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Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes, and business success, with today’s most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.
Saul Marquez: Welcome back to the podcast. Today I have Imran Cronk. He’s the CEO at Ride Health. Originally from North Carolina and now living in New York City. His goal is to maximize society’s health and well-being by working across delivery systems and public policy institutions. Health care is so central because it influences and is affected by every aspect of our lives and Imran is focused on how transportation barriers impede access to care. We’ve had a lot of episodes on the podcast about social determinants of health and things that we could do to improve them and also consider them as part of our understanding of bettering outcomes and playing within this realm of value based care. And Imran is here to share his thoughts on how he works with patients providers, insurers, and transportation companies to make that happen. He also has served on the board in the greater Philadelphia area for the American Cancer Society and participates as a New York City fellow with Kairos Society. So he’s got a good experience and breadth of experience and I’m looking forward to our conversation. Imran thanks for joining us today.
Imran Cronk: Thank you Saul, good to be here.
Imran Cronk: It’s a pleasure to have you on my friend. And hey by the way I appreciate you making it on. I know you had a hectic day today and I appreciate you going above and beyond to make it.
Imran Cronk: Well of course, don’t wanna miss it.
Saul Marquez: So what is it that got you into the medical sector to begin with?
Imran Cronk: So I was always interested in healthcare administration and policy because it felt like the kind of industry where the better you did the more lives you could save or at least improve. That always resonated with me and I got into transportation as an aspect of the healthcare industry not a five or six years ago when I was a volunteer in a hospital down in North Carolina and the patient was discharged and didn’t have a way to get home and he came up to me and explained the situation and I suggested that I go over and ask the nurses station if they had something for him. He went over there and he asked if they had a cab voucher or a bus pass and they told him they didn’t have anything for him that he’d have to figure something else out. So he was kind of wandering around a little bit in the waiting area. And so I went up and asked him what he planned to do and he said well I try to walk home. Oh my gosh. This gentleman was perhaps 60, 65 years old. I asked him you know where do you live. And he described this area that was about eight or nine miles away from the facility and he was a little bit off balance, staggering. He told me that some medication he’d been given had compromised his vision and no part of this sounded like a good idea for this guy to just wander off into the night. So I offered him a ride home and about 15 minutes later just after midnight my shift ended. That’s what happened and everything turned out okay. But it was a little weird driving a total stranger home in the middle of the night and it kind of got the gears turning about why this was an issue, why this had been a problem. And it sort of opened my eyes to the way the transportation barriers. Something as simple as that can be a factor that impacts someone’s ability to access healthcare services. And that’s kind of how the journey began.
Saul Marquez: Well kudos to you Imran for giving him a ride home. And yeah that’s pretty sad to think that we can’t figure out a patch for that last mile so to speak and this guy was forced to potentially walk home and it’s just really sad especially with the things that are going on in his care and the limitations that it created for him. So now you’re you’ve decided to take it in your own hands to bridge this gap. So what would you say is a hot topic that needs to be on every medical leaders agenda and how are you guys addressing it today?
Imran Cronk: Yeah that’s that’s a great question. You know I think a lot of health care organization leaders across the provider and payer and other types of organizations are really thinking about how they extend care and care coordination beyond the traditional four walls in the case of a hospital or health system. Beyond the occasional points of contact that they may have as a payer and really trying to bring care into communities in the places where people have where they live their lives. So one way we’re addressing that is we’re enabling these organizations to have greater insight into and control and influence over ensuring that people are actually able to navigate the logistical barriers that impede their access to care because if someone can’t get to their appointments or to their recurring treatment or home from the hospital in a timely manner it delays and prevents them from engaging with their care in a way that keeps them healthy. And as you know health systems and payers navigate these new worlds value-based payment and reimbursement. It’s really incumbent upon them to pay attention to these factors that are that are happening. Ambient outside of their traditional purview. That’s what I would say needs to be on the minds of every health care leader and I think is on the minds of a lot of them. So for right health we provide a a web based dashboard that enables care coordinators and social workers to arrange transportation on behalf of lower income or older adults or individuals with limited mobility. And we allow the care coordinators to arrange anything from an Uber to an ambulance for these patients. So it’s the entire spectrum of medical transportation depending on the individual patient or member’s needs and once a care coordinator is put in the right request we take on the work of coordinating with the transportation service based on what’s matched in our decision engine. And then we communicate information to the patients and to their caregivers and family members whatever the appropriate point of contact is to help them understand what’s going on because transportation can be pretty confusing for people sometimes and they really have a need to be informed in a timely and comprehensive manner about what’s going on. So we send them information over SMS, text messages, as well as over voice calls to mobile phones and home landlines because not everyone has a smartphone and can text so you really need to meet people where they are and communicate in a way that will resonate with them and they’ll be receptive to. So that’s how we really connect the dots between health systems, transportation services, and patients, and family members, and really try to bring these siloed stakeholders onto a common platform onto the same page to create smoother experiences for everyone
Saul Marquez: I think it’s a great highlight of what you guys do Imran and I think this could even be expanded to things like medications right getting getting folks the medications that they need or getting them there so they could get what they need because that’s also a factor.
