Access to private transportation, or lack thereof, has long been a barrier to participation in clinical trials. And COVID-19 isn’t making things easier, with public health guidelines discouraging the use of public transport and ride-hailing services setting up policies against passengers with COVID-19 symptoms.
So, how are institutions running COVID-19 trials getting patients in for site visits? New York-based Ride Health is on the job.
The company is partnering with ACTIV-2, a study backed by the National Institutes of Health (NIH) testing treatments for COVID-19, and the NIH-founded COVID-19 Prevention Trials Network (CoVPN), the “harmonizer” network for the five vaccine trials backed by Operation Warp Speed. It will provide transportation to and from study sites for participants through its network of COVID-19-equipped providers. That means all drivers will follow guidelines from the Centers for Disease Control and Prevention, as well as state-mandated precautions, for each ride.
The ACTIV-2 study is testing treatments for patients with mild to moderate COVID-19 who are not hospitalized, starting with Eli Lilly’s antibody, LY-CoV555. It aims to enroll 2,000 participants, while each of the vaccine trials under CoVPN is expected to enroll about 30,000 people.
Ride Health started out four years ago with a mission to get patients to and from hospitals so that they wouldn’t miss or delay care, or get stranded because they didn’t have a ride. It raised a $6.2 million seed round in January 2020 to pursue that vision. Back then, clinical trials weren’t really on the radar, said Imran Cronk, CEO and founder of Ride Health.
Since then, it has teamed up with Genentech, which has had an “increasing focus around what they call inclusive research and involving more minority and older populations,” Cronk said.
Ride Health doesn’t provide the rides itself but works with a network of transportation providers to get patients where they need to go. For patients traveling to and from hospitals, these include ride-hailing services, such as Uber and Lyft, and nonemergency medical transportation providers. For patients participating in COVID-19 trials, this means traveling with drivers who use personal protective equipment, disinfect high-contact surfaces between rides and maintain partitions in the vehicle to separate the front and back seating areas.
Through the Ride Health platform, a study coordinator can request rides on behalf of participants and then credit those against insurance plan benefits or funding sources, namely the trial site or the biopharma company sponsoring the trial, Cronk said. It then matches participants to the appropriate ride, keeping them in the loop during the ride through text messages or calls. The company has a team monitoring rides and intervening if there are any issues, he added.
“When COVID-19 hit last March, we immediately recognized there would be a need for COVID-19-positive rides and we thought we were in a position to orchestrate a network of COVID-19-positive transportation providers,” Cronk said. “What was happening early on was a lot of people who were COVID-19-positive or had confirmed exposure were being transported with expensive and limited EMS services.”
The company has built a network of providers in urban and rural areas across all 50 states and Puerto Rico to bring patients to nearly 300 sites across ACTIV-2 and the CoVPN studies, said Amin Farhoomand, health services market lead at Ride Health. This includes providing transportation to trial sites in states like South Dakota and Wyoming that typically don’t participate in trials, he added.
"As we designed the ACTIV-2 protocol, it became clear that we would need to address transportation for study participants," said Judith Currier, M.D., in a statement. Currier is chair of the AIDS Clinical Trials Group, an NIH-funded network that is conducting the ACTIV-2 study. "We didn't want transportation to be a barrier to participation given the sensitivity around travel for people who have COVID-19. We needed a partner who could facilitate a rapid, national rollout of a service that could transport ACTIV-2 participants, regardless of mobility limitations or technology capabilities."
ACTIV-2 and the CoVPN trials are expanding and could potentially reach 400 sites in total, Farhoomand said.
“It was definitely a challenge. If you look at the landscape, Uber, Lyft and larger transportation brokers had a strong stance on how they won’t provide COVID-19-positive rides,” Farhoomand said. “We got to work with local taxi companies, local nonemergency transportation providers and help them sustain their business during the pandemic.”
Ride Health’s clinical trial work will extend beyond the pandemic. Its goal is to provide transportation for patients across all clinical trials, not just those testing treatments and vaccines for COVID-19, Farhoomand said. Since starting out on musculoskeletal and oncology trials with Genentech, the company has started working with hospital centers on individual trials they’re conducting, he said.