Summary
Each year in the US 5.8 Million people miss or delay healthcare because they can’t access safe, reliable transportation. Onward’s technology enables a Door-through-Door Companion rideshare service for individuals with cognitive or mobility impairments. One innovative differentiator in the platform is our ability to consistently pair riders with their preferred Companion Drivers enabling Companion drivers to learn their riders’ unique needs while building trust and relationship.
Planning and Implementation
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What was the challenge you were trying to address?
Social determinants of health (SDoH) drive 80% of health outcomes and transportation is the third most prominent SDoH in the United States, impacting nearly all other social determinants. A lack of access to easy, reliable transportation causes over 5.8 Million Americans to miss their healthcare appointments each year. Forty percent of older and disabled adults rely on friends and family for rides with over 80% of caregivers listing coordinating transport as a primary duty (AARP). Transportation is the #1 type of caregiving support (NADTC). A large percentage of older adults require access to door-to-door or door-through-door transportation support including the 35% of individuals over 50 who have trouble getting up from a chair (Rand 2021).
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Who were you trying to impact?
Older people in general, Older people with chronic health conditions or disability, Older people with vulnerabilities
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What sectors were you targeting?
Health, Long-term care, Transportation
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Who else was involved?
Government, Health Care
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How did older people participate?
Older people were consulted during the planning process
Lessons learned
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Please describe how collaboration worked in your initiative.
We currently partner with the San Francisco VA, UCSF Health, Alameda Health System, and Onlok and CEI, two Program of All-Inclusive Care for the Elderly (PACE) programs in the Bay Area, and provide over 1,500 rides per month to dialysis, procedures, and surgeries. Their teams help to identify high risk populations who suffer from transportation insecurity to enroll for companion ride services.
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What was the impact of your initiative on older people, their families, and/or their communities?
Today by providing over 1500 rides per month for dialysis appointments, procedures, routine care, and also for grocery and medication pickups Onward helps people access care that otherwise could not. The additional level of support from Companion drivers helps Older Adults maintain both their health and their independence, enabling them to age in place. Because of the consistent rider-driver pairing enabled through the technology, we routinely hear things like, “I am only going to my dialysis appointment today because of my driver.” Based on Rider feedback via an in app 5-Star review, we receive 4.96 stars on average with over 97% 5 star reviews.
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What issues did you face, and how did you address them?
One of the greatest challenges is finding qualified drivers who align with our mission of serving Older Adults who are willing and able to undergo the necessary training to provide companion services, but when we find them, they are dedicated. They have shared with us their reasons for joining us from, “I didn’t like how people were treating seniors on the bus.” to “I used to drive my mother to her appointments, when she passed, I needed somewhere for my love to go.”
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What lessons did you learn from implementing this initiative?
Consistent Driver Pairing Drives Better Support - By consistently pairing Companion Drivers with the same rider or pool of riders, drivers are able to learn condition specific needs. For example, to be cautious with the fistula site when supporting riders going to dialysis appointments. Also drivers learn the level of physical assistance their riders require. Drivers Care can Extend Beyond Rides - As drivers are welcomed into the homes of their riders they are able to observe other needs that may impact the health and wellbeing of their riders. For example poor living conditions, signs of neglect, or other small needs that can be reported back to care management teams as part of a Integrated Care model.
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Do you have any other reflections you would like to share?
Onward’s ability to impact access to healthcare and social isolation through companion transportation supports and promotes the UN Decade of Health Ageing action areas of integrated care and age-friendly environments. Transportation is a core element of the Age Friendly Primary Care toolkit from the organization as well as the second element of the Social Connection’s Social Isolation and Loneliness Workgroup (SILWG) framework for addressing social isolation and loneliness for people, including but not limited to older adults.