Imran Cronk: Absolutely we have it happen. A lot of times where a coordinator will arrange a ride from someone’s home to their appointment for some type of treatment or a consultation and then they’ll also arrange on the way back not a one way ride just to the home but a multipart ride back that involves a stop at the pharmacy or a stop at a social services office to be able to access whatever resources that patient needs. So we’re seeing our partners use this in really interesting ways that we didn’t envision when we started out to help those patients address their their non-medical needs.
Saul Marquez: Fascinating. I think it’s a great great service and give us an example Imran of how your organization has created results by doing things differently.
Imran Cronk: Yeah. So we’ve seen some good successes so far we’ve been able to reduce cost on a per ride basis on average by 30% by using more efficient and cost effective modes of transportation. I think on demand rides haring instead of traditional taxi cabs as well as those kinds of resources instead of more complex and expensive pair transit you need ambulances. So organizations are happy with just those cost reductions but we don’t only strive for financial value. We strive for it for clinical and operational value. So one of our main focuses is to help reduce no show rates to appointments and no show rates you know vary depending on the care setting but on average we’ve been able to reduce no shows by about 35%. And that really makes a difference not only for patients who are now getting more regular and timely access to care but also for organizations who are seeing fewer open slots and last minute cancellations and rescheduling that wreak havoc on operations. And then on the inpatient side of the house we are making a difference in terms of reducing the incidence of delayed discharge where a patient may be ready to go in the morning but no one’s able to come take them up until the early evening or they may be ready to go late at night but no one can come and get them until the morning. So with right health and some process work we’ve done with discharge units at facilities across the nation. We’ve been able to see an average of nine hours of reduced length of stay because we’re facilitating on time discharges instead of delayed discharges. That has implications for not only the hard costs of monitoring someone who no longer needs to be in bed but there’s also an opportunity cost and not to mention a missed care opportunity for patients who may need that bed. So we’ve been seeing success across just hard cost reductions as well as reduced notion those and delayed discharges not to mention upside improvements in patient experience and satisfaction. And these metrics are critically important to us because we don’t view transportation as just a cost center or a way to band-aid gaps in transitions of care. We view transportation when strategically deployed as an asset that can drive upside clinical and financial and operational value for our partners and for their patients.
Saul Marquez: Now that’s that’s definitely a strategic way of looking at it. Moran and no doubt valuable to care but also the management of the business of health care. So love that you took us down this path as you guys have built out your solution. Share with us a time that you had a setback and what you learned from that?
Imran Cronk: Yeah that’s that’s an interesting question. We’ve had a lot of moments where we’ve certainly learned important lessons. And I think one of those was an instance where it was very early on in our time working with patients and institutions and there was a you know our normal flow is for a round trip chemotherapy appointment for example, the patient gets the ride to the appointment they get a several hours while they’re in the chair and then they come out the other side they press one in response to the text message we’ve sent and their ride is dispatched to take them home and we had a moment one afternoon where the patient arrived for his appointment at 1:00 p.m. and we would have expected him to trigger the ride at 5 or 6 p.m. and 5 p.m. came in at 6 p.m. came in 1 7 p.m. 8 p.m. I didn’t notice until I happened to be reviewing the rides for the day that about eight thirty PM that that patient had never triggered his ride home and that was an oversight we should have monitoring to be able to catch that and we do now but we didn’t at the time so we relied on manually see that. Now it’s kind of like a little moment you know have no idea what’s happening with that patient at that point.
Saul Marquez: For sure.
Imran Cronk: So we kind of scrambled and called the patient to see what was going on. And we reached him and he told us that he had been taken to the emergency department across the street from the cancer center because he had been feeling more nauseous and lightheaded than usual after his chemotherapy. And I was kind of taken aback as that it never happened before. And this was literally three weeks into our launch so well is there anything we can do with regard to the ride that we had set up and he said “Well no I saw your message a few hours ago I think when I’m all done here I’m just gonna press one. Is that going to work?” And again taken aback that he he got it and I said “Yeah yeah that’ll work.” So a couple hours later when it was around 10 p.m. 10:30. Sure enough he progressed one. And he had his ride home. It was it was one of those moments where you kind of breathe a sigh of relief because everything worked out okay. But it kind of showed us that the you know medicine is unpredictable and clinical experiences and patient journeys are very unpredictable and transportation has to be very adaptable to accommodate that. So I guess it was a moment where we dodged a bullet of sorts but it was a lesson learned for sure about the importance of monitoring and check in with patients on a consistent basis.
Saul Marquez: Yeah that’s very interesting. Thanks for sharing that Imran and just thinking through that maybe even having a delay feature where you know it says hey press one you don’t hear back within ten minutes you get another message that says Hey is everything okay. Yeah. It’s so unpredictable.
Imran Cronk: Yeah. Yeah. And you know that that also showed us kind of how high reliability we have to be because if you think about all the people whose evening is we’re made easier by that simple press one to get your ride home. The patient avoided staying in the hospital bed overnight or the emergency department but his care coordinator who had left it like 5 or 6 p.m. that day didn’t have to worry about whether the patient was going to have a ride home. She knew that that had been set up with this resource.
