18.11.2019

With new tech and an old-school helpline, a startup is out to fix India’s ambulance services

In 2013, Antoine Poirson was helping set up a power plant in Rajasthan when an employee was crushed under a solar reflector uprooted by a heavy gust of wind. The man may have survived but the ambulance trip was too long and there were no trained paramedics around.

Poirson never got over the incident—particularly, as he describes it, the “inefficient and unprofessional system which did not perform at all.”

Two years later, in 2015, Poirson met Prabhdeep Singh, who’d worked in the pharmaceutical sector, at business school at INSEAD Paris. The two got talking about the gaps in Indian healthcare, especially ambulance services that can take hours in unyielding traffic. “Having lived through this problem that millions go through in India every year, Prabhdeep’s idea of transforming the industry immediately resonated with me,” Poirson told Quartz. “That’s how StanPlus was born.”

Together with fellow INSEAD MBA student and geospatial expert Jose Leon, Poirson and Singh created a prototype of a platform to aggregate and dispatch life-saving services. The trio went on to win the INSEAD venture competition, securing initial funding of $15,000, which then compelled Poirson and Singh to move to Hyderabad and really get to work.

Today, StanPlus has aggregated a fleet of 300 ambulances that caters to emergency and non-emergency cases in Hyderabad, Vijayawada, and eight surrounding cities, where it has partnered with 15 hospitals to serve 2,500 beds. Using technology—a reliable call centre and efficient routing decisions made using geospatial data—the ambulance service aims to reach victims within the “golden hour” (the first hour after an injury, when emergency treatment is most effective), besides serving families of chronic patients who frequent hospitals.

Driving ahead

India has a severe shortfall of ambulances: only three per thousand people estimated. And three out of five of them may not even be functional.

“Setting up the service is the easier part,” Vaibhav Poddar, head of ambulance and emergency services at Delhi-based Max Healthcare, told Quartz. “The density of ambulances (in the Delhi National Capital Region) is probably higher than those of developing countries, but how many are actually on the road? How many are well-equipped? How many have paramedics and drivers?”

These are the problems StanPlus is out to solve. Every vehicle in the startup’s fleet of 300 has three trained drivers who take turns during a 24-hour period, alongside trained paramedics onboard at all times. The platform aggregates the ambulances of hospitals, private operators, government-run services, and its own—six advanced life support (ALS) ambulances. It then uses geospatial technology, analysing routing and traffic data to station ambulances at calculated intervals, attempting to reach every emergency case in each city it serves within 20 minutes of the call. The eventual target is to bring down the time to 12 minutes.

There is a helpline to book an ambulance. Instead of a smartphone app, StanPlus chose to operate on a call-centre model because “(people) want reassurance that the ambulance is on its way,” said Singh, who now serves as CEO of StanPlus. On average, it receives over 60 calls per city every day, with each one answered in less than 30 seconds.

To manage and operate ambulances on behalf of hospitals and clinics, the company charges them a nominal subscription fee. However, the bulk of its revenue comes from customers. Every time someone calls for an ambulance, they have to foot the bill for the service, which could start from Rs600 and sometimes stretch to over Rs2 lakh.

While it did not reveal its financials, the company said it is growing at over 25% each month in terms of the number of booking requests, as well as revenue. By next year, it expects to be operationally profitable in Hyderabad, and is on track to generate a million dollars worth of bookings overall by June 2018, Singh said.

In October, the medical technology startup raised $1.1 million in its first funding round led by KStart, under Bengaluru-based Kalaari Capital, to beef up its network in Hyderabad and beyond. “The medical transportation market in India is unstructured and unreliable and is ripe for disruption,” Muthiah Venkateswaran, a partner at KStart Capital, told Quartz.

Attention to detail

StanPlus ambulances. (Stanplus)

With its fleet of six ALS ambulances, StanPlus can curate bespoke services.

In the past, for instance, it has readied a fleet of neonatal ambulances, complete with the necessary equipment and paramedics, and transported three babies—a three-day-old, a three-month-old, and a six-month-old child—across 200km within one day.

“If you expect a birth to happen anytime from now to the next 10 days, we can schedule an ambulance to stand 10 minutes away for 10 days,” Singh said. Similarly, repeat patients can book the service for their regular sessions.

The company is now deploying one new ambulance of its own every month in Hyderabad, and plans to continue to add to its captive fleet.

In a country where ambulances are routinely criticised for poor maintenance and subpar equipment, StanPlus is obsessive about quality. The company ensures that its vans are sanitised daily and fumigated every week, and are stocked with all life-saving devices. All drivers and paramedics also periodically go through training.

This attention to detail is something that healthcare organisations appreciate. “Maintaining medical travel vehicles is not our core (business),” explained Vikram Vuppala, the founder and CEO of dialysis centre NephroPlus, where patients must be brought in on a regular schedule for treatment. For healthcare providers like Vuppala, outsourcing transport for its patients is a convenient and reliable option. “If a company is 100% focused on it, (they will) be more efficient and have better service quality around it,” Vuppala said.

However, StanPlus isn’t alone. In the last few years, a variety of similar services have cropped up. There’s Uber-backed Ambee which, earlier this year, launched an app to aggregate and send out ambulances. Ratan Tata-backed MUrgency operates in Mumbai, and claims to ensure ambulance arrivals within nine minutes of making a call in urban areas. For non-emergency needs, there is medical taxi service eSahai, which is available in Hyderabad and Visakhapatnam. The government-backed National Ambulance Service is also active in several states.

But with over $1 million in the bank, StanPlus has the firepower to take on the competition, and give Indian patients the service that they really need.

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