Drone Network Design for Cardiac Arrest Response

Abstract

Problem definition: Our objective is to design a defibrillator-enabled drone network that augments the existing emergency medical services (EMS) system to rapidly respond to out-of-hospital cardiac arrest (OHCA). Academic/practical relevance: OHCA claims more than 400,000 lives each year in North America and is one of the most time-sensitive medical emergencies. Drone-delivered automated external defibrillators (AEDs) have the potential to be a transformative innovation in the provision of emergency care for OHCA. Methodology: We develop an integrated location-queuing model that incorporates existing EMS response times and is based on the p-median architecture, where each base constitutes an explicit [Formula: see text] queue (i.e., Erlang loss). We then develop a reformulation technique that exploits the existing EMS response times, allowing us to solve real-world instances to optimality using an off-the-shelf solver. We evaluate our solutions using a tactical simulation model that accounts for the effects of congestion and dispatching, and we use a machine-learning model to translate our response-time reductions into survival estimates. Results: Using real data from an area covering 26,000 square kilometers around Toronto, Canada, we find that a modest number of drones are required to significantly reduce response times in all regions. An objective function that minimizes average response time results in drone resources concentrated in cities, with little impact on the tail of the distribution. In contrast, optimizing for the tail of the response-time distribution produces larger and more geographically dispersed drone networks that improve response-time equity across the regions. We estimate that the response-time reductions achieved by the drone network are associated with between a 42% and 76% higher survival rate and up to 144 additional lives saved each year across the geographical region we consider. Managerial implications: Overall, this paper provides a realistic framework that can be leveraged by system designers and/or EMS personnel seeking to investigate design questions associated with a drone network. An objective function focused on improving the tail of the response-time distribution is well-suited for use in practice because the model provides equitable solutions that reduce the entire response-time distribution and corresponds to the real-world metrics, on which EMS systems are most commonly evaluated.