Onward specializes in getting patients to their dialysis appointments. We understand that patients need extra care, support and coordination to make the appointment a success.
In the US, roughly 750,000 have end-stage renal disease and nearly 500,000 were receiving regular dialysis to treat it. To conduct their dialysis, these patients were traveling to and from a local dialysis facility such as DaVita, Fresenius or Satellite Health three times a week.
The transportation to and from the facility is often an issue. Only 26% of dialysis patients are able to drive themselves while another 20% rely on family and friends to get them to their appointments. The remaining 50% use other transportation options such as paratransit, Medicaid’s non-emergency medical transportation, ridesharing (Uber/Lyft), our service (Onward Rides), and sometimes even ambulances.
Before a patient goes on their trip to dialysis, they have to restrict their diet. In general, those who undergo dialysis will need to eat more high protein foods, eat less of foods that are high in salt, potassium, and phosphorus, and adjust how much they can drink (most try to limit to 32 oz a day). Because of this, many patients will have some swelling.
"They're not supposed to be having lots of things with salt, not supposed to drink a lot of liquids, don't drink coffee. There's a lot of dos and don'ts that come with end stage renal disease. The least thing I can do is find something that softens the blow of getting them there and back." - Geri, a care manager who uses Onward
Our team of drivers are carefully vetted and interviewed personally so we can ensure they are compassionate and can provide care to someone who is sensitive. They enjoy helping people and being there to provide assistance.
When an Onward driver arrives for a pickup, they will get out of the car and provide any assistance needed to get the patient from their home and into the car safely.
"Sometimes there can be ambivalence even if they want to go, whether they want to submit to all that. Even along the way they are worn down, they're tired, they're worried. My hope is to make everything surrounding that as nice and comfortable as possible - and consistent and encouraging. That's what I'm looking for in terms of a ride."- Geri, a care manager who schedules Onward for regular dialysis trips
A Group Effort
Caring for someone with renal disease takes a lot of coordination and often involves multiple parties. At Onward, we work hard to provide convenience and peace of mind for everyone involved. Specifically:
- Onward allows a care manager to plan all of their pickups in advance so you can rest assured that the pickup is booked and will happen.
- Onward will alert the care manager (via text and/or email) when a patient is picked up and dropped off so even if they aren't on the trip, they are kept in the loop.
- Should there be any problems with a pickup or if a patient wants to cancel, we store on file the care manager's name and number and will work with them to take all the necessary steps to get the patient to their appointment or make alternate arrangements
Cancellations are the Enemy
Many studies have discussed the dramatic impact of missing a dialysis appointment. This JASN study shows that the likelihood of hospitalization or a trip to the ER goes from 1% for those who receive treatment to 5% if an appointment is missed.
Onward takes these cancellations very seriously. Specifically:
- We confirm every appointment at 3pm the day before pickup and then again 1 hour before pickup.
- We keep on file the name of the person ordering the service as well as the care managers at their dialysis clinic. For any message we receive about a cancellation, we will contact all the parties involved to either repair the ride or immediately reschedule.
"It leaves it too much, I don't want to say chance, but change of plans or cancellation if it's an Uber, Lyft, a taxi or even a friend. This [Onward] is a professional service that they [the rider] are committed to financially. And, most importantly, it is someone who is consistently there - especially in the time of COVID." Geri, a care manager and Onward customer
Dialysis is not fun, but Onward can make it better by providing a familiar and caring face during each trip.
Onward allows for riders to specify which drivers they like and schedule to get the same driver each time. Having the same driver allows for a relationship to build and for the driver to learn how to personalize the ride to the rider's preferences. For example, Onward has one patient who loves Frank Sinatra. Once the Onward driver learned that, she created a Sinatra playlist for the rider so that each trip they could listen together on the ride.