Saul Marquez: Yep.
Imran Cronk: And the driver who would have been scheduled to pick him up around 5:00 p.m. no longer had a wasted trip. So it kind of showed us how much was hinging on that one little process which which worked out in this case. But we definitely built a lot more tooling and process around that to take care of these kinds of contingencies.
Imran Cronk: That’s awesome man. Now congratulations that it worked out. Sounds like you learned a lot from it and yet it’s amazing once you insert yourself into that process how much value you’re actually providing. What would you say one of the proudest leadership experiences you’ve had today the right help?
Imran Cronk: Well I guess it was the first time I went away for a trip for a couple of days to see clients and everything ran smoothly back home. That was definitely a proud moment. You know anytime you have a company that you start and bring people on gradually it’s always a process of trying to make as a little rely and depend upon you as possible. And that was definitely a journey and we’re still you know working toward it as we advance through stages but I think that was a really proud moment because the team really came together and showed us that we had a bunch of really dedicated and smart and talented people on board. So I think it’s kind of simple but that was the proudest moment.
Saul Marquez: Hey man it’s simple but crucial. So congrats on and being able to do that and so as you guys continue building and growing, what’s an exciting project or focus that you’re working on today?
Imran Cronk: Yeah. One of the most exciting among a few that I could talk about is this project we’re working on that will bring digital connect me to kind of off the grid resources from a transportation perspective. So think about volunteer networks that exist in grassroots fashion or around the country or hospitals own shuttle fleets that they have had for a while and they’ve invested in that haven’t invested enough in that they have real time rounding dispatch or also different kinds of fleets that belong to organizations that are not hospitals but are more like municipalities that have an interest in connecting those fleets and even the small cap companies that are not on one of those apps on the curb. We have a product coming on within the next few months that will connect to those fleets and allow them to be a part of the ride health ecosystem in the same way that the other digitally connected third party professional transportation resources are. And we think that’s going to be really exciting because it will connect volunteers and communities who have vehicles time on their hands to be able to help those who who need access to transportation to be particularly impactful in rural areas. And then for our health system partners and other organizations like skilled nursing facilities being able to use their own in-house fleets that they’ve invested in instead of always having to outsource to third parties is going to be a tremendous cost savings and value. So I think that’s gonna be one of the more transformative products that we have. And it’s really another component though of the ecosystem we’re building.
Imran Cronk: That’s awesome man. So given the capabilities that you guys have built for management and flow to folks so they can more appropriately use the their current base of transportation modes.
Imran Cronk: Exactly.
Saul Marquez: That’s awesome man. That’s great. Yeah. You never know the little nuggets of value you’ll be able to to help customers drive until you’re in it and sounds like you guys are figuring it out all out quickly. Imran let’s pretend you and I are building a course on Healthcare Leadership. It is the one to one of Imran Cronk and so we’re gonna have four questions deal a lightning round style followed by a book that you recommend to the listeners. You ready?
Imran Cronk: Sounds good.
Saul Marquez: All right. What’s the best way to improve health care outcomes?
Imran Cronk: Make sure people can get there in the first place.
Saul Marquez: But what is the biggest mistake or pitfall to avoid?
Imran Cronk: Making patients not feel heard and making them feel like they’re just another cog in the system.
Saul Marquez: How do you stay relevant despite constant change?
Imran Cronk: That’s fairly simple because we’re still building the plane while it takes off. But I’d say reading and speaking and listening to people is a crucial way to stay relevant. So it can inform your actions.
Saul Marquez: What’s one area of focus that drives everything in your organization?
Imran Cronk: Well we always say our kind of prime directive our priority number one is to get the patient to the appointment and on time and safely that kind of trumps everything else for us and everything else follows.
Saul Marquez: Love the simplicity of that man. What book would you recommend to the listeners?
Imran Cronk: Meditations it’s when I read a while ago and recently revisited Marcus Aurelius and I think it’s a classic.
Saul Marquez: Love it man. It’s a great one. And folks if you want to get a hold of all of the info here as well as links to Ride Health which is ride/ as well as a link to meditations and a full transcript, just go to outcomes and you’ll find all that there. Imran This has been a blast. Before we conclude I’d love if you could just share a closing thought with the listeners and then the best place where they could follow you or reach out.
Imran Cronk: Yeah it’s sort of as a closing thought I would encourage anyone listening who has a story or something that that they have been curious about based on an experience to dive into that. To think a little bit deeper about that. The one experience I had five years ago has led to all of this and become the driving force of my life at this point. So you never know where those sort of thought exercises will take you and in terms of getting in touch I’m on LinkedIn emails if you reach out with your questions or thoughts or ideas I look forward to hear from you all. And thanks Saul for the opportunity to be here.
Saul Marquez: It’s a pleasure to host you Imran and looking forward to seeing just you guys take off. Man you guys are doing really great. Keep up the great work my friend.
Imran Cronk: Thank you. Thanks for having me.
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