambulances-esque services when needed, it will likely save a lot of lives.
Dowwie 9y ago
Those with acute renal failure (kidneys) largely need to go to and from a dialysis center a couple of times a week. Dialysis is an exhausting, lengthy process. Once the treatment is finished, a patient really is not fit to drive yet many do for the sake of cost. Driving after dialysis is like DWI. It isn't safe for anyone on the road. If Uber Health can provide affordable transportation services for dialysis patients, it is providing a life changing service that is sorely needed. This is a great idea and I hope that the service succeeds.
deleted 9y ago
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brokenmachine 9y ago
Who needs ambulances when we have Uber!!

301 points by coloneltcb 9y ago

I wonder if there will be a way to pair a driver with a patient who only speaks Spanish. Health care transportation is a huge market for elderly in Miami, especially since retirement homes are taboo in many hispanic cultures.

jamesmishra 9y ago
(Disclosure: I am a former Uber employee.) A handful of cities already have UberESPAÑOL. I'm not certain, but I imagine that the healthcare provider's dashboard should be able to request the product if it is available at the pickup location. https://www.uber.com/drive/san-diego/resources/san-diego-uber-espanol/ https://www.uber.com/drive/san-diego/resources/san-diego-ube...

nathan_long 9y ago

> To ensure Uber Health meets HIPAA standards, we have been working hard to develop, implement, and customize numerous safeguards. The stories I've seen about employees tracking individual riders lead me to view this skeptically.

samstave 9y ago
Any links to these stories, I’d like to read some. I’m sure there are people at Uber who are fascinated by seeing where celebs take ubers... and can’t blame them.
- cryptoz 9y ago
  Really? You can't blame them? For wanting to and then actually executing illegal methods of spying on someone's private life? I absolutely blame them. That's abhorrent behavior. Here are some juicy stories for you to read if you want to know the details of all the kinds of stupidity and evil it takes to invade someone's privacy like that. https://www.revealnews.org/article/uber-said-it-protects-you-from-spying-security-sources-say-otherwise/ https://www.revealnews.org/article/uber-said-it-protects-you...
  - samstave 9y ago
    I didnt say it was OK - im saying "i cant blame them"=="I understand humans, and this is not a surprising outcome from having access to that data in a company known for sexual mis-conduct, crazy ceo egoist stories and illegally accessing an employees medical records, etc etc etc" So blame was the wrong word...
lhorie 9y ago
HIPAA violations can cost a lot of money (up to $50,000 per record, depending on the severity level). A single incident can cost a few million dollars in fines, so there's a _very_ strong incentive to do things the right way.
cryptoz 9y ago
Uber executives have specifically stolen health records from a patient in order to attempt to create a media frenzy about how an Uber passenger who was raped by a driver was actually liar and a cheater. Uber executives went on a long-haul journey to insanely attempt to ruin the life of one of their customers, who had already been raped by one of their drivers, by stealing her medical documents and ridiculing her in public. No thanks Uber. There is absolutely no way I would use this service. Edit: It should also be remembered that Uber hired this driver, the rapist, as a known rapist (a recorded criminal history of being convicted for rape). Uber hired him without caring about his background or past criminal behaviour. Uber hired him with the knowledge that he could well be a rapist, since they declined to do a simple background check, presumably because it would "take too long" and they consider the occasional rape just a part of doing business. The evil behaviour and willful disregard for the safety of their normal Uber passengers - before trying to ruin their lives with deception, theft and lies - makes it 100% impossible to trust them about anything ever again, especially personal health. #DeleteUber.
- EggsOnToast 9y ago
  I'd like to agree with your position but in the current environment I can't. Uber is a shitty company, I can get on that bandwagon and ride it to the other end of the continent. But in my country, America, this sort of service is immensely valuable to the elderly community and yet there is a dire shortage of acceptably priced choices to provide for those peoples' needs. If Uber's service is priced better than the entrenched players then I'll sign that pact with blood.
  - loceng 9y ago
    Allowing bad behaviour in order to get something cheaper is IMHO the wrong way to do things. If you want to look at why everything is so expensive, look at capitalism and all of the for-profit layers people add to cost structures - extracting value from society and adding a constant negative pressure to the quality of everyone's lives; whether the amount of extracted is reasonable or not is what needs to be looked at in each case. A certain minimum of transportation should likely be a right.
jtmcmc 9y ago
I would bet they have put access restrictions on these because violating hippa can be a felony whereas in general there are 0 legal requirements to restrict access to internal data to a company generally.
- matheusmoreira 9y ago
  So if a company stores medical history data it's only required by law to prevent the data from leaking to the public? It's okay if a system administrator employed by the company has read access to people's medical records?
  - arkades 9y ago
    No. Anyone internal to the company viewing medical data without an explicit need is in violation of hipaa. But I don’t think that’s what the poster was saying.
    - matheusmoreira 9y ago
      I see. I don't know the details of HIPAA but that seems reasonable. What kinds of needs justify use of the data?
      - wallflower 9y ago
        One example. A friend of mine who works at a hospital told me about a colleague (a nurse) who looked up her own test results since she was anxious and could not wait using her login to the main system (for providers). She got flagged in the system and reprimanded. Every access is logged.
        northern_lights 9y ago
        it's worth noting for others that this was almost certainly a hospital policy violation, not a hipaa violation. There's nothing in hipaa that prevents a person from accessing their own record (though I have heard hospital administrators try to claim otherwise).
asabjorn 9y ago
Uber has strong internal data access controls at this point, and any user data access need a ticket and a justification before accessing.
- cryptoz 9y ago
  After nearly a decade of lying, cheating, intentionally breaking the laws of various countries, spying on paying cusomters, spying on other people, aggressively attacking and spying on journalists, of attempting to discredit victims of rape by Uber drivers, harassing their competition using illegal tactics and lying about it, etc, I don't care if they have "strong internal data access controls". They should have had that Day 1, they should never have lied or cheated and they certainly should not ever expect anyone to trust them about anything ever again. First, I doubt that it's true that they have strong controls. I don't trust organizations that have such a long, clear and bragging history of lying. Second, that sounds like the Titanic being unsinkable. As if I'm going to trust Uber with personal health data - they are the first group I'd suspect to try to sell that data under the table, the first group I'd expect to abuse the power, and also the first group I'd expect to suffer internal leaks or external hacks. No way I would trust this given the very recent and abhorrent behaviour of the executives at the company. Edit: Also this, > and any user data access need a ticket and a justification before accessing is not secure. Sounds to me like any user can make a ticket and create any justification they like. This is like the NSA saying "any user of our PRISM system is logged and watched" - but what happens when millions of tickets are going through? Is each one actually being carefully inspected for abuse? If Uber executives are in charge of this decision then no way do I trust it.
  - asabjorn 9y ago
    It will definitely take time for Uber to earn trust back, and it is fair that you feel the way you do. Hopefully Uber will earn your and other people’s trust through us showing over time that we continue doing the right thing. My intention here is not to go into details, which would not be appropriate for me as an engineer that doesn’t work on those aspects. I am only saying we care a lot about this.
sudouser 9y ago
now their creepily stalking methods will allow them to know when someone famous or a loveint is sick

