Thanks to innovative designs and new technology, ambulances will become more and more sophisticated, and life-saving care will continue to improve patient outcomes.
Technology is transforming the medical field, with innovations not only addressing scale and cost, but also improving patient care, providing faster diagnoses and ultimately increasing survival rates. By 2050, it is estimated one in six people in the world will be over 65 years old, and the number of people aged 80-and-over will triple from 143 million today to a staggering 426 million. This growing population will require more care, placing greater demands on resources and staffing. Coupled with global health workforce shortages, health professionals are now looking at how technology can be used to empower and support patients in the future. It is likely that most people will need to rely on care from an ambulance from time to time across the course of their lives. But in many places, it is sadly not as simple as calling up an ambulance and letting it do its job.
India’s healthcare industry is growing at a rapid pace and is expected to become a USD 280-billion industry by 2020, with a high percent of global stakeholder involvement. Improvement in healthcare infrastructure and facilities and ease of access to them is the only way India can fight against diseases. Emergency medical services (EMS) is an integral part of India’s health, and its growth is irreversible.
Indian EMS has gone beyond the national boundaries, and many international organizations and manufacturers have partnered with Indian EMS providers. American and European academic institutions have and continue to provide expertise to Indian providers, hospitals, and teaching institutes, and with Indian EMS growing at an exponential rate, more such opportunities are opening up. Global organizations like American Medical Response and Global Medical Response have already established footprints in India, as have Stanford and George Washington Universities, as investors, consultants, academic partners, or technical expertise providers.
There are over 100,000 vacancies available in India for trained EMTs who can be deployed in ambulances. India needs training organizations and investments to bridge this gap. EMS education is an area that invites global attention. There has been a surge in training programs for nursing and paramedic training.
With more than 24,000 ambulances in the government sector alone, and an equal number in the private and charitable sector, equipment requirements to comply with the new standards, mandated by the National Ambulance Code, have caught the attention of US- and Europe-based equipment manufacturers, who now recognize there is a big market for their products – from spine boards to high-end automated external defibrillators to software for computer-aided dispatch.
The global EMS market size was valued at USD 21.4 billion in 2019 and is expected to register a CAGR of 7 percent over the next six years, estimates Grand View Research. Increasing demand for emergency care, rising incidence of trauma, and increasing healthcare expenditure across the globe are the major driving factors for the EMS market. The basic life-support (BLS) segment accounted for a major share of the global ambulance services market.
The global ambulance equipment market is expected to expand at a CAGR of 3.3 percent by 2026, predicts Coherent Market Insights. Continuous technological advancement, increasing incidence of chronic disorders, and increasing road accidents are a few factors responsible for the market growth. Increasing adoption of portable oxygen concentrators by ambulatory or emergency medical services to meet the growing ambulatory oxygen needs of patients during surgeries, in turn, is reducing the healthcare burden and is expected to have a significant effect on ambulance equipment market growth. Introduction of ambulance drones in the near future may also provide huge opportunities for adoption of ambulance equipment and thus, transforming the delivery of healthcare services.
Manufactures in the ambulance equipment market are focused on expansion of their products through partnerships to various regions. Moreover, established and new players are launching new and advanced ambulances and services to provide high level of comfort and medical services to patients.
India, China, and the US take the lead in the total number of ambulances that respond to stroke calls. However, the number of stroke cases is much higher than the calls that are actually answered by ambulances. To reduce the severity of this problem, healthcare providers in the ambulance services landscape are increasing the availability of tele-EMS.
Companies in the ambulance services market are helping healthcare institutions introduce reimbursement incentives. With the help of tele-EMS, healthcare providers can educate patients about the various financial incentives available and offer them a wide range of transport options in case of emergencies. Efforts are being made to implement new reforms in the delivery system to provide patient-centric and cost-efficient care, so that patients need not suffer due to increasing costs of pre-hospital care.
Technology will have an impact on every part of the patient journey. In 2030, there will be interconnected, transparent medical records that will be available to the people who need to see those records in the setting where they need to see them. When an ambulance is called, both the ambulance driver and the receiving hospital will already have a very clear idea about a patient – medical history and medical needs – even while the patient is still en route to the hospital. It is not just that electronic medical record (EMR) will be available online; it is that with AI, the EMR will be tailored and curated to the setting, which will result in faster and more accurate care.
