Market trends in the emergency response sector
I believe words like ‘unreliable’, ‘unresponsive’ and ‘unregulated’ have been closely associated with medical transport in emergency response services in India. Today we have apps to track our food , but not ambulances. About 10-12 years ago, the medical transportation industry was limited to the state government providing services directly to the general public. We have seen many gaps in these services, with the government working on public-private partnerships with a few private organizations to provide such services.
However, we felt that there was a significant lack in terms of ambulance accessibility, maintenance and the availability of highly trained paramedics to provide pre-hospital care within these ambulances. I believe that over time many private ambulance service providers have come into place in each of these states in the cities, especially the tier one and tier two cities. The reason why private ambulances came is because of the demand for ambulances and also the demand for high quality ambulances I believe. These private ambulance service providers have also recently been regulated by the government under the AIS 125 standards to ensure that there is standardization and regulation in the medical transport service industry today.
Currently, I think players like us, Medulance, who use something as simple as geolocation, the proliferation of smartphones, and the scanning of medical records to shave minutes off response time, have been very successful in providing fast and reliable emergency care. Not only have we been able to use a network of ambulances across cities, but by using something as simple as geolocation we are able to dispatch the closest ambulance possible to a person’s vacation. , which I believe is key, because I believe that help should be given when it matters most. So I believe that the ambulance industry today, even if we consider the market for ambulance services run by state governments today, is a billion dollar industry. And overall, if we talk about integrated pre-hospital care services, which include not only ambulances, but also medical rooms and training services for paramedics, we can definitely say that the industry is worth about $5-6 billion in India alone, and around $75 billion worldwide in this case.
What are the challenges of the emergency response industry?
Speaking of the challenges in the emergency response space, I believe the number one reason why someone is unable to provide a scalable solution to the ongoing problems in the country is that it is not not a recurring service. It’s not like in the taxi industry, where it becomes very difficult to establish immediate recall, because the general customer needs the service maybe tomorrow or not, maybe in the next 10 years. Therefore, it becomes very difficult to maintain a reminder in mind over a period of time.
I believe that challenges have always existed with public services, of which I have already pointed out the quality of paramedics, the quality of ambulances, the lack of technology in emergency response, and I also believe that the lack of awareness citizens a did not allow people to get fast and reliable help. Over time, significant developments in technology, I believe also in medical devices, have helped us to improve the emergency response landscape in the country.
COVID-19 has exposed the challenges of the emergency response space, not only in India, but I believe, worldwide. What we have also seen in the second wave of the pandemic is that, in addition to the lack of availability of ambulances, paramedics and doctors inside the ambulances, there has been a significant increase in times admission to hospital. This therefore means that the patients themselves spent a lot of time in the ambulances outside the hospital. As a result, the average hospital stay has increased to around two to three hours, which is usually around 30 minutes. As a result, the already existing ambulances have become increasingly rare.
What are the lessons of COVID-19 in the emergency response sector?
As a result, the COVID training we received was significant. First, we realized there also needed to be a data-driven approach to emergency response. In a data-driven approach, we felt this should be handled in two parts. One is on the workforce management side, so we have enough call center executives to meet any spike that the third or fourth wave might see. Furthermore, we also believe that a data-driven approach should be considered for the ambulances themselves. So we can strategically place these ambulances across locations, especially where we see hotspots or high spikes in cases. So we are already better prepared.
I believe that coordination with hospitals today is very important so that we know where the beds are available. So there must also be a data-driven approach, so that the availability of hospital beds is highlighted on a dashboard made available to emergency response services. Thus, such a situation never occurs when an ambulance stands outside the hospital with a critical patient for two to three hours.
Medulance: Journey So Far
So we started in 2017 and it is very important to understand why we started. It was also the lack of an efficient ambulance service that led to the death of one of my co-founder’s grandfathers due to the unavailability of ambulances in 2010. So in 2016 we achieved that platforms like Ola and Uber had come to use something as simple as geolocation, given the proliferation of smartphones. We thought, why can’t we do this in an industry where problems are much more prevalent? Like I said, the industry was unresponsive, unregulated and unreliable, so it’s very important for a company like ours to find solutions that are scalable, local, and address the problem that existed in the country.
We started by consolidating private ambulance service providers in Delhi NCR. We realized that we could quickly verify the legality of these ambulances in terms of registration certificates, drivers and paramedics with valid licenses to board a fleet of approximately 350 high quality ambulances in the city of Delhi to begin with. We also learned something very quickly. We realized that this is not a general B2C model, even though we serve the general public, because I said people don’t need ambulances on a regular basis. It becomes very difficult to form a priority callback as it is not a recurring service. So we moved to a slightly B2B model to ensure we had a similar impact by targeting the same population. while ensuring that it is a sustainable business model. It can go on to impact millions of lives over a period of time. To do this, we began working with organizations, employees of organizations, insurance companies, and even tapping into large-scale residential companies to find a captive audience. So that we can not only provide fast and reliable help, but also ensure that we have a captive audience who know where to turn when help is most needed. Today, we have a subscriber base of around 50 lakh subscribers and a fleet of around 5000 ambulances in 40 cities across the country. We have been able to save and assist over five lakh lives and around one lakh plus suspected COVID positive patients till date. Thus, medulance has made significant progress over the past four years.
What are Medulance’s future plans?
We started in 2017. We were also able to become profitable in FY1920. We saw a 5x increase in revenue and a much larger increase in lives saved between FY19-20 and FY20- 21. Today, Medulance has a fleet of around 5,000 ambulances spread across 40 cities and has saved or assisted over five lakh lives, including over one lakh COVID suspects and positive patients. What we want to make sure is that we want to continue to work in partnership with state governments. We have had a successful partnership with the government of Delhi. In fact, we want to continue to make sure that we can take our model to at least two more states over the next two years. We want to add a fleet of around 5,000 more ambulances and even reach more tier two and tier three cities today.
Medulance continues to be a profitable entity. The idea is that we want to make sure that we are not acting as a social service, but continue to impact millions of lives in the emergency response sector over the years and we want to continue to do it. We also want to start an air ambulance service. We believe that a reliable and affordable air ambulance service can have a significant impact. What we need to do is integrate the right kinds of charter companies and medical personnel to make the service more reliable and affordable for the general public. Medulance also wants to make sure that we can continue to work with insurance companies and organizations so that we can continue to create a captive audience, as I said, so that they know where to go when the help is most needed.