atonse 9y ago

It's still taking me a while to dissociate Uber with Travis Kalanick and his army of bros, even though they seem to be trying a lot of new initiatives. Anyone have a good article on Uber's attempts to de-bro itself?

bhups 9y ago
https://www.politico.com/story/2018/02/28/uber-were-moving-away-from-antagonistic-relationship-with-cities-430098 https://www.politico.com/story/2018/02/28/uber-were-moving-a...
loceng 9y ago
Uber support still has dark patterns within it - this organization is trying to win by optimizing at all costs. I don't trust them, and worse, based on passed verified behaviour of Uber's - I feel somewhat hesitant even speaking badly of Uber in case of retaliation. We need strong whistler-blower laws with substantial pre-defined payouts to disincentive this kind of behaviour in every organization and at every level.
- ghostbrainalpha 9y ago
  Are any of the dark patterns you are thinking of public knowledge?
lhorie 9y ago
I wrote about some of the changes I've seen as a new employee coming in near the end of the shitstorm: https://news.ycombinator.com/item?id=16179104 https://news.ycombinator.com/item?id=16179104
- atonse 9y ago
  Wow thank you. I just might resurrect my account with them.
  - nugi 9y ago
    Reeally? Thats all it took?

thisisit 9y ago

So I am confused - are they going to introduce a new fleet or is it asking their existing drivers to do this? If they are going to introduce a new fleet - how is it different from a normal ambulance service?

