India’s healthcare landscape has seen significant strides in insurance access, primary care outreach and digital health adoption. Yet there remains a critical gap that often decides the outcome before any treatment begins, i.e., emergency response. From the moment a medical crisis strikes, sometimes lives depend on what happens in the first sixty minutes. The systems that activate during this period are fragmented and inconsistently deployed across the country. Strengthening this emergency layer is not a peripheral challenge but a central pillar of India’s public health ambitions, as emphasised by public health experts in India.
The impact of delay: Where lives are lost first
Emergency care is not defined by hospital walls alone. It begins on the road, in homes, in rural clinics and crowded city corners where the response clock starts ticking. India has witnessed an alarming number of preventable deaths simply because help arrives too late. A significant proportion of these occur because injured individuals do not receive any clinical intervention within the first hour, often referred to as the Golden Hour in trauma care. According to the National Crime Records Bureau, 1.6 lakh deaths occurred due to road accidents in 2023, but almost 50 per cent of these deaths could have been avoided with immediate medical care, showing how critical timely intervention can be. This depicts one such instance wherein the golden hour could have made a real difference.
The issue is not confined to accident trauma. Cardiac arrests, strokes and high-risk childbirths require immediate action. The gap is pronounced in rural and peri-urban areas where ambulance response is slow and facilities are spread thin. Timely care within this window can reduce mortality by up to 30 per cent, which underscores the urgent need for a robust emergency layer.
Fragmentation in response: A system without a grid
India lacks a unified national emergency medical services (EMS) grid. Ambulance coverage remains low in many regions and there are large gaps in training and equipment. GPS navigation is not standard. Ambulances often arrive without paramedics or are used more for transport than for administering medical support en route. Advanced pre-hospital care is not standard practice, and often, emergency vehicles arrive without paramedics or even essential equipment.
The problem is compounded by poor public awareness. Many citizens are not equipped to recognise symptoms of stroke or heart failure, which delays the initial call for help. There is limited training in basic life support or first response even in densely populated zones. Despite growing investments in tertiary hospitals, the pre-hospital phase of care has not received matching attention.
Building capacity through regional models and collaboration
Some Indian states offer clear direction on how emergency response systems can be integrated into the broader health framework. Tamil Nadu is widely recognised for its structured trauma care system, especially the Tamil Nadu Accident and Emergency Care Initiative (TAEI) and the implementation of an IT-based Trauma Registry. These efforts focus on continuity of care, from the roadside to rehabilitation. Recent evaluations of the Trauma Registry Program in Tamil Nadu confirm the expansion and systematic approach to trauma care, tracking patients from the scene to rehabilitation.
Some private platforms operating integrated emergency services, for example, have demonstrated the ability to deploy advanced ambulance fleets, real-time patient monitoring and rapid prioritisation, all integrated with hospital systems. These hybrid models can offer much-needed capacity, especially in underserved areas
Technology and training: The two accelerators
Today, ambulances equipped with 5G-enabled systems allow remote vital monitoring, enabling ER doctors to assess patients in transit. These systems also feed real-time data to hospitals and provide accurate ETAs to prepare triage teams before arrival. Such capabilities significantly reduce lag in emergency response and decision-making.
In urban areas, tech-enabled platforms are adapting models from Q-commerce, stationing medical teams and ambulances close to high-demand zones and using predictive analytics to position resources dynamically. These innovations are helping to cut response times and increase patient survival rates in metropolitan regions.
Another factor coming into play that helps is having a skilled and well-trained response workforce. Some services nowadays are proactively investing in structured training for their paramedics, nurses and emergency staff to ensure clinical quality even outside hospital walls. These efforts combined are becoming a pillar of support in the emergent service ecosystem. They are aiding in building confidence in at-home and in-transit care, especially when dealing with high-acuity cases.
Care beyond emergencies: Extending the circle of care
An emerging area of focus is pre-hospital and post-discharge care delivered at home. Several integrated health services have expanded their capabilities to support patients not just in emergencies, but throughout their recovery journey. These services include at-home diagnostics, vital monitoring, IV medication and wound care, further offering continuity that reduces pressure on hospitals while improving patient comfort.
This model is particularly relevant in India, where many patients face barriers in travelling for repeated follow-ups. By supporting recovery in-home, these services ensure fewer disruptions in care, faster healing and reduced hospital readmissions. They also close the gap in clinical care that typically exists between discharge and full recovery.
Additionally, these service providers also enjoy close relationships with hospitals and diagnostic networks. Others have hospital-adjacent hubs of operation and allow ER teams to view incoming patient information in real-time, accelerating the triage process and lessening the burden on emergency departments. This smooth transition between community and clinical care is a positive direction for Indian healthcare.
Conclusion: The path ahead
India’s public health outcomes will increasingly depend on its ability to respond well before the hospital doors open. India is ranked 49th out of 89 countries in the 2025 Health Index, reflecting how much work remains to be done. Emergency care is not a single service but a coordinated layer of recognition, response and clinical support. It requires investment in paramedics, data systems, public education and hospital preparedness. Most importantly, it needs the same policy visibility and funding as primary and preventive care.
With 5G-enabled ambulances, trained paramedics, app-based response platforms and in-home care extensions, India is slowly building this capability. However, scale and consistency are still work in progress. For a country of over 1.4 billion, the emergency layer cannot afford to lag. It must be seen not as a separate silo but as the true first point of care. Systems that respond within minutes can save hundreds of thousands of lives each year. India’s health ambitions depend on how quickly and effectively it can build this capability into its national framework.