Post on 06-Apr-2018
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Challenges in Emergency Medical
Services in India
LavanyaMarla
SystemsScientist,CMU
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GVKEMRI(EmergencyMedicalResearchInstitute)
FirstEMS(911type)ProviderinIndia
Startedin
2005
in
one
state
Nowpresentin10states
CMUTeam
Prof.Ramayya Krishnan
Lavanya Marla
Yisong Yue Aayush Kumar
UnderstandingoperationsinHyderabad
CMU-Heinz and GVK-EMRI Collaboration
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PriortoEMRI,nocentralambulanceprovider
Adhocemergencyprovidernetworks
Hospitalambulances,
taxis
Publicprivatepartnership
Funding:
95%
state
gov,
5%
private
partner Nofeeschargedforservice(paidbystate)
Highlyresourceconstrained
75Mpeople,
75
ambulance
bases
(AP)
Cellphonebasedcommunications
Ground realities at EMRI
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Publicacceptability
Cleartrafficforambulance
Competitionwith
ad
hoc
networks
Decreasesutilizationofambulances
Noreal
time
position
availability
Newcities
Newtrafficpatterns
Highrise
buildings
without
elevators
Newmodesoftransport
Challenges at EMRI
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Howcan
performance
be
improved
using
existingresources(e.g.,ambulances)?
Howtocharacterizethestateofthesystem?
How
to
model
how
the
system
is
affected
by
currentallocationanddispatchingpolicy?
Canadecision
support
tool
be
developed
to
answerthesequestions?
Key Questions of Interest and First steps
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Networkconsistsofambulanceslocatedatbases
Eachbaseservicescallsthatariseinasetofgridsaround
it
Thedefault(EMRI)modelistohaveoneambulancein
eachbase
to
serve
calls
in
the
associated
grids
Acallthatisservicedconsistsoftheambulancearriving
fromthe
base
to
ascene
and
then
taking
the
patient
to
ahospitalfromthesceneandthenreturningtobase
Key Concepts
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Consistencywithcurrentdispatchingmodel
Assignnearestfreeambulanceavailable
Priorityorder
for
ambulances
Donotaddextrabasesthanthose
determined
by
EMRI
Logisticalchallenges
Donotaddextraambulances
Derivecongestion
information
from
data
logs
Design Principles
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Modeling Concept: Chain Formation
25 min (20 min)
30 min
(15 min)
45 min
(25 min)
Dependency
Graph
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Modeling Concept: Chain Formation
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Modeling Concept: Chain Formation
25 min
18 min
(12 minutes saved)
15 min
(30 minutes saved)
25 min
(no vehicle assigned previously)
Modified
Dependency
Graphfornew
allocation
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Breaking dependencies improves service
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Simulation framework
Simulationapproachtoevaluateambulancetobaseallocations
SimulateDispatch
Officer
assigning
ambulances
to
calls
Simulateresponsetimesandoutcomes
Datadrivenapproach(basedonactualcalllogs)
Basedoncalllogswecanmodel:
Callcongestionpatterns
Chainsandotherlongrangesystem
effects
Utilizationofvariousbaselocations
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G =dependencygraph
C(G) =totalcostofgraphG
T(G,S) =modified
dependency
graph
with
change
S
toallocation
Changeinobjective(F):
F(G,S):
Monotonicallyincreasing
Orderinvariant
Approximatelysubmodular
))- C(T(G,SF(G,S)=C(G
Mathematical formulation
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Simulation-optimization approach
TestaddinganambulanceatlocationmM
Goal:AllocateNambulancesamongMbases
Number
ambulances
added