Health system-provided rideshare is safe and addresses barriers to colonoscopy completion

In 2019, nearly 14 million colonoscopies were performed in the United States. In these settings, the accepted practice is that a responsible person drives and chaperones patients home after receiving procedural sedation, including colonoscopy. Lack of access to transportation and/or a chaperone is a persistent barrier to care in safety-net health systems and federally qualified health centers as a result of lower incomes, underinsurance, and higher social needs. Given racial, ethnic, and socioeconomic disparities in many digestive diseases that require colonoscopy for diagnosis and management, innovative solutions are needed to overcome logistical barriers to colonoscopy completion, especially in these settings.

We conducted a nonrandomized, mixed-methods, pilot trial of a rideshare NEMT intervention at Harbor view Medical Center (HMC), a safety-net health care system in Seattle, WA. At HMC, patients scheduled to receive procedural sedation must confirm transportation and a chaperone on pre-procedure calls. Patients scheduled for a colonoscopy with moderate sedation who reported a lack of transportation and/or a chaperone during these calls were eligible to participate. Patients who received monitored anesthesia care including propofol, used a mobility device that could not fit into a rideshare vehicle, or required a ferry to get home were excluded. The study was approved by the Institutional Cancer Consortium Review Board, which includes HMC.