Expert urges govt to improve emergency call algorithm, do sandbox tests

 

An expert in the medical emergency dispatch system has urged authorities to test its Next Generation Malaysian Emergency Response Services 999 System (NG Mers 999) in a “sandbox” before applying the system nationwide.

While acknowledging the benefits of having such an advanced technology in managing medical emergency calls and ambulance dispatching, Dr Sarah Shaikh Abdul Karim stressed that the bottom line of the emergency calls system is that every call must be connected to the response centre.

This aspect, she added, should be ensured to perform correctly when transitioning to a new system by the agencies involved.

“All national emergency number systems have contingencies to prevent dropped calls from occurring.

“The bottom line is, when you call the 999 number, you must be connected to the response centre because it is a critical key performance of the National Emergency Number,” said Sarah, who was an Mers national coordinator in the Health Ministry until her retirement earlier this year.

Malaysiakini contacted Sarah to get her view on the controversial implementation of NG Mers 999, which had been shrouded in technical problems since it went operational on Nov 16 and led to the government temporarily reverting to its old system.

Social media was abuzz with complaints of calls made to the 999 emergency line that did not get through, while ambulances were sent to faraway locations beyond their jurisdiction.

System developer and operator Telekom Malaysia (TM) blamed the glitches on a sudden spike in calls received, which were mostly silent and prank calls, and the government had since launched a joint committee involving the Health and Communications ministries to review the technical and operational aspects of NG Mers 999.

Possible lack of human verification

Adding further, Sarah said, based on complaints and accounts of incidents going viral on social media, it appeared that NG Mers 999 was also facing issues with its algorithm.

“Using the next-generation system, dispatchers will have better geo-location of callers and have better guidance on which is the nearest and most appropriate ambulance to send.

“Based on the chatter in social media, it seems that there is an error in the algorithm, especially on geo-fencing or virtual boundaries.

“This algorithm requires in-depth collaborative effort from both the Health Ministry team and NG Mers 999 programmers to understand the complexity and dynamicity of ambulance operations.

“It is important to note and truly understand that one size does not fit all in the field of ambulance operations. Geofencing algorithms are very local and different between states, between districts and between kampungs,” said the associate professor who now lectures at the Management and Science University (MSU).

She believed there was an absence of human verification when ambulances were dispatched using algorithms and urged authorities to also engage with stakeholders on the operational mapping and geofencing for ambulance services.

This should then be followed by a robust simulation to understand the surge capacity situations of each area.

“We should never underestimate local knowledge. Study back the algorithm and ensure it is compliant with medical rules on artificial intelligence.

“Do many simulations up to the level of surge capacity encountered. Then run a sandbox,” Sarah said, referring to the practice of testing a programme or application in an isolated environment to mitigate failures.

Sharing her experience running the older version of Mers 999, the doctor said the system’s rollout was done in several phases.

For ambulance services, Sarah said it began with seven centres in the Klang Valley for pilot testing before the system was expanded nationally in three phases, which allowed them to learn, improve and update the system. - Mkini