From 2016 through 2021, the Smart Columbus Program demonstrated smart city concepts, comprised of eight transportation, mobility and data projects in Columbus, Ohio. These projects were aimed at improving access to jobs, enhancing tourism, stimulating the economy, connecting residents to safe and reliable transportation, and supporting efficient and sustainable movement of people and goods. The Prenatal Trip Assistance (PTA) project assessed non-emergency medical transportation (NEMT) operations by Medicaid Managed Care Organizations (MCOs) in an effort to decrease the premature birth and infant mortality rates in the region. The PTA project developed an expanded on-demand NEMT service for pregnant individuals to schedule rides using a website, a smartphone mobile app, or a call center. In addition, PTA provided car seats for on-demand transportation, allowing participants to avoid having to carry car seats to postpartum appointments. Following outreach activities, the developed PTA system was deployed in May 2019, during which data was continually collected to assess the performance of the system.

Methodology

Between May 31, 2019, and June 30, 2020, 143 participants enrolled in a study of PTA effectiveness, with half of them randomly assigned to the usual care group where trips were only scheduled in advance through call centers, and the other half assigned to the intervention group with access to additional flexible scheduling resources using the app, website, or call center. The evaluation study period was based on data collected through January 12, 2021. The primary measure of PTA effectiveness was the satisfaction rate of all participants in the deployment. Analysts used a baseline interview after enrollment and an online survey to assess use of and satisfaction with transportation services every 30 days following enrollment, including questions asking whether the user would recommend the mobile app, website, or call center service to other individuals. Trip data, including the number of trips taken, destination, dates of trips, trip timeliness information, and adherence data (whether trip was cancelled, rescheduled, or occurred as scheduled) were collected by the study transportation broker and Medicaid MCOs. Pregnancy outcome data were also obtained from the Ohio Department of Health.

Findings

• Increased overall satisfaction, as measured by a response of satisfied or very satisfied in the study exit survey, was found in the intervention group (90 percent) compared with the usual care group (79 percent).
• With respect to the mobile app, 82.8 percent of individuals said they would recommend the app to others. Overall, 93.1 percent of users reported being very satisfied or somewhat satisfied with the mobile app.
• Trip data showed that PTA facilitated more usage of NEMT trip benefits during the study period. Study participants took more NEMT trips for prenatal care in the PTA intervention group (a median of 19 trips) than the usual care group (a median of 2 trips). In addition, the percentage of people who did not take any NEMT trips during the study period was 44 percent in the usual care group compared to 19 percent in the PTA intervention group.
• No meaningful difference was found between usual care and intervention groups in pre-term delivery or infant mortality data available to the researchers.