Registration Name : eINDIA2011/AN/280
Project Category : eHealth::Best Civil Society/ Development Agency Initiative of the Year
Project Name : GVK EMRI 108 Emergency Response Service
Details of Applicant
Name : Subodh Satyawadi
Address : GVK EMRI, Devar Yamzal, Medchal Road
City : Secunderabad
State : Andhra Pradesh
Country : INDIA
Zip Code : 500014
Details of Project/Implementing Agency
Name of Organisation : GVK Emergency Management and Research Institute (GVK EMRI)
Address : GVK EMRI, Devar Yamzal, Medchal Road,,
City : Secunderabad
State : Andhra Pradesh
Country : INDIA
Zip Code : 500014
Name of the headÂ of Organisation : Mr. Subodh Satyawadi
Website : www.emri.in
Brief description of theÂ programme/project/Initiative :
â€œ108 Emergency Response Serviceâ€ is an unique innovative Pro-Poor, not for Profit service delivery model to provide Emergency Response and Emergency Health Care Services across India.â€ â€œ108â€ provides an integrated emergency response 24 X 7 for any type of Emergency -Medical, Police, Fire through easy to remember – Three digit, toll-free number â€“ â€œ108â€. GVK EMRI is a Pioneer of Emergency Management in India, wherein 108 evolved with initial model of a Corporate Social Responsibility. The model was later adopted by state governments and migrated to a framework of Public-Private- Partnership (PPP) mode with individual State Governments sculpturing a way forward to become a National Entity. GVK EMRI manages and leverages local government resources for better outcomes to serve the poor, utilizing technology and advanced equipped ambulances to provide assistance in emergency. Providing cost effective solution with a total financial burden of Rupee 1 per citizen per month, the 108 project funding is minuscule in comparison to the overall health budget and State Government expenditure on health. Through a simple, yet comprehensive structure of Sense, Reach and Care, emergency is identified (Sense), a life saving ambulance reaches (Reach) and a trained paramedic provides pre-hospital emergency care (Care) to the victim in distress. GVK EMRI is Registered under AP Societies Act 2001 and GVK EMRIâ€™s 108 Emergency Response Service project is operational in 11 States of India (Andhra Pradesh, Gujarat, Madhya Pradesh, Goa, Tamilnadu, Karnataka, Uttarakhand, Assam, Meghalaya, Himachal Pradesh, Chhattisgarh) and will be soon operational in Uttar Pradesh as well as two Union Territories â€“ Dadara & Nagar Haveli and Daman& Diu.
Why was the project started :
Innovation acknowledged and appreciated popularly as â€œ108â€ was necessitated by the fact that more than 4 million deaths per annum occurred in emergency situations. Many lives could have been saved but were not, for want Emergency Response Service (ERS) in the states and the entire country. India has an estimated 4,00,000 medical, crime or fire related emergencies per day. Of the 4 Million deaths reported every year, 80% victims are at the bottom of the pyramid and 80% of these deaths occur in hospitals within the first hour of admission after the emergency necessitating the requirement of a service such as 108 which is free of cost to the end user and available at any place, any time. The â€œ108â€ project was conceptualized and implemented to confront the requirement of â€¢ Access (One single toll free number to dial incase of emergency) â€¢ Availability (Availability of Life Saving Ambulance to reach victim and transport to nearest and appropriate health facility). â€¢ Affectionate Care to be provided on site of emergency by trained paramedics with compassion and focus towards Saving Lives) and â€¢ Affordability of the emergency services by every citizen independent of income, religion and community. Accidents and emergencies occur on a daily basis. These are individual emergencies that can be scaled down with proper education and awareness; however, they cannot be eliminated. For a robust health care delivery model, each country requires an organized emergency response mechanism in place. To address this issue of timely assistance, organized approach and appropriate channelizing of resources in an emergency, a streamlined operating service such as 108 initiative was implemented. Science and technology have created a new age today with a world of high speed and reach in every corner; this necessitates in-tandem emergency assistance. The developing countries like ours are grappling with serious issues of emergency handling, maternal and child mortality, epidemics, long standing illnesses, lack of medical aid to those at the bottom of pyramid. Government of India and various State Governments are actively working for achieving World Health Organization (WHO) supported Millennium Development Goals (MDG). An improvement in these key indices for health development necessitates a reliable emergency response such as GVK EMRI and care system to support the initiatives in this direction.
