When an entrance door is over 6 feet high and thick glass with no handicap access button, how does the individual with a mobility issue enter? I have visited two office doors to medical practices where five physicians provided healthcare, and there was no way for the disabled to enter if they did not have an assistant with them.

This is not only objectionable; this is illegal. When it is an entrance to a medical practice, it would seem this is even more relevant and more of a dismissal of respect for these patients.

After WWII, disabled soldiers discovered that their sidewalks, streets, and corners were inaccessible, prompting the United States to apply curb cuts. Wheelchair users had it rough before curb cuts came along; they had to locate the closest driveway, cross the street in the face of approaching traffic, and then locate the next accessible driveway to cross the street. Even though changes were initiated, not every community or every shopping center has been inclined to include cutouts in sidewalks.

The ADA laws are quite specific as to the requirements regarding doors, styles, door widths, etc., and anyone wishing to familiarize themselves with these requirements can go to the website called “ADA compliance…”

ADA Mandates

What does the ADA mandate? The numerals in front of the requirements indicate the portion of the law it addresses. Here are a few examples of what shops, practices, community centers, and other buildings need to adhere to:

Revolving Doors and Turnstiles. Revolving doors or turnstiles shall not be the only means of passage at an accessible entrance or along an accessible route. An accessible gate or door shall be provided adjacent to the turnstile or revolving door and shall be so designed as to facilitate the same use pattern.

4.13.3 Gates. Gates, including ticket gates, shall meet all applicable specifications of 4.13.

4.13.4 Double-Leaf Doorways. If doorways have two independently operated door leaves, then at least one leaf shall meet the specifications in 4.13.5 and 4.13.6. That leaf shall be an active leaf.

4.13.5 Clear Width. Doorways shall have a minimum clear opening of 32 in (815 mm) with the door open 90 degrees, measured between the face of the door and the opposite stop.

According to media reports, the MTA (Metropolitan Transit Authority) appears to issue inadequate warnings to riders to be cautious when riding the subway in New York City. Transit officials have been dealing with the aftermath of Gov. Kathy Hochul’s orders, which halted dozens of subway accessibility projects. A lawsuit will probably force the agency to address hundreds of subway platform gaps.

The complaint claims the MTA violates the city’s Human Rights Law by neglecting to eliminate “excessive” spaces between subway trains and platforms. Accessibility advocates say this makes the system “dangerous” for disabled and elderly riders. The plaintiffs filed the lawsuit in 2022.

The 2022 agreement laid out the state’s promise to upgrade 95 percent of inaccessible stations with ramps or elevators over the next few decades. Disabled subway commuters can access only 131 of the 493 stations comprising the authority’s system.

The Restrictions on Travel

According to the National Household Travel Survey (NHTS), 18.6 million Americans aged 5 and up (6.1 percent of the total population in that age bracket), 10.0 million Americans aged 18–64 (5.1 percent of the 18–64 age group), and 7.7 million Americans aged 65 and up (14.1 percent of the 65+ age group) reported having a disability that limited their ability to travel.

Individuals who reported disabilities that hindered their ability to travel disclosed the following problems:

They were less likely to be employed, live in a vehicle-owning household, and travel. They took fewer trips because of health issues and came from lower-income households. To compensate for their disabilities, they relied on others for rides, which limited their travel to daytime. They used rideshares and special transportation services like Dial-A-Ride.

However, it’s not just restrictions on travel because ADA applies to things closer to our homes, like the local library or the community center. Within the past week, I have been contacted by two individuals (one on a local Facebook page and one on my Bluesky account).

The woman on the Facebook page was reaching out to people living in her town who might help her. She lives on the upper floor of an apartment building and has mobility issues requiring the building elevator. Unfortunately, the landlord told her the elevator was being repaired and would be out of service for several weeks.

