Kolkata Medical Emergency System & Services (KMES): An efficient, responsive, integrated & sustainable model of Medical Emergency
Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.
Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.
Spread Strategies: Moving forward, what are the main strategies for scaling impact?
Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?
Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?
Founding Story
Team
Rajib
Sengupta
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, Kolkata
, Kolkata (Next city is Bangalore)
Friends and family, Individuals, Foundations, NGOs, Customers.
Developing relationships with local govt & providers rests at the center of KMES approach.Several Hospitals,Ambulances,Blood Banks are already part of KMES. While Govt. support has been obtained, a policy by Govt advising KMES adoption,will make it more impactful."Doctors For You" is our partner in Paramedic Training. For Technology we are partnering with Opensource communities(e.g:DHIS2,OpenMRS,Sahana, OpenDataKit) to stop recreating the wheel.
We rely on a simple assumption:Instead of competition let’s collaborate where collaboration should not be limited to institutions, but should also empower & involve citizens.We empower citizens with easily accessible realtime information,a responsive emergency centre, community emergency training,dos & don'ts in road accident & implicitly nudge them towards Good Samaritan Practices which we hope, by public pressure will be a law(goo.gl/JHuZEJ)
Active citizenship: Projects that work to promote active engagement with road safety from individual citizens, pedestrians, communities, and social networks, or that use education as a tool to raise awareness and promote engagement, Technology: Projects that leverage technology to promote road safety, Infrastructure: Projects that address road or administrative infrastructure, emergency care, or financial systems.
Yes
The project due to its unique & innovative,yet practical & feasible concept is seen as a bottom-up solution for medical emergency which can be replicated across cities in India where emergency service is provided by varied emergency service providers with varying capability in absence of govt sponsored medical emergency system(e.g:911 in USA).Realizing the immense potential of the idea during medical emergency not only in Kolkata,but in any cities of developing countries,the project has been awarded three prestigious awards-1)Rockefeller Foundation Centennial Innovation Challenge award in 2012(http://goo.gl/dp5vYN) 2) 2nd Prize in Emergency HealthCare innovation in the Country’s leading Emergency Service Award program conducted by AIIMS New Delhi in 2013, and 3) Recently, Grand Challenge Canada Stars in Global Health(http://goo.gl/3LWy9g).Bangalore has very similar emergency healthcare scenario where emergency services are provided by multiple isolated providers each with varying capability. While in the Hospital infrastructure side, the situation may be a little better compared to Kolkata, but the medical emergency care that starts at the site & stops at the door of the Hospital is pretty much similar.Such as, no pool of paramedics,no readily accessible information of nearest hospitals with emergency facilities/ICU availability, no blood bank availability info etc and no awareness among citizens on dos and don'ts during road accidents.We have to accept the fact that, Road accidents will remain and with increase in traffic it may only go-up, whether it's Kolkata or Bangalore.As such a centralized medical emergency system in each city is a must for providing the maximum chance for survival of a road accident victim. Due to the complex nature of Indian Healthcare(State vs Central,Pvt vs public),having a governmental centralized medical emergency system is a distant dream while a private org cannot build and sustain on it's own. As such, we need to use the power of collaboration & crowd-sourcing to build a 911 for Indian cities whether it is Kolkata or Bangalore.
Comments
Wonderful idea. Most powerful because it creates a highly replicable model. Indeed, Bangalore could be next with this competition being the perfect opportunity. One area that should be emphasised is how you can share the data you are gathering with other organisations in different cities. I think your data (if you are gathering it approriately) could help other orgs evolve their own programs. Love your collaborative attitude.
Such an informative topic! That is comprehended delivery of the resource for readers and most appreciable.
Sherlock Holmes Coat Wool Cape
Sachin, Thanks a lot for the encouraging comment and a great idea. As you have guessed, the biggest obstacle is
convincing the institutions/organizations to collaborate and share data.At the very onset of the project we identified
the following complexities in a medical emergency system implementation in Kolkata, where emergency care is provided by
multitude of service providers with varying capability. Here are few of the complexities from an Hospital ER/ICU
perspective:
1.Each Hospital has different workflow and it is very difficult to standardize Bed Management
2.The service providers are very heterogeneous when it comes to data & information mgmt
3.All Hospital information management systems are proprietary, closed & isolated. Several of them do not have any
internal IT staff to integrate the internal systems.
