PRP193: Utilization of Uber Health and a Patient Navigation Program to Promote Colonoscopy Screening Among High-Risk Patients

Lisa Ho; Zumana Miyfa, BS, MS2


Colonoscopy screening starting at age 50 is key for early detection and prevention of colorectal cancer (CRC). However, barriers to care, such as inadequate insurance, transportation, and healthcare literacy can deter a patient from completing a diagnostic colonoscopy. At the Hamilton Health Clinic in Harrisburg, Pennsylvania, many patients who are 100% below the poverty level are not scheduled for a colonoscopy despite receiving a positive fecal immunochemical test (FIT). This results in delayed and increased CRC diagnoses, leading to a rise in healthcare costs and morbidity. The purpose of this study was to pilot and evaluate a free ride-sharing service paired with medical student patient navigation for colonoscopy screening. The implementation of this workflow is hypothesized to improve “no show” rates, increase colonoscopy screening rate of Hamilton Health, and provide support for patients. Design: case series study. This study focused on population-based screening at a community clinic (Hamilton Health) and outpatient diagnostic colonoscopy at Penn State Health Hershey Medical Center. Patients with a positive FIT were scheduled for a diagnostic colonoscopy. When transportation needs were identified, medical student navigators organized transportation using Uber Health, contacted patients to ensure effective colonoscopy preparation, and escorted patients to and from their procedure. Preliminary results show patients completed appointments with satisfactory colonoscopy preparation and increased colonoscopy rates following a positive FIT. Average round-trip travel cost calculations will help plan future financial needs. Anticipatory outcomes include success of the program’s workflow. This student-organized program established the first clinically oriented ride-sharing program associated with Penn State Health. The novel approach of utilizing grants to fund Uber Health rides and establishing a student-run navigation program allows high-risk patients in Harrisburg to overcome barriers associated with colonoscopy screening. With this initiative, healthcare accessibility is improved to aid in earlier detection of CRC. Future aims seek to assess program feasibility and acceptability via post-procedure patient and navigator surveys. Furthermore, this model serves as a pilot study that has the potential to be replicated in other regions, institutions, and for other medical conditions.
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Tim Riley

This is an important pilot which should be grounds for investment in a larger scale trial to assess the impact and return on investment of this intervention. Excellent work!

Megan Mendez Miller 11/21/2020

Thank you, Tim - next stages past the pilot, as you alluded to, are currently in the works but complicated/slowed by COVID as engaging populations in cancer screening during our pandemic is a challenge (whether community-based as in this project or office-based with those who have less insurance/access barriers to healthcare).

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