GVK EMRIâ€™s vision is to respond to 30 million emergencies, to save 1 million lives annually and to deliver services at global standards. Improving health, quality of life and reducing poverty has been the larger vision behind inception of GVK EMRI. Spearheading the mission of â€œSaving Livesâ€ and integrating the larger objective of GVK EMRI to provide the â€œRight to Safetyâ€ for common man, â€œ108â€ project was founded to provide an end-to end solution in the hour of need to the distressed.
Target group : GVK EMRI has set path breaking precedent for all in health care domain to innovate, collaborate and implement initiatives effectively, targeted towards community at large. Looking forward towards making these services available to every citizen of this country, empowering a sovereign republic of India to manage emergencies with a service, by the people, for the people and of the People, GVK EMRI envisages a service delivery with high quality and standards.
Geographical reach : Transforming Emergency management with its presence in 11 States of India, the 108 project proceeded from a fleet of 70 ambulances in 2005 serving 14 million population living in 27 cities and 50 towns of Andhra Pradesh to safeguarding lives of more than 372 million people with 3,006 ambulances in present day. 108 shields 40 % of the Indian population and as on October 2011. Having responded to more than 1, 30, 04,000 emergencies, 108 interventions have saved 3,55,126 lives in critical condition. With Impressive metrics, 108 handles 1 Emergency every 8 seconds and Saves 1 Life every 8 minutes. â€œ108â€ Project is presently implemented successfully in areas of foot hills of Himalayas (Uttarakhand and Himachal Pradesh), flood prone areas of Assam and Andhra Pradesh; Tribal areas of Chhattisgarh, Andhra and Madhya Pradesh; Desert areas and varied geographies of Gujarat. This demonstrates that this intiative if strategically managed as by GVK EMRI can be in totality operated in diverse agro-ecological zones, different social structures and communities. Strengthening mega urban agglomerates to assisting population in cities, semi urban areas, rural and tribal belts, from flat landscapes to the hilly and mountainous regions, crusading health care for children, women and men, 108 has hammered barriers across all strata to define a sustainable, replicable model suited for our Indian spectrum.
Date from which theÂ project became operational : 15 August 2005
Is the Project still operational : YES
10 points that make the programme/project innovative?
- Unique Integrated Emergency Response Service for Medical, Police and Fire emergencies through single universal toll-free number â€˜108â€™ which can be dialed from any landline or mobile. Transforming emergency management with this unique integrated emergency response enabling Medical, Police and Fire assistance in an emergency situation, the 108 number empowers citizen to receive emergency services and provides rights towards safety. In a short span of time, 108 has become a powerful brand with high recall amongst masses from educated conscious citizens, young children to the illiterate. 108 Emergency Response Services has strengthened state government efforts of unified multipronged approach in situations of man-made and natural disasters for providing on scene and en-route care as well as evacuation of the victims to hospitals.
- GVK EMRI operates in a Public Private Partnership (PPP) framework wherein respective state governments provide funds for Operational and Capital expenditure. The funds are utilized and managed for emergency response in the state for better outcomes and to serve poor. GVK EMRI as Private Partner brings leadership, innovation, execution and technological capabilities with collaboration and Research Intelligence, Training, Knowledge transfer and Quality assurance.
- 108 Service is free of cost to citizen (end user). Burden of One Rupee / Citizen / Month is borne to exchequer which if correlated, is lesser than any state or national budget on health. Comparing with advanced countries like the USA, one ambulance trip of GVK EMRI ambulance amounts to 13$ – 16$ as against one ambulance trip in US relating to 600$ to 700$. Poor, under privileged truly benefit from the 108 service.
