Professor Lavanya Marla addresses complexities in emergency health care in India

11/4/2015 Emily Scott

An engineer brings to bear the full scope of her systems knowledge to address a problem affecting the health of billions of people

Written by Emily Scott

<a href="/directory/faculty/lavanyam">Lavanya Marla</a>
Lavanya Marla

Assistant Professor Lavanya Marla’s research has always been inspired by real-world problems.

Now that she's received a grant from the Indo-U.S. 21st Century Knowledge Initiative, she has the opportunity to research an important real-world problem surrounding the challenges that have arisen from the development of emergency medical service systems in India.

The Indo-U.S. 21st Century Knowledge Initiative provides grants that allow researchers at U.S. and Indian institutions to collaborate on projects that link the two societies. As PI for her project, Marla is collaborating with associate professor Milind Sohoni (Co-PI) from the Indian School of Business.

Their project is formally titled “Cooperative-competitive, data-driven, operational strategies for extremely resource-constrained settings in emerging economies.” They aim to study and address the challenges within the emergency medical service systems in India.

A centralized 911-like system like in the U.S. did not exist in India until a few years ago. India’s current emergency medical service system works as a private/public partnership. Private companies bid for services, which can create a competitive atmosphere.

But because this system was created so recently, Marla said many Indian citizens are still not aware that the system exists. Many decide to use their own modes of transportation or call a hospital directly.

Many challenges can arise in this environment, including service delays, wastage of resources, and low reliability on the ambulances. Health outcomes could also potentially be affected.

“This problem is rich enough that it’s got a technological requirement, there’s a business need, and there’s a governmental policy aspect to it,” Marla said. “It’s got all the angles that you really need for a rich enough and broad enough real world problem.”

Marla said she decided to launch this research since she had previously collected data on this problem and had talked to government officials and some private providers.

“I got a good sense of the problems,” she said. “Having spent the time to see what people are doing … gave me a good sense of what kind of research questions I needed to solve the real world problems.”

Marla’s research aims to learn more about these problems by corresponding with all stakeholders, getting them to communicate better with each other, and seeing if any solutions can arise.

This past summer, Marla began her research by meeting with these stakeholders — including government officials, policymakers, and private ambulance providers — in five different Indian states to figure out what issues need to be addressed.

She spoke to private ambulance providers to find out how they operate and what technologies they utilize. Her goal was to figure out the nature of the relationship between the government and the private providers.

During this time, she was also collecting data on the private providers’ experiences and on the public’s acceptance of their services. She discovered that there is a strong behavioral component behind this complex situation that involves belief systems and specific human characteristics.

Marla said one of their research agendas moving forward includes understanding and characterizing this human behavior.

“We can see from the data and find out what kind of characteristics of people make them call competing ambulances,” Marla said. “This is looking at economic, social, a whole bunch of factors. We also want to see what characteristic can make the system far more favorable to use.”

Moving forward, they plan to hold a workshop next year that will allow government officials, policymakers, and private providers to come together and hopefully set a plan in motion.

“We believe that bringing them to the same table and showing them the data will at least spark off a conversation to say: ‘this is what needs to be done,’” Marla said.

Currently, their main goal is to address and study the smaller questions surrounding these emergency medical service systems. Moving forward, Marla hopes they can make an impact on these systems, but that may make many years.

“There are not many people in India working on this problem,” she said. “I think we are in a very good position to study these questions, because the U.S. doesn’t have the same exact setting … We have some very unique research questions. At the same time, we also have a unique opportunity to potentially make an impact and at least get people started to ask the right questions.”

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This story was published November 4, 2015.