emri challenges

8/3/2019 EMRI Challenges

1/21

Challenges in Emergency Medical

Services in India

LavanyaMarla

SystemsScientist,CMU


2/21

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


3/21

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


4/21

Publicacceptability

Cleartrafficforambulance

Competitionwith

ad

hoc

networks

Decreasesutilizationofambulances

Noreal

time

position

availability

Newcities

Newtrafficpatterns

Highrise

buildings

without

elevators

Newmodesoftransport

Challenges at EMRI


5/21

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


6/21

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


7/21

Consistencywithcurrentdispatchingmodel

Assignnearestfreeambulanceavailable

Priorityorder

for

ambulances

Donotaddextrabasesthanthose

determined

by

EMRI

Logisticalchallenges

Donotaddextraambulances

Derivecongestion

information

from

data

logs

Design Principles


8/21

Modeling Concept: Chain Formation

25 min (20 min)

30 min

(15 min)

45 min

(25 min)

Dependency

Graph


9/21



10/21


25 min

18 min

(12 minutes saved)

15 min

(30 minutes saved)

25 min

(no vehicle assigned previously)

Modified

Dependency

Graphfornew

allocation


11/21

Breaking dependencies improves service


12/21

Simulation framework

Simulationapproachtoevaluateambulancetobaseallocations

SimulateDispatch

Officer

assigning

ambulances

to

calls

Simulateresponsetimesandoutcomes

Datadrivenapproach(basedonactualcalllogs)

Basedoncalllogswecanmodel:

Callcongestionpatterns

Chainsandotherlongrangesystem

effects

Utilizationofvariousbaselocations


13/21

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


14/21

Simulation-optimization approach

TestaddinganambulanceatlocationmM

Goal:AllocateNambulancesamongMbases

Number

ambulances

added

emri challenges

Documents