- GVK EMRI has woven together the latest telecommunication, computing, medical, and transportation technologies to provide affordable (free) emergency services in tribal, rural, and urban areas. Technology is an enabler to take the operations of 108 services to global standards. Public Switching Telephone Network, Servers, Data networks, Computer Telephony Integration, Telephone ERS, GIS database, specialized applications, Voice loggers are utilized extensively for streamlined operating service. Computer communication toolkit assists in immediate call answering, collection and record and relay of information. Geospatial information system direct immediate incident identification and Geographical positioning systems (GPS) as well as automated vehicle locating technology (AVLT) map ambulances for speedy assignment. Combined cutting edge technologies (telecom, computing, medical and transportation) to create new capabilities for the first time in the World). Supporting video presentation displays technological capabilities at GVK EMRI
- Suitably crafted and designed model involving Sense Reach and Care functions with a turn around feedback after 48 Hours. This is the backbone in handling each emergency. Emergency is identified (Sense), equipped ambulance reaches (Reach) and trained paramedic provides pre-hospital (Care). This exceptional structure encompasses a paradigm of end to end approach to emergency. Beneficiary feedback is obtained for analyzing and improving performance
- World class equipped ambulances suited for Indian terrian support in expeditious transport and quality prehospital care. State of the art ambulances with focus on public safety and comfort for attendants is furnished with life saving equipment and supplies. Advance life support ambulances possess multiparameter monitor, defibrillator and ventilator. Critical cases of cardiac and trauma emergencies requiring urgent identification can be supported by ERC physicians with help of telemedicine. Pharmacological agents in need of hour for patients like snake bite victims are available in GVK EMRIâ€™s ambulances.
- Capacity building to keep vitality and vigor of 108 happens through training which focuses on qualitative pre hospital care. Development and grooming of cadres as Communication Officer (CO) to receive calls, Dispatch Officer (DO) to designate the ambulance to handle emergency, Emergency Medical Technician (EMT), a paramedic working in the ambulance providing care at scene and en-route to hospital teaming with the ambulance driver, called Pilot who as well is trained in simple skills. Internationally known as the On Line Medical Direction (OLMD), guidance online is a cardinal piece in pre-hospital care. At GVK EMRI, Emergency Response Centre Physicians (ERCP) stationed at the Emergency Response Centre (ERC) are available 24X7 to advise the Emergency Medical Technicians (EMTs) and support in all cases. Similar steps education in Emergency Care initiated to strengthen backward and forward linkages in society and bridge gap of understanding protocols.
- Collaborative interface with Government machinery, media, medical fraternity and public for continued has enabled GVK EMRI on consolidating the present achievements and leveraging resources for an inclusive growth. Collaborating with national boards, international organizations, GEO MED, Germany for Emergency Data Based Surveillance, world leaders, academic institutions like Stanford School of Medicine, USA for post-graduate education and certification of emergency care ensures next level of gaining stature in trained personnel creation.
- Detailed processes with explicit guidelines and set measurables ensure uniform qualitative outcomes. Periodic auditing with review of performance generates avenues for constant upgrading, further refinement, innovation and development.
- Extra mile efforts of GVK EMRI have delighted beneficiaries, stakeholders and governments by active involvement in state programs, synergizing to optimize health initiatives of the state and strengthening infrastructure for growth.
List the 5 achievements of the programme/project
- 108 has impacted more than 40 crore people spread across 11 states with fleet of more than 3006 ambulances. 16596 associates in GVK EMRI team identify themselves with mission of saving lives. As on October 2011, 108 has responded to 1,30,04,000 emergencies and has saved 3,55,126 lives in critical condition. In around 4% of all pregnancy related transports, emergency deliveries assisted on scene and while en-route in ambulance have brought smiles to families of the mother and child. Major killer emergencies such as Pregnancy related maternal and child emergencies, Trauma, Cardiac, Respiratory, Poisoning and other EMs are dealt with care, passion, professionalism and patience. (Client certificates from each operating state attached for deeper understanding)
- Popularity of 108 and mass appeal across all sections of society has made 108 a lifeline for people. GVK EMRIâ€™s 108 Service is a boon to the people. An efficient work mechanism with path breaking speed which has benefitted multitudes and is creating value for the society has been appreciated by all sectors of society including Media and public at large. The bureaucratic network has endorsed GVK EMRIâ€™s innovation, recognizing the potential of these services. Diverse entities, International Agencies such as the CEDPA, Senior Government officials and opinion leaders such as Shri Amit Mohan Prasad, Jt. Sec. NRHM GoI, Dr. K Venkatesh, IGP, Maharashtra, with independent view of thought have expressed their appreciation for the 108 project. Medical experts, Dr. Williams K Mallon, Director, Div. of International Medicines, University of South California, and many others have commended the prehospital care innovation and heralded the advent of revolutionary Emergency Response Services, in India. (Above observations can be perused in the attachment â€“ Experts Speak)
- Contribution in reduction of Maternal and infant deaths across operational states by expeditious transport of pregnant ladies and safe assisted delivery option while enroute in impending delivery situations. GVK EMRI has thus safeguarded lives of young mothers and babies. Maternal mortality remains one of the most daunting public health problems in India and reduction in maternal mortality has been identified as a prominent component in the millennium developmental goal which is further reflected in the National Rural Health Mission. With present Maternal Mortality Ratio (MMR) at 301 per 1, 00,000 live births in India, a pragmatic strategy of maximizing institutional deliveries GVK EMRI has enabled the public healthcare system to reduce the MMR by approximately 20 â€“ 25%. â€œThree delaysâ€ of delay in deciding to seek care, delay in reaching care, and delay in receiving adequate treatments is significantly reduced through GVK EMRI innovative approaches. (Strategy towards achieving Safe Motherhood in India â€“ Case Study) GVK EMRI has been instrumental in improving overall health system through utilization of healthcare facility.
