Lack of transportation is a critical barrier to health care for many vulnerable patients. Essential hospitals often work through this barrier by coordinating rides to clinics or hospitals for those patients who would otherwise miss their appointments. But Boston Medical Center (BMC) has taken this practice one step further by working with the city of Boston to implement Prescribe-a-Bike, an innovative program that provides access to affordable transportation while promoting healthy living.
Through Prescribe-a-Bike, BMC physicians write prescriptions for memberships to Hubway, Boston’s bike-sharing program. Subsidized by the city of Boston, patients pay $5 for an annual membership (compared to the typical cost of $85) and are allowed unlimited rides that last 60 minutes or less (compared to the typical length of 30 minutes). Enrollees also receive a free helmet.
Giving patients control
“The vision I had in my head was ‘Wouldn’t it be great if people used the bike system to get to and from the hospital – to their appointments, to visit family – in addition to riding around town?’” says Alan Meyers, MD, a pediatrician at BMC.
A subway stop previously located one block away from the hospital recently moved several blocks away. Buses – which Meyers says sometimes require two or three transfers – often inconvenience and delay patients.
Prescribe-a-Bike puts patients back in control of their own transportation. Hubway has installed several bike stations at or near the hospital and is continuing to expand into the low-income areas where many BMC patients live.
Exercise is key
Meyers hopes that, in addition to providing another transportation option for patients, the program will incorporate valuable physical exercise into the routines of patients who may not pursue other exercise options.
The holy grail in promoting exercise is being able to have patients include something that’s vigorous into their daily routine. That it serves the purpose of transportation [as well] is huge. That’s a big part of what’s driving this effort at the hospital.
Targeted outreach, simple process for staff buy-in
One of the most important factors to the program’s success, according to Meyers, is educating BMC clinicians about the program and encouraging them to share information about the program with their patients.
Meyers and other BMC staff have launched email campaigns, hosted lunch meetings, and attended several clinical groups’ staff meetings to spread the word. Clinicians who commute to the hospital by bike received targeted outreach.
To encourage staff participation, BMC built an easy prescription process into the electronic health record (EHR) system. A form for Hubway membership is part of each patient’s EHR. Clinicians can simply print a page from the record for the patient to take to the hospital’s transportation office. There, staff sign patients up using an online system connected to the city’s database.
Setting the standard
Nicole Freedman, director of bicycle programs for the city of Boston, recently told Boston magazine that the program hopes to enroll 1,000 low-income residents in the subsidized Hubway program in 2014. Meyers would like to see Prescribe-a-Bike achieve the same level of awareness among clinicians as BMC’s Preventive Food Pantry, which was established more than 10 years ago and is widely known among staff.
“I’m going to get happier and happier if I see five people [enroll in the program],” he says. “I’ll be happy if there are 50 people. I’ll be delirious if there are 500 people. I would just like to see it work.”
Even though patient enrollment has just started, BMC has already achieved success as a local leader in this initiative. As Freedman noted, “We have already received some calls from other hospitals and health clinics who are interested. It’s a new way to reach out and promote health.”
For more information about Prescribe-a-Bike, please contact:
Alan Meyers, MD
Boston Medical Center