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AN INTELLIGENT FIRST-AID PLATFORM FOR THE TIANJIN MEDICAL

EMERGENCY CENTER (TJMEC)

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CUSP-GX 7003 Civic Analytics and Urban Intelligence

Final Report

Yinuo Zhao

16/12/2021

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Table of Contents

❖ Introduction 2

❖ Background & Motivation 2

❖ Assessment of the Organization and Operation 3

❖ Platform Vision 4

❖ Challenges 6

❖ Solutions to Challenges 6

❖ Future Strategies 8

❖ Conclusion 8

❖ References 9

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Introduction

The Tianjin Medical Emergency Center (TJMEC) is the only core medical emergency center

located in Tianjin, China. The TJMEC uses phone calls to communicate with hospitals about

the availability of space and doctors in hospitals. This is a very time-consuming process for

connecting patients and hospitals to dispatched ambulances. The TJMEC is accused of

having an ineffective rescue process for their slow reactions in a few emergencies. There is

an urgent need for actions to be taken to improve the situation. To solve the problem, I

propose a platform based on computer technology like smart intelligence to make the first-aid

process of the TJMEC more efficient through data sharing and management. The platform

will have access to the ambulance command system and mobile electronic medical records. It

will consistently work with hospitals in case of any emergency. Intelligent technology and

big data can help the TJMEC meet the needs of more emergency and severe cases for quality

service in today’s society.

Background & Motivation

The TJMEC is responsible for receiving all emergency calls and providing emergency services

for nearly 14 million citizens (Tianjin population, 2021) in Tianjin. It is the command center

and the central nervous system for 30 emergency stations in 7 areas of operations and provides

comprehensive Emergency Medical Services (EMS) network management. The TJMEC is on

call 24 hours a day and fully equipped with comprehensive emergency equipment. But their

coordination and command mechanism are unresponsive and outdated (Bai.L, 2021). The

traffic problems in Tianjin are serious and constrain the quality of EMS, as shown in the

following pictures.

Figure 1: Traffic in Tianjin Figure 2: Traffic in Tianjin’s Main Street

There are 3 important P’s involved in the importance of first aid (Ryser, 2019). The first one is

to preserve life by keeping the patient alive in an emergency. The second P is to prevent the

patient's condition from getting worse. The third P is promotion, in which we take the

immediate necessary action to help the situation improve. These three principal P's form the

basis of my motivation for this project. An efficient first-aid system can save many

precious lives and reduce the death and morbidity rates.

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The Assessment of Organization and Operation

The TJMEC is co-managed by the Tianjin Municipal People's Government and the Tianjin

Municipal Health Commission. Based on various interviews and research, it would be fair

to say that there is no racial bias in the departments of the TJMEC. There are more than

56 ethnic groups in China, and 91.5% of the people are of Han nationality. At the TJMEC, 95%

of staff are Han people, and the remaining 5% are from ethnic minorities. In fact, the TJEMC

has more compromising policies for staff members of minority nationalities.

On the other hand, since the TJMEC is a public organization supervised by the government,

the average wage of its employees is lower than that of many private hospitals and

organizations. This reduces the efficiency of the TJEMC by diminishing the employees'

dashing spirits and making them emaciated. A better employee benefit plan should be

implemented to motivate employees.

The TJEMC made a public commitment to high-quality, fast, satisfactory service and the same

dispatching time for urban and suburban areas in 2005 (The TJMEC, 2005). However, until

recently, the TJMEC’s average reaction time is still over 2 hours in May,2021. This reaction

time is even worse in suburban areas. The difference in the reaction time embodies the

unfairness in providing emergency medical services. The geographical allocation of the sub-

stations is also not on the principle of the best social benefit. The TJEMC has set up 7 operation

sections, while the 6 suburban areas have access to only one station. It is irrational for the six

suburban areas to have such a disproportionate number of first-aid stations. To better serve

the suburban residents, additional first-aid stations should be established accordingly.

The TJEMC has established a comprehensive organizational structure with a very detailed

division of labor. The Dispatch Command Department of the TJEMC is equipped with LED

electronic screens and a remote video monitoring system. The system’s terminals are set up in

each section of the center to ensure timely and effective EMS deployment. There is also a

communication network system with special telephones, GPS positioning, medical priority

hierarchical dispatching (MPDS), and other functions. Although various technology products

are used, not all of them are necessary. Developing devices with integrated functions could

increase efficiency.

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Platform Vision

The platform is expected to have access to the ambulance command system and mobile

electronic medical records. It also includes hospitals' basic information, such as the availability

of doctors and beds. The platform's notification system will help doctors understand the

patient's pre-existing and current medical conditions in advance. This will be more helpful for

doctors to perform better and more timely treatment after the patient arrives. An emergency

dispatching system installed on the platform can combine and analyze spatial and temporal

conditions to find the optimal route and save time.

This new technology platform will help the TJMEC use the latest information technology to

integrate patients’ information and propose the possible therapeutic measures with the existing

technology. EMS will strengthen ties with hospital resources through the platform. Emergency

patients can receive the timeliest treatment. Building this regional emergency platform

covering the entire city will improve emergency reaction abilities and reduce the death and

morbidity rates.

Ideally, the platform vision is like Figure 3 and Figure 4 below in plan.