- Notable appreciation by late Dr. C. K. Prahalad terming GVK EMRI â€œGandhian Innovationâ€ in the Harvard Business Review (Issue Jul â€“Aug 2010) for synthesizing technologies (telecom, computing, medical and transportation) with commitment to serve the unserved has been a feather in cap of GVK EMRI. ( Attachment of Harvard business Review article uploaded for perusal)
- Receiving accolades from various quarters, GVK EMRI was recognized by CSI Nihilent e-Governance Special Jury Award â€“ 18 Dec 2008, NASSCOM – CNBC Best IT User Award Dec 2008 and Award for Excellence in Disaster Management, 2008 from DMICS. In 2008 GVK EMRI was appreciated as the â€œBest NGO Initiativeâ€, 2008 by E-India Award as well as Best NGO Award â€“ICONG in 2010. Microsoft foundation awarded the Microsoft Citizenship Partner of the Year award, 2007 and Presidential NENA Award during NENA Annual Conference, 2007 for utilizing technology. (Award is highlighted in supporting GVKEMRI corporate presentation and corporate film) Piramal Prize – 1st prize awarded for, â€œDemocratizing Health Careâ€ in established organizations category by Centre for Innovation, Incubation and Entrepreneurship (CIIE), of the Indian Institute for Management-Ahmedabad (IIM A) and Ajay G. Piramal Foundation. The award reiterated the scalable, replicable, impactful people centric processes and activities of GVK EMRI.
List the 5 key challenges faced while implementing the programme/project/initiative
- Partnership with individual state governments was achieved through transparent approach, streamlined processes and cost effective policies with people focus.
- Involving all sections of government machinery including Police and Fire wings with regular interface and mutual understanding for knowledge sharing
- Challenge of prompt response time for Urban & Rural areas confronted with strategic ambulance placement based on population load and emergencies in particular area, analyzing time variation and external factors of influence.
- Creating capabilities in terms of trained manpower for Emergency response centre (ERC) & ambulances with essential knowledge and skills to provide care at par with global standards
- Public sensitization of 108 number for emergencies was overcome by regular local community awareness demonstrations, activities for information in schools and villages, regular communication at gram panchayat and taluka levels.
List the 5 points how can the programme serve as a model that can be replicated or adapted by others?
- Partnership with government, domain experts and allied key functionaries to bring in innovations of futuristic value.
- Research and analytics wing to monitor, forecast and strategize for impending emergencies. Evidence based understanding shared with stakeholders to eventually prevent and control emergencies.
- Distinguished efforts on training and developmental activities to take overall healthcare to next level with capacity building.
- Surging past barriers of cultures, religions, caste, economics and genders GVK EMRI has demonstrated and equitable service model for all.
- Robustly linked Sense Reach and Care model involving technology in all aspects
List 5 points to elaborate on the scalability of the programme/project/iniative
- Cost effective optimum resource utilization for ensuring sustainable operations.
- Managing and leveraging government resources, synergizing strengths of public and private sectors made this unique project being identified with high speed, scale, replicable status conquering challenging geographies, infrastructure, cultures and medical facilities in developing stages.
- Processes and standardized protocols for all operational wings. Well defined documentation ensuring precision in service delivery
- Extensive application of technology to provide equitable healthcare to all at all times.
- Flat organistional structure enabling employees towards exponential performance.
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