4.Though several standards exist for interoperability of clinical data (HL7, CCR etc), none exists for medical emergency
services.
5.No hospitals, Blood banks want to share their Patient data due to privacy and financial reason
6.In-fact, several of them do not want any automated interface between their internal system and KMES due to fear of
theft of patient list
7.And finally, several of the Hospitals manage the beds using paper tickets (known as bed-tickets) and do not have any
electronic system in place
Similar issues exists for Blood Banks and Ambulances also.
We tackled these issues by following few pragmatic approaches:
1.Multiple options to integrate, instead of dictating all to use a specific standard. KMES provides customizable
solutions for each Hospital/Blood Bank/Ambulances to integrate its own data source.
2.If agreed, real time integration with internal electronic systems
3.Easy, one-click update which do not have any electronic bed management system or not willing for automated integration.
4.Minimalistic intrusion to the existing internal system.
5.Only captures Supply chain information (CCU, BSU) without any patients record.
6.Efficient and optimum implementation framework uses Opensource technologies so that the wheel is not recreated.
Importance is given in implementation rather than on technology.
Aside the impact in saving public life, one of our negotiation point with the organization was, we will provide them
monthly, quarterly, yearly report of usage (which they don't have currently), based on which the organization itself can
evolve, make their workflow better etc. Your comment takes it to the next level , where the historical data of one org ,
which is running very efficiently can help the other org.
I have bring this comment to the notice of our Public Health research and communication team and we surely will keep it
in our conversation with the organizations in our continued discussions.
Let's chat more.
Thanks,
Rajib
good idea indeed !!
rescue road accident victim in golden hour is very much important and establishing trauma help is required.
I strongly recommend to implement this project by the government and bring all the Ambulances under one umbrella. Being a Motor Vehicles Inspector I faced some problems in providing Ambulance to the accident victims. There shall be one organization it should receive the calls and allocate the Ambulance, so that it will reach the victim as early as possible. To make this the government has to make some policy on this
Can this be scalable to 108 nationally ? In postaccident scenario, the approach looks practical .
Can this be scalable to 108 nationally ? In postaccident scenario, the approach looks practical . Economic sustainability aspect needs to come out clearer.
Dear Mr Venkichatalam,
Yes. I think this model can be scaled to 108. But we believe that India need a significant modification of the current 108 model. In most of the LMIC cities (including India's 108), the route usually taken to solve the medical emergency problem is to introduce a new Ambulance fleet without fulfilling the pre-requisites, such as paramedic workforce, real-time information from facilities etc. Setting up a city-wide Ambulance system is financially prohibitive (huge capital investment is required) and logistically difficult to implement (competes with existing services, local political issues). Plus, to maintain the quality, they either have to charge heavily or need to be funded by the government, failing which these services soon become unsustainable. The "Ambulance only model" cannot be the solution for a central medical emergency system for a diverse country like India, specifically where Health is a state subject and often implemented under the constrains of local political, economical and cultural issues. In the current 108 model , Government is becoming another ambulance provider, without really creating the infrastructure & resources required to satisfy the golden hour. We think government should provide the appropriate infrastructure and integration points. This leads to the second point of financial sustainability,
We recognized the fact that in a mega-metropolis like Kolkata, government or private, no-one can do this alone. It is financially not feasible and sustainable also. The KMES approach tries to solve this in a financial feasible manner, by NOT introducing any brand new emergency service (and an ambulance fleet). Instead, we are integrating the existing services for better utilization and enhancing / strengthening the services, as required with the proper toolset (Toolset is defined as Product, People or Processes – e.g: Providing Paramedic training, GPS enabling etc.) under the Kolkata Medical Emergency System (KMES) umbrella.
Thanks,
Rajib
It is a wonderful idea to try and replicate 911 in the Indian environment, the concept of immediate and effective paramedic assistance is invaluable.. Unfortunately dense traffic congestion might defeat the purpose of this wonderful endeavor, although In the US once you hear the ambulance sirens, it is mandatory to move aside and let it pass. In India, however,due to the densely packed traffic, there is no space to move. Ultimately the ambulance is forced to sit in traffic loosing precious minutes.Undoubtedly, your idea is a great first step, ultimately, to save our citizens we have to solve the problem of dense traffic issue simultaneously.Perhaps