FireBeyond 9y ago
I saw no explicit mention of any healthcare training on this. I realize it's more "cabulance" than ambulance (BLS - basic life support, or ALS - advanced), but still... there's probably at least an implicit assumption that there's a modicum of first aid or other training with the drivers. A whole host of potential liability issues, Uber's favorite thing to avoid.
jtmcmc 9y ago
I think this is aimed not at ambulances but at like all those assisted care ridership services that exist. I assume they are going to need a large fleet of improved accessibility cars though (for wheel chairs, walkers, etc..)
GavinMcG 9y ago
Ambulances are necessary for a few reasons. The obvious ones are acute illness or trauma, where a life threat could develop emergently. Another significant segment of ambulance traffic is psychiatric, where direct monitoring is needed even if there's no likely medical intervention. And another segment is for bariatric or non-ambulatory people. But this service doesn't seem to be for people who need to be transported so much as for people who need transportation. That is, the target for this service isn't the person who has a medical issue that needs to be addressed in transport. It's for people who need a transport and whose destination happens to be medical in nature. That's why it seems to be marketed primarily to medical providers rather than patients, with the benefit of a reduction in missed appointments and an increase in efficiency. If there is a new fleet, then, it's likely that the vehicles would have none of the medical equipment that ambulances do. (Though maybe they'd have more leg room, or a stool to help people in, or other minor accessibility considerations.) I'd also expect that drivers would be specially trained in HIPAA, and probably in recognizing imminent life threats so that they could call 911 in case someone was trying to use them as an ambulance.

DanBC 9y ago

One thing they could do is coordinate with English NHS Trusts and the "Crisis Care Concordat" to talk about conveying people who are mentally ill, who need to go to hospital, but who don't need a fully stocked ambo. They'd have to make sure it was free at the point of delivery to the patient. They'd have to have good governance (so, actually doing background checks) and have better training for drivers. But a non-medical (more normal) conveyance to hospital is probably something many people want.

gaius 9y ago
Absolutely not, while Uber flaunts their noncompliance with TfL et al they should not receive a single penny of taxpayer’s money - and there’s the matter of them dodging employer’s NI thereby directly undercutting the NHS too.
- DanBC 9y ago
  Wait til you find out how much Priory Group or Virgin already get for treating NHS patients.
  - gaius 9y ago
    Yes Branston is tax-dodging scum like the rest of them. If Fred The Shred got his knighthood revoked then so should he.

vinceguidry 9y ago

Non-emergency healthcare transportation is a pretty big market that can't be served well by taxi companies. You may not have noticed the ubiquitous branded vans which drive around large cities ferrying seniors around. They're operated by numerous small-to-medium companies. I'm sure there's a few large regional companies at it as well. Uber has probably already disrupted that industry in a large way. I'd be quaking in my boots right now if I made my living doing this.

callumprentice 9y ago

The other side of removing transportation as a barrier to care is have the doctors come to you. We've started using Heal (http://heal.com http://heal.com) recently when the whole family was sick with the flu and it was great. Doctor and assistant come to your home within a 2 hour window. Cost is same copay you incur at a doctor's office. We used it several times and doctors were great. Seems like a no-brainer to not force sick folk to travel and spread germs. Only downside really was that you don't usually see the same doctor twice although I believe you can request by name.

homero 9y ago
How do you deal with patients keeping the doctor there for an hour? Drives taking an hour in between? It's nice and I'd love it, but I can't see how it's feasible against an office where they can see 6 patients an hour. Great pricing however. Is it really $99 total? That's cheaper than driving and a copay.
- callumprentice 9y ago
  In my experiences, they're in and out pretty quickly. I didn't feel rushed but certainly not the mellow chit-chat I've experienced in the past when I visit my regular doctor where I used to live. My cost is $20 per visit for the copay - I guess they bill the insurance company in the same way as if you'd gone into the practice.
- dragonwriter 9y ago
  > Is it really $99 total? $99 is the cost with no insurance; with insurance they bill and you pay your normal copay. $99 is probably less than their average reimbursement. > That's cheaper than driving and a copay. If you have really high cost of driving, have poor insurance, or are comparing it to average urgent care copays instead of primary/specialist office visits (IIRC, copays for primary average around $25 and specialist around $40; $60-75 seems improbably high transport cost for most people to drive to a doctor, even with non-free parking), sure. But unless appointment availability is really high, it's going to be higher latency, on average, than urgent care, and in any case it seems necessarily to be less well equipped than most urgent care facilities (meaning you are more likely to need to go somewhere else and be seen after your visit when using it as an urgent care.)

thingschanged 9y ago

These healthcare companies make a huge amount of money billing insurance companies and medicare, so I imagine at some point its profitable for them to pay for the transport of the patient back and forth.

mountainofdeath 9y ago

Looks like they are trying to tap into the goliath pile of cash that is Medicare by offering better service with the same billing structure. Most of the companies in this space are either regular taxi companies or fly-by-night transportation "companies" because of how easy the money is.

juanmirocks 9y ago

I'm extremely excited and happy for any possible innovations that may save lives / improve our health, even if just a little.

