This article has been updated October 5th, 2023, by providing this link to the October 12th Taxi/EMS Zoom Webinar hosted by the Canadian Taxi Association for interested Taxi companies and municipalities:
Sending select passengers to hospital by Taxi rather than by ambulance is saving Niagara Region approximately $1000 per trip, Public Health Committee members heard at their July meeting. The Region is on track to save $200,000 in transportation expenses on an investment of only $10,000, a return on investment of 1900 per cent.
In the five months since the Taxi medical pilot has been operational, the average cost of a Taxi trip has been $15.00 to $20.00. According to Municipal Benchmarking Network Canada, Niagara EMS Operating Cost per Patient Transported by ambulance averaged $1,006 in 2018.
In a presentation to the Niagara Region Public Health and Social Services Committee in July, Marty Mako, Commander of Niagara Mobile Integrated Health provided an overview and an update for Committee members. His overall assessment is that the program is saving Niagara Region money, and clients are very happy with the service being provided by Central Taxi.
“We’re looking at 200 ambulance transports for the year, because we just had over 100 and just hit July 1st with some six months left in the year. We follow up with these individuals, and patient satisfaction has been high with the new service, which was nice for us to see. And more importantly, no adverse patient outcomes have been reported,” Mako told Committee.
“I have to give tech Central Taxi credit. Their managers have been right on top of addressing any issues we brought up. And then more formally, we have checkpoint meetings every three months with their management team and our leadership team to talk about quality improvement opportunities with this being a brand-new program. And thus far that’s been going well.
“Communication with the Central Taxi management has been really important; they’ve asked us to connect with them whenever we have any operational, logistical technological issues with the booking process.”
Central Taxi’s Marc Andre Way confirms that the pilot Taxi medical program has been positive for both clients and drivers.
“Our drivers are very confident, very comfortable with this,” Way says. “They are transporting clients at basically the same level of health and support needed that they would normally transport. The difference is that they are being booked by the paramedic service rather than the clients themselves.”
Way points out that Taxi drivers are not in any case to perform as paramedics: “The paramedics and EMS services are requesting rides for patients that do not need paramedic support on the ride. That is where the savings are for Niagara.”
In his presentation, Mako pointed out that transportation to medical appointments or urgent care treatment is crucial to good health:
“Starting with why this pilot was needed: we know that access to safe affordable, accessible transportation is an important social determinant of health and in the Niagara region, it does impact all communities, both rural and urban. It is an important contributor to health equity, which we know is now a component of our interim strategic plan and public health and emergency services.
“Each year in the Niagara region, numerous Niagara residents don’t obtain the medical and health care that they need, primarily due to a transportation barrier, meaning they cannot get from their place of residence to their medical facility that they need to visit purely due to that access barrier.
“Speaking for Niagara EMS, specifically, our experience has been that many residents call 911 for low acuity health emergencies when their need really is that conveyance to hospital that they don’t need the care and treatment of a paramedic while enroute, but they do need to get there, and an ambulance provides that transport option.
“Looking at it from a bit of a bigger picture perspective, in addition to meeting patient needs, this initiative also helps preserve ambulance capacity, and hospital emergency department capacity during a time as I’m sure you’re all aware of when both systems are significantly stressed and strained.”
Councillors were very interested in the Taxi medical service and had numerous questions for Mako, including ensuring the service would not be abused.
“Individuals cannot call 911 and request a taxi,” Mako explained, noting that all Taxis are booked through EMS or paramedic staff who have determined that Taxi medical transportation in a particular situation is safe, and the client is eligible to use it.
“This service is used only when patients have been fully assessed and triaged by Niagara EMS, it has been determined they do not require further treatment by a paramedic, and transport to their healthcare destination is the only barrier to seeking medical care.”
“By deferring an EMS transport to an Emergency Department (ED), there are also additional costs saved to the health care system. For each patient that is diverted from an Emergency Department, there are additional savings to the hospital system of approximately $276.00/visit (as per the Niagara Health System Annual Report 2019/20),” reads the report presented at the July 12 meeting of the Niagara Region Public Health and Social Services Committee meeting.
“Based on usage from Q1 2022, a conservative annual forecast of 200 ambulance transports to ED diverted and 20 diversions away from the ED entirely, would result in approximately $206,720 in offset expenditures to Niagara’s healthcare system, from an investment of less than $10,000.”