As India advances on its way to being technologically advanced and sufficient, the healthcare sector has to step up and cater to the health needs of people quicker and more efficiently. One of these needs is to provide emergency transportation services to patients who live in remote areas or require immediate medical support that cannot be fulfilled by ground ambulances.

In cases where the patient’s destination might be geographically inaccessible by a ground ambulance, or a quick organ transplant is needed or the congested roads of metropolitan cities act as a hindrance, Helicopter Emergency Management Services (HEMS) are needed to bridge that gap. Additionally, HEMS has varied applications including and not limited to trauma care, emergency pregnancy, disaster management, paediatric transportation etc.

One of the reasons India needs HEMS now more than ever is because of the unfortunate rise in road accidents and other chronic emergencies. Every year nearly 4.5 lakh road accidents occur in India, out of which 1.5 lakh people lose their lives. Additionally, 30 lakh people die of cardiovascular diseases every year, most of which are heart attacks. Timely HEMS could really help save many more lives.

Post analysing India’s market for air ambulance and HEMS, it was identified that such services in India are very scarce and only 5-8 aircraft operators are active in this sector. Moreover, most air ambulance transportation services that are provided are pre-planned and require a great deal of compliance with rules and regulations. Hence, these don’t qualify as emergency quick response services.

In difficult terrains of Jammu & Kashmir and Leh-Ladakh, the Indian Air Force provides HEMS on a regular basis, since there is a serious dearth of hospitals/medical services in such scarcely populated areas.

On analysing the North American market of HEMS, it was found that private players have been very active in this sector. In fact, according to the Federal Aviation Administration in the US, there are currently 75 air ambulance companies that operate approximately 1,515 helicopters.

The global air ambulance services market size was $ 4.1 billion in 2020. Most HEMS are prevalent in North America, mostly the United States. The global market is expected to expand to a staggering $ 9.58 billion in 2028

There are roughly 3 types of business models in which HEMS companies operate. First being the government operated and funded services. Second is the hospital-owned services where hospitals own helicopters and provide HEMS, sending their own paramedics and equipment. Lastly, under a pure community-based model the air medical service typically is owned by the aviation operator, who hires or contracts out medical direction, paramedics and flight nurses, provides the aircraft, pilots and mechanics, and patient billing. Revenues depend to a large degree on flight volume.

Indian HEMS companies could potentially provide more robust services in the near future if provided support through legal, financial and technical means. An important step towards achieving that goal is a more accessible air-space for private companies in India. For that, the industry requires permission from the government for flying helicopters below 5000 feet. This is a major requirement for HEMS to thrive in India.

To provide a major boost to the industry, the government should preferably take an active step to procure more helicopters fit for such services and provide HEMS itself. Even if the government completely bears the cost of such services, the operating cost for 4 years would be less than building and maintaining a district hospital.

The Asia-Pacific region is expected to command the major share of growth in the HEMS industry in the next decade. And India has rightly shown bright signs for the future.

Recently, covid infected patients located in difficult terrains and geographically inaccessible locations had been airlifted in a helicopter. An isolation pod was used to protect the pilots and other staff from being infected by the patient. This was India’s first-ever integrated fixed-wing air ambulance and was jointly launched by Kyathi and the International Critical Air Transfer Team (ICATT). More such innovative developments would be a great sign for this industry.

While Indian companies can be expected to operate in this sector, it is important to understand that proper operational guidelines need to be in place to avoid various risks associated with HEMS. Certified and trained medical staff, insurance coverage, common emergency contact for HEMS, swift communication and a logistical set-up are a few things that are extremely crucial for the smooth operation of HEMS in India.

Such services can surely help India on the path to development, technological advancement and quality healthcare for citizens.

This has been co-authored by Sarthak Bindal.  

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