For example, in an ambulance, what the ambulance worker really cares about is whether the patient has a medicine allergy, is on certain medications, or has a medical condition that will require immediate critical care. The receiving hospital will also get that information. And the hospital will have the technology to track the exact location of the ambulance and its estimated time of arrival, as well as the flow of resources within the hospital, like which doctors and nurses are where, and are they busy or not? This will allow the hospital to mobilize the right people to the right location. Another part of the experience that will change in 2030 is doctor-patient engagement.
Today’s technological advances are different from the computerization of the healthcare system in the 1990s, which drew doctors away from patients and toward computer screens.
The next level of digitization will not be tied to a fixed infrastructure, so it will relieve doctors of the need to be stuck to the screen. It will free up their time so that they can engage with the patient. For example, a doctor will wear a small microphone during conversations with the patient, and the history-taking will be recorded. Natural-language-processing models tailored to the doctor’s style will pick up the important keywords, and the history will be structured into a data schema that can be used in the back end and in the EMR.
In the future, AI models will capture and immediately structure the data – it would not be the free text that one sees in EMRs today. Then, if the doctor prescribes a simple drug treatment, EMRs and technology will be able to prevent overuse or misuse of drugs, or side effects due to drug-drug interaction. If a patient needs to be admitted, technological tracking will allow for better flow management so that patients can be moved in and out of the right beds in the right wards. The hospital staff will have much better oversight on which patients are ready for discharge and when, reducing the likelihood of a patient having to line up in the corridor, lying on a gurney, while waiting for a bed to be freed up.
Another way that technology will help in the future is that if anyone need to go into the operation theater for a type of surgery that is not performed often by the local doctors, an expert surgeon in another location can conduct the procedure using robotic surgery and 5G connectivity. These technologies will be game changing – they will break down the four walls of the hospital by enabling greater access to clinical resources.
As emergency equipment becomes more and more miniaturized, ambulances will have more life-saving options on board for patient monitoring and care. And in some larger cities with traffic congestion problems, ambulance providers are experimenting with motorcycle response units to circumvent stalled traffic, arriving to stabilize a patient until the ambulance arrives on the scene.
One thing is clear, thanks to innovative designs and new technology, ambulances will become more and more sophisticated, and life-saving care will continue to improve patient outcomes.
EMS – Poised for growth
After the induction of new Ambulance Code (AIS-125) in India for ambulances, the function and constructional requirements of ambulances have improved significantly in Indian EMS system. The majority of equipment and devices used in Indian Type A, B, C, and D ambulances are at par with the international, European, and American standards. The devices like stretchers, spinal boards, pick-up stretchers, suction, and ventilators are now 10G crash-certified and their fixations are AIS 125-certified, making Indian ambulances safer for patients and operators.
The demand for upgraded EMS has been rising steadily in India. We now have a common access number, formation of AIS 125, trained paramedics, gradation of ambulances and hospitals, network of hospitals, and physical and human resources training centers for better EMS service. This helps save lives by making access easy for all the patients. Methods, technology, personal skills are standardized in emergency services to provide protection for the providers
In India, we are now using stretchers, which are EN1789- and EN1865-certified, and designed for use in ambulances specifically. This is the reason that advanced equipment manufacturers are growing over the years. The stretchers are 10G- and 20G-certified as per the European norms. Trained technicians or paramedics provide first aid to the patient, i.e., pre-hospital care, and shift the patient to an appropriate facility. Earlier EMS were being provided only with road ambulances, but now we have fully equipped air ambulances, with vacuum mattresses and extrication devices. ALS kits with specialized bike ambulances handle cardiac, burns, and first-aid situations, and these ambulances are used by healthcare groups, state governments, and leading hospitals.
Although there has been a considerable improvement in emergency services in India, but there is still a long way to go before a comprehensive EMS is implemented across the country. Available emergency services are not sufficient to meet the demand as a large number of advanced ambulances are still needed to cover the entire population, and empaneled health facilities/hospitals, training, and innovative devices as AIS 125 are required to be used in EMS.
NGOs and hospitals have come forward to provide their own EMS. There have been considerable efforts by states across India to develop emergency services. Introduction of latest norms as AIS 125 ensures a mix of state-of-the-art devices that improve safety and reduce trouble for professionals in pre-hospital EMS and improves patient safety in ambulances; this is why 10G is so important for ambulances, patients, and their operators.