Abstract
One of the most important health care services is emergency medical service as it plays a vital role in saving people's lives and reducing the rate of mortality and morbidity. Over the last years, many review papers have discussed emergency medical services (EMS) location problems, however, only few review papers consider the full range of EMS systems. This review paper tries to fill this gap. Our review introduces the concept of emergency care pathway following the current trend in health care systems, i.e., shifting the central role from health care providers to patients. Considering the emergency care pathway, we provide a broad literature review and analysis in order to identify emerging challenges for future research.
1 Introduction
Emergency medical service is one of the most important health care services as it plays a vital role in saving people’s lives and reducing the rate of mortality and morbidity. The importance and sensitivity of decision making in the Emergency Medical Services (EMS) field have been recognized by operations research scientists, EMS planners, and health care practitioners who studied many problems arising in the management of EMS systems since the 1960s.
Locating EMS vehicles has been widely studied as is shown by numerous review papers that appeared over the last years. One of the first review papers that addressed EMS location models is the paper of ReVelle et al. [1]. Brotcorne et al. [2] presented a review paper on ambulance location and relocation problems, and classified the existing models in three main groups: static and deterministic models, probabilistic models, and dynamic models. Goldberg [3] surveyed operations research models for the deployment of EMS vehicles while focusing on modeling aspects and problems assumptions. In these review papers, challenges posed by real world applications, potentials gaps in the literature, and new trends have been addressed.
9 Big EMS, big data, big challenge
In the previous sections, many challenges were highlighted such as those arising when dealing with the problem of incorporating equity and uncertainty aspects, the need for reliable forecasts and new methodological hybridizations.
In our opinion, the biggest challenge is to adopt a holistic outcome-based approach for the ECP, which should be conceived as a methodology that details all decisions, treatments, and reports related to a patient. From this point of view, one of the main difficulties is the collection of information regarding all events involving the patient before, during and after the EMS intervention. Usually, EMS systems collect a large amount of data, but this does not include data on what happens before and after the involvement of an EMS vehicle. Therefore, the main challenge is to develop new reliable models (probably hybrids and supported by new ICT solutions) that are capable to represent the inherent complexity behind the definition of an ECP.