She is, as she said, “a prisoner in my home” and cannot shop, do the laundry or leave the building. The landlord had been unresponsive to her calls, as she said. The townspeople on the page offered various forms of help and directed her to the local ADA town manager.

Another woman with mobility difficulties couldn’t access the ladies’ room in the local library because she couldn’t open the door. When she indicated to library managers her need for accessibility, they informed her there was little they could do.

The town also told her they could do nothing to assist with the library door. The best solution that they offered was to prop the door open, and this, of course, raises privacy and safety issues. No one seemed to offer any help for her, and I indicated it might be helpful to look for state organizations devoted to disability issues’ resolutions. Hopefully, she will find one or more who will provide the needed aid.

Another town that had, several years ago, built a large new community center also failed to notice that both the entrance doors and the doors to the lavatories were not ADA-compliant and could not be opened without assistance.

Local officials estimated that installing a push-button door would cost $17,000 to fix the front door issue. After months of foot-dragging, they did comply and also offered a means for those with vision disabilities to access the door opener.

The work is still being considered for the lavatory doors, which have an additional impediment of a “modesty panel” directly in front of the door when it opens. This means anyone in a wheelchair has an another obstacle at the entrance.

While anyone who is able-bodied fails to appreciate the seriousness and the loss of independence as well as that of self-esteem for those with disabilities, this is still not acceptable. We must adhere to the laws and respect people’s rights.

No one wants to enter into lawsuits in order to obtain remediation of these issues, but that remains an option. Town officials should ask themselves one question: What is more expensive, fixing the door or dealing with a million-dollar lawsuit?

The post Preventing the Disabled From Entering Safely Is the Issue appeared first on Medika Life.

People pay attention when Amazon – a power brand – makes a move, and since the release crossed the wires, business journalists and analysts have been reporting and posting on their social platforms that this acquisition will transform the US healthcare scene and disrupt the status quo.

Everyone seems to be making money in the health sector, why not Amazon?

The purchase certainly enables Amazon to leverage its logistics expertise and cloud-based information-storage savvy to reduce friction points in accessing care and, simultaneously, add to its burgeoning health-revenue-based business.

But will the purchase of One Medical transform the vast and fragmented US health system? Let’s not jump to that conclusion just yet.

The US Health System Swamp

This is not Amazon’s first time dipping its big toe into the murky waters of the US health system, yet many observers rate this move as more significant than the company’s previous ventures.

Considering Amazon’s past track record in working to transform healthcare, it’s best to view the company’s aspirations to improve the care experience with a healthy dose of skepticism.

This is because the US health system is too big and pasted together for any single effort to have an effect.

Created slapdash in the decades since World War II, today, the US system is so fragmented that business leaders outside health care cannot fathom how companies in the health ecosystem operate or make money.

It’s hard for them to imagine how pharmacy benefit management companies make money, or how payers both encourage preventive care and, at the same time, reject physician requests for diagnostic procedures.

Amazon knows there is plenty of money to go around, and they want in, but it’s not easy to figure out how.

But, Amazon understands consumer experience better than any other company, and this time they are sticking to their knitting by tracking the access to care supply chain.

Stumbles Are a Learning Opportunity

It’s a wise move considering past efforts. Remember the Amazon partnership with JP Morgan and Berkshire Hathaway?

These three amigos were bullish on how their economic power and influence would transform healthcare, but in the end, their joint project Haven faced more significant problems than money, data or supply chain expertise could solve.

Haven’s death underlined just how increasingly fragmented the US health system is. Perhaps the three leaders at the top could never completely define the challenge Haven was created to address?

Ultimately, their desire to reduce healthcare costs and improve the consumer experience – which were goals Haven had in common with Amazon’s aspirations for One Medical – was emblematic of focusing on symptoms, not the underlying disease.

And while the Haven shutdown may have been accelerated by a lack of collaborative mindset, unwieldy structure or even a lack of unifying strategic priorities, it’s likely that the stake in the heart for Haven was the same specter confronting the authors of Medicare in 1964: fear of change and protectionism.