Figure 3: Dashboard Vision

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Figure 4: Notification function dashboard

Based on an initial financial analysis, the platform cost is estimated to be around

$62,619,543.93 (400,000,000 RMB). The major funding budget assumption for this project is

based on the "Sen billion Medical," which is a company that has installed intelligent medical

platforms in the major hospitals in China. The budget percentage table is as follows:

Category Particulars Estimated Costs

(RMB)

Estimated Costs

(USD)

CAPEX

Construction of

platforms, integrated

data connections,

database establishment.

245,000,000 38,346,558.98

OPEX

Recruitment of skilled

staff, and other

operational costs.

155,000,000 24,272,984.95

Total 400,000,000 62,619,543.93

CAPEX is the sum of Strategic Investment and the Rolling Investment

OPEX is the sum of O&M costs plus the depreciation in the project.

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Challenges

With the increase in people’s life expectancy, the demand for emergency services has grown,

too. However, the current situation of the local medical service and healthcare industry is far

from satisfactory. The intelligent medical system and the infrastructure construction has not

covered all of Tianjin's relevant institutions. Therefore, information technology needs to be

used to set up a platform with sharing information and higher coordination efficiency.

The first challenge of the construction of an emergency intelligent platform is the adequate

budget. Both of the recruitment of new employees and the construction of the platform depend

on funding. The second challenge is the shortage of technicians. The previous challenges’

solution needs governmental cooperation, leading and support. Another challenge is getting

access to different databases. The electronic medical records datasets integration requires

communication and negotiation between the TJMEC and Tianjin hospital leaders. In the

process of data collection and integration, people may worry about the risks of privacy

disclosure. Funding and technical support, the backing of relevant institutions and

public’s trust are essential to setting up the intelligent platform.

The TJMEC also faces challenges of improving internal efficiency. The welfare of the

employees needs improvement to motivate internal staff. The uneven distribution of emergency

stations also needs to be reevaluated.

Another issue would be the lack of supervision of emergency medical care. The TJMEC is

unable to provide proper supervision of the emergency procedure right now. The status, follow-

up care and treatment of patients are unknown and untraceable. This increases the risks of

improper operations and the abuse of power in EMS.

Solutions to Challenges

To acquire an adequate budget, it is necessary to cooperate with the government. The "Tianjin

Smart Medical and Health Special Action Plan '' proposed by the Tianjin Municipal

Government indicates that the government will increase financial investment in the healthcare

industry. This plan focuses on supporting technical projects such as health information

integration systems, smart hospitals, and the application of high-end technology in the medical

industry. The TJMEC can submit the plan of the intelligent platform and applications for

funding to the municipal government for approval.

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To promote the reforms to the coordination command and the notification systems of EMS, the

TJMEC is required to work with 20 tertiary hospitals in the city. This improvement will need

to recruit more software engineers and technicians in the technical department of the TJMEC

to help to update the hospital's information system and integrate electronic medical record data.

Information retrieval and integration will also require the hospital medical director's permission.

According to the "Tianjin Smart Medical and Health Special Action Plan", Tianjin is seizing

the opportunity to develop intelligent medical technology to provide better emergency medical

services to its citizens. I believe that getting permission and support from the government is

not a big difficulty for Jin Wen Li, the medical director of the TJMEC. The TJMEC will also

make a government-regulated announcement that citizens' personal information will only be

used for medical treatment.

To improve the welfare of employees, a specific financial analysis based on the salary balanced

comparison method will be done. A new welfare standard needs to be set up with the wages in

private hospitals as a benchmark. The new employee benefit plan will be released to employees

after negotiations with the executive office manager. This action will help the TJMEC motivate

employees and improve their working efficiency from within. For an appropriate distribution

of first aid stations, I plan to implement a spatial model analysis for the whole region of Tianjin

and a real-time analysis for the siting of new first aid stations.

For better policing and follow-up, our platform will use big data analysis and quality testing

with visualization. The medical records of patients will be saved so that suitable treatments can

be offered, and any misconduct will be reported on the platform. Ideally, the overall

visualization should look like Figure 5.

Figure 5: Data Visualization Platform for Government Supervision

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Future Strategies

The TJEMC service radius of emergency stations will not exceed 4 km in urban areas, while

in rural areas it will be 20 km. This project will be completed by the end of 2025. The

coordination arrangement of the ambulances will be optimized so that a mobile system of the

hospital can be efficient enough to treat patients who are under serious circumstances. The goal

here is to have at least one ambulance available for every 30,000 citizens.

Under an epidemic of COVID-19, more efforts and new standards are needed to provide better

EMS. Creating an intelligent EMS platform with the setting of an electronic tracking system

for ambulances on task by installing "RFID tags" can better save lives. All the reform and

innovation in the TJMEC system will be under proper supervision

Conclusion

To salvage the TJMEC’s reputation, a more up-to-date platform is required.

With this platform, the connection between the TJMEC and local hospitals will be closer and

the reaction time to emergency calls will be reduced. Considering several strengths, more

budget and human resources will be worth it. The local government and people should see the

potential of the intelligent platform and provide certain help. The establishment of the platform

with relevant efforts can realize efficiencies, boost productivity, and enhance readiness through

better command arrangement, internal efficiency, and databases

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References

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