JustAnotherPat 9y ago

I would imagine disabled and old people would use this the most (people who use Acess-A-Ride in nyc for example), but obviously this means vehicles would have to be accessible to them, and how can you guarantee that with Uber using shady contractors who have to maintain their own vehicles?

tgb 9y ago

Maybe I'm the only one who uses spacebar to mean "scroll down" (I find it very convenient), but I'm certain that no one uses it with the intent to open a giant search bar that obscures the article.

kakarot 9y ago
Space scrolls for me just fine.
- tgb 9y ago
  Odd - I just Chrome, Firefox and Edge and all have pull up search boxes when I scroll with space.
SilasX 9y ago
I confirm what you're seeing on Firefox with Vimium -- very annoying. Site designs from 20 years ago are, sadly, more usable most of the time.
steveadoo 9y ago
If you click on the article spacebar starts scrolling again. Weird.

neuro_imager 9y ago

(Physician here) I am so pleased that competent technology companies (Google, Amazon and now Uber) are entering the healthcare space. I really heope this portends the demise of the overcharging, outdated garbage (such as EPIC) that passes for healthcare IT at most hospitals.

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SkyPuncher 9y ago

It looks like Uber is looking to put the cost onto the provider. I think it could make sense for large health organizations, but I see it being an issue extending down to the chain. I'm curious what adoption among patients will actually look like. A provider in Philadelphia tried providing their patients with free rides and found that a free ride made absolutely no difference whether patients missed their appointment. https://www.reuters.com/article/us-health-ridesharing-missed-appointment/free-lyft-may-not-help-poor-people-keep-doctor-appointments-idUSKBN1FS2SF https://www.reuters.com/article/us-health-ridesharing-missed...

troycarlson 9y ago
I believe a missed appointment will cost the provider more than the cost of a ride. Also, I believe CMS reimburses for non-emergency medical transportation, which may include Uber Health. https://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaid-integrity-education/downloads/nemt-booklet.pdf https://www.cms.gov/medicare-medicaid-coordination/fraud-pre...
omarforgotpwd 9y ago
That makes a lot of sense. The medical providers just need the patient to show up to bill insurance. What does it matter to pay $10, or $20 if you’re bringing a patient in for a $700 service. Not only do you lose the $700 in revenue the utilization of your capital assets decreases (wasted time) which means your fixed costs (rent, debt, fixed payroll, medical equipment, etc) are spread across fewer appointments meaning your net margins are shrinking and you’re either becoming less profitable or raising your prices. Some people may think this is wasteful but I can see how there might be a positive ROI on offering Uber rides if it really makes a difference in getting patients to show up on time.

socialist_coder 9y ago

I can't even read this because of their stupid geo redirect. It redirects me to https://www.uber.com/de/newsroom/uber-health/ https://www.uber.com/de/newsroom/uber-health/ which gives a 404 error. God, I hate geo redirects. I wish you could set some "don't do geo based redirects" option in your browser that sites would then respect.

autotune 9y ago
Unfortunately this happens on the backend, for instance as a built-in feature of a CDN or DNS routing based on your IP, so the only real way around it is to use a VPN that'll let you switch countries and show a different IP address when browsing the web. It's not like a user agent string that can be modified or anything like that.
- netsharc 9y ago
  https://developer.mozilla.org/en-US/docs/Web/HTTP/Headers/Accept-Language https://developer.mozilla.org/en-US/docs/Web/HTTP/Headers/Ac... . Browsers send them. But nah, let's be too clever and offer localized content based on IP! No localized content? Enjoy the 404!
netsharc 9y ago
Geo redirects... they make me furious! I remember reading in the Google Forum from an American who flew to Kuwait (War contractor?) and when they loaded up Google on their laptop, it's in Arabic. They were furious...

908087 9y ago

Among the companies I'd trust with anything related to my health or associated data, Uber ranks right next to Equifax.

jackietreehorn 9y ago
This is pretty much my sentiment. Uber is basically a company that has engaged in illegal, unethical, and reckless behavior over and over and over again. Not exactly the type of company I want involved in health care. On the plus side the inevitable HIPPA violations will (hopefully) carry some teeth and maybe force Uber to change finally.

dsr_ 9y ago

Every bit of Uber's history says that they are willing to bend rules and ignore ethics in favor of expanding their business. They aren't interested in protecting the public, their employee-contractors, or their employees. All of this is well-documented in stories discussed here on HN. Why would anyone trust them in any aspect of healthcare?