It is almost certain that Amazon will accelerate One Medical’s pursuit of profitability and debt reduction, but HIPAA requirements will block Amazon from accessing One Medical patient data.

So, rather than being a transformative moment, this may well be a $4 billion investment for Amazon’s leaders to learn more about just how the US healthcare system is broken.

It also hopefully will allow Amazon to apply these lessons and use its expertise to make a little piece of the puzzle operate better.

Where Amazon Has an Edge

There are four decision-making health sectors: payers, policymakers, product innovators, and providers.

But the fifth sector, made up of patients – which everyone is putatively focused on helping, does not even have a seat at the decision-making table.

Amazon has an edge in that they understand the customer experience better than any other player – and they know how to establish and keep consumers’ trust.

While patients undoubtedly have the most skin in the access-to-care game, their interests and voice often go unheard outside corporate conference rooms.

But Amazon has consistently fostered consumer confidence by reducing friction points, a patient-centric service orientation very much missing from the health system.

Building on the notion that consumer experience must be prioritised is a great differentiator, but it will not help when cutting deals with payers or providers.

Amazon is now pitted against mega-players such as UnitedHealth Group’s Optum, CVS Health’s Aetna and hospital systems that are transforming into massive physician networks.

Amazon’s acquisition now invites other players to snatch-up companies like One Medical striving to turn a profit.

Amazon’s next steps are what observers should be watching closely.

How does this acquisition connect to its other purchases and partnerships, such as Amazon Care, the employee-specific telemedicine and in-person primary care service company launched three years ago?

Amazon Care operates at locations in Seattle, Baltimore, Boston, Dallas, Los Angeles, Washington, D.C, Austin, Texas, and Arlington, Virginia. Will Amazon Care and One Medical merge?

Will it impact their online pharmacy business? Amazon bought PillPack two years ago for $1 billion, yet despite its unparalleled delivery expertise, the company has still to gain traction in the pharmacy sector.

Plus, remember the smart collaboration that Amazon struck with telehealth giant Teladoc giving the latter broader consumer access to “I want a doctor” using Alexa as a virtual-care tech platform.

Leading economist and authority on integrated delivery systems, Dr. Alain C. Enthoven, wrote more than a decade ago that the “healthcare system is fragmented, with a misalignment of incentives, or lack of coordination, that spawns inefficient allocation of resources. Fragmentation adversely impacts quality, cost, and outcomes.”

Not much has changed since Dr. Enthoven penned those words; fragmentation complicates every aspect of care.

Amazon may be a supply-chain management behemoth, but can they transform or disrupt the system so that care becomes less expensive? Will people with pressing health concerns have greater access to care? Maybe.

Amazon has joined the club of mega players committed to making waves within the health ecosystem – Apple, Google, Microsoft, Oracle, Teladoc and others.

Combined, these players add more complexity to a non-integrated system that generates more and more layers – each with its own economic model and an invoice to be paid by some part of the ailing health system.

At the bottom of this system, supporting it, hopefully benefitting from it but just as often held captive by it, is the patient-consumer. This is where Amazon is likely to focus, but will that focus result in transformation?

Reflecting on the Amazon acquisition, innovation theorist John Nosta wrote that an “essential component to this discussion is time. The imposition of social imperatives like equity in the context of the early stages of technological development crush innovation at its very core.”

The United States health ecosystem is a modern-day version of the mythological Labyrinth.

Like the Cretan maze, it is almost impossible to navigate, but Amazon certainly has the resources, patience and self-interest to explore and try to solve the puzzle.

While success will not come easily or quickly, expect this e-commerce giant to continue to press forward with its headline-grabbing investments, learning until it gets it right. Improving our lot is not Amazon’s business objective, but we may benefit as an outcome.

The post The Health System Will Not Be Transformed by Amazon – But It Will Improve appeared first on Medika Life.