India's 10-min ambulance for emergency medical services: An architectural transformation linking household to hospital

India's 10-min ambulance for emergency medical services: An architectural transformation linking household to hospitalIn India, a prominent quick commerce company has recently implemented a 10-min ambulance service for emergency cases, 1 which could be seen as a global precedent.This 10-min service model, parallel to the company's successful large-scale 10-min grocery and essential delivery model, can be availed using the same quick commerce app, requiring only a smartphone and internet access.Designed for rapid, free medical assistance, this addresses a major gap: in India, most emergency deaths occur before reaching the hospital, not after.2 Strong evidence demonstrates this pre-hospital pain point in India.About 30% of trauma deaths occur before hospital arrival in India.Despite experiencing the world's highest road traffic crashes, over 80% of crash victims miss the golden hour. 2 Only 43% of emergency cases reach the hospital by ambulance.3 Only 7% of head-injury cases are reached within the first hour, and only 12% of stroke patients use ambulances.The observed response times for highways are generally 25-35 min, whereas the average in urban India is 30 min.4 This new model demonstrated strong value despite being young and limited to a few cities in India.The service was initiated experimentally with just five basic life-support ambulances in Gurugram areas, located southwest of New Delhi, India's capital.Within its first year, it expanded to a fleet of 25 basic life-support ambulances and now has 47 ambulances, with services expanded to selected areas of New Delhi (Figure 1).As such, the service has expanded to cover highdensity urban catchments characterized by heavy traffic burden and prolonged conventional response times.Publicly available information suggested over 4200 total cases attended with an 87% on-time arrival rate. 1 However, the company's disclosure indicates 21,705 attended cases to date. 5 In global emergency medicine doctrine, care now operates under a universal principle in which outcomes are measured by treatment quality and the probability of timely access.This is reflected in international consensus statements that survival from out-of-hospital cardiac arrest increases dramatically when immediate intervention occurs for instance.6 As such, without a timely first contact interval, definitive hospital care becomes irrelevant.Within this framework, India's model stands out for introducing a distinct architecture for consumer-triggered digital dispatch