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yalogin 9y ago

How is this different from regular Uber? Will it be billed to my insurance? If so Uber has found a brilliant way to charge 10 and 20x rates for regular Uber rides. Sorry, I am very skeptical when it comes to healthcare offerings.

jamesmishra 9y ago

(Disclosure: I am a former Uber employee.) HEY! In 2016, I worked on the pilot program that was the predecessor of the product. It was just me and an intern finding ways to modify Uber's core dispatch and billing workflows to make workflows like this possible. The project started attracting interest in the company, and we handed it off to a newly-formed dedicated team for the project. They made it into a fully-fledged, HIPAA-compliant product with a great UX. I'm absolutely ecstatic that this launched. Although I probably can't answer any questions about the project, since they probably had to rewrite all of my prototype code.

BillinghamJ 9y ago
Looks like it has evolved from Uber Central right? Or is it based off something else?

dayjah 9y ago

What might not be super clear to most folks is that this is one of the last areas that medallion owners make bank. Typically, in many US cities local taxi operators have deals with the govt to ferry the elderly around. So this in effect is uber putting the final nail into the taxi company coffin. I've spoken to taxi drivers which have resisted switching to the gig economy because they made enough from this government tie up to not have to move; I guess that all changes from here on out.

ProAm 9y ago

I would never trust Uber with anything sensitive, health related or remotely private after their history of stealing medical records to attempt to cover one of their drives rape. [1] [1] https://www.recode.net/2017/6/7/15754316/uber-executive-india-assault-rape-medical-records https://www.recode.net/2017/6/7/15754316/uber-executive-indi...

cheath 9y ago

As someone who struggles to get my Grandmother to doctors appointments and, as a result, she has high cancelation rates - I think this has the opportunity to be an incredibly valuable two-sided market. - Doctors are incentivized to have fewer cancelations and help get their patients to and from appointments. - People get to the doctor more often and have better care. Uber is easy to hate on, but this seems like a societal net-positive. Good for them.

olivermarks 9y ago

Meanwhile, 'Passengers Who Call Uber Instead Of An Ambulance Put Drivers At Risk Sick people are increasingly using ride-hail to get to the emergency room, putting drivers in an uncomfortable position and a potentially tricky legal bind' https://www.buzzfeed.com/carolineodonovan/taking-uber-lyft-emergency-room-legal-liabilities?utm_term=.raexWaeKn#.dcMKLXvEq https://www.buzzfeed.com/carolineodonovan/taking-uber-lyft-e...

BoorishBears 9y ago
I was in a digital health hackathon a few weeks ago and one of the ideas pitched was Uber for hospital visits. One of my first thoughts, and one of the risks people couldn’t get over, was if a person isn’t so sick they don’t need an ambulance, why doesn’t a normal Uber work? The natural assumption is people who have no business getting in a car with someone else would be the ones to use it the most.

wk2jkhkjdfglsl 9y ago

Its a really nice idea, but will the cost not be passed on to the consumer in the form of inflated health insurance premiums? The health industry already stupidly too expensive in the US. Is having Uber suckling on the heath insurance teat a good thing?

nugi 9y ago
You are light grey, but this is a huge point. Insurance preimums are almost untennable right now. This will slowly raise them for everyone.

robk 9y ago

This just doesn't scale. Babylon Health here in London is using machine learning to do more of the triage in app. That's the only way to narrow the pipeline early with any form of scale.

foobarbazetc 9y ago

This already exists. It’s called paratransit. E.g.: http://www.sfparatransit.com/ http://www.sfparatransit.com/ Trained people who can handle mobility and disability needs. It’s unclear where the gulf is between people who just book an Uber to go to the doctor (which seems to be all this is, just arranged by the provider themselves instead) and services that have trained professionals transporting people.

Brajeshwar 9y ago

This is interesting. About 2 years ago, I emailed or perhaps filled up their contact form that it would be a good idea to do this for India. India road/traffic condition is so bad and there is no formal/official importance given to Ambulances. If Uber taxis can serve as on-demand ambulances-esque services when needed, it will likely save a lot of lives.

Dowwie 9y ago

Those with acute renal failure (kidneys) largely need to go to and from a dialysis center a couple of times a week. Dialysis is an exhausting, lengthy process. Once the treatment is finished, a patient really is not fit to drive yet many do for the sake of cost. Driving after dialysis is like DWI. It isn't safe for anyone on the road. If Uber Health can provide affordable transportation services for dialysis patients, it is providing a life changing service that is sorely needed. This is a great idea and I hope that the service succeeds.

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brokenmachine 9y ago

Who needs ambulances when we have Uber!!