“95% of Indians can’t afford air ambulances, so we built train ICUs”

IBT spoke with Dr. Neeraj Jha, founder and CEO of Hanuman Care, a digital-first EMS startup that’s redefining how emergency medical services operate in India. With over 20 years of experience spanning healthcare management, hospital systems, and tech integration, Dr. Jha is leading efforts to make emergency response faster, more intelligent, and more inclusive.

From designing India’s first e-rickshaw ambulance to introducing long-distance train-based emergency transfers, his innovations blend on-ground practicality with forward-thinking solutions. His contributions have earned him accolades such as the Medicaid 40 Under 40, the Atal Samman, and the Six Sigma Oscar for Healthcare. In this conversation, Dr. Jha shares his journey and the vision driving Hanuman Care.

IBT: What motivated you to start Hanuman Care? What were the critical gaps in India’s emergency medical system that inspired you to take this step?

Dr. Niraj: The idea behind Hanuman Care stemmed from three core experiences: my training in emergency medical services, a background in management, and a belief in lifelong learning. Over the course of 10–12 years working in healthcare, I consistently noticed a fragmented system, especially in emergency care. The divide between urban and rural healthcare access was stark, and pre-hospital care remained in a very underdeveloped state.

Though both central and state governments are making efforts to improve emergency medical services, there’s still a long way to go. The private healthcare sector is growing, and EMS represents a major gap that needs to be addressed. I saw an opportunity to fill that gap. With my training, passion, and clarity of purpose, I decided to act rather than wait for someone else to fix it.

IBT: Your tagline suggests reliability in times of crisis. How do you ensure this promise, especially in semi-urban and rural regions with limited access?

Dr. Niraj: Thank you for recognizing our core value. We’re committed to responding only to those emergency calls we know we can fulfill — and doing so quickly, with a 99.9% success rate. Today, we operate with a network of over 3,000 ambulances across just four states. Our strong presence in rural and suburban areas is a result of deep learning.

If owning ambulances were the answer, India’s top hospitals — with all their resources — would have already solved the EMS challenge. But emergency care isn’t just a logistics issue; it’s a coordination problem that requires agility, intelligence, and inclusivity. That’s where technology helps — enabling real-time demand-supply matching, monitoring availability, and ensuring optimal dispatch, even in remote areas.

Still, technology alone isn’t enough. EMS isn’t a taxi service — ambulances are life-saving vehicles, and when lives are at stake, there’s no room for exclusivity. In those moments, collaboration is essential.

That’s why we built a decentralized, community-based network of stakeholders — from solo ambulance owners in villages to large fleet aggregators in cities — all aligned with our protocols. This inclusive model, powered by tech and driven by compassion, enables us to deliver reliably even in the most underserved regions. Ultimately, it’s not just about reach — it’s about being ready when it matters most.

IBT: How has technology helped you streamline emergency response and improve care delivery?

Dr. Niraj: Technology is vital, but its effectiveness depends on real-world understanding. When we launched, we made the mistake of investing heavily in an app, thinking booking an ambulance could be as simple as ordering food or groceries. But we soon realized that ambulance needs are rare — maybe once in a lifetime per family. Sustaining customer engagement on an ambulance app is difficult and costly.

We learned from that and evolved. Today, we operate a robust call center integrating human agents, AI-driven voice systems, and real-time dispatch capabilities. We support pre-arrival notifications to hospitals, real-time data exchange, and seamless coordination between patients, ambulance staff, and hospital emergency rooms. Every component — from triage to patient updates — is designed for smooth, coordinated care. Mistakes have taught us more than success ever could, and we continue to improve every day.

IBT: One of your standout offerings is the train ambulance — a unique concept in India. What led to this innovation, and how does it help patients needing long-distance transport?

Dr. Niraj: The train ambulance emerged from necessity. While working in regions like Bihar, Jharkhand, and the Northeast, we saw that many patients needed to travel long distances for treatment — to hospitals in Delhi, Mumbai, Vellore, and Bangalore. Air ambulances are prohibitively expensive for most — 95% of Indians simply can’t afford them.

Insurance rarely covers medical travel, so we created a frugal and effective alternative. We began booking first or second AC train tickets for patients, doctors, and caregivers. Along with that, we provide paramedics, emergency equipment, and medicines. We manage the entire journey — including the critical transfer between road and rail — with specially trained staff. Essentially, we create a makeshift ICU onboard, maintaining continuity of care throughout. It’s a lifeline for patients needing safe, affordable long-distance transport.

IBT: To build such a comprehensive emergency network, you need a sustainable model. How do you balance purpose with profit at Hanuman Care?

Dr. Niraj: Sustainability is a continuous learning process for us. Currently, we operate on very thin margins. Managing finances is challenging, but our motivation comes from the gratitude and trust we receive from patients and doctors. That keeps us going.

Emergency services can be a viable business — but not if you evaluate them purely based on revenue per trip. Investors and banks often miss the larger picture, focusing only on transport logistics, not on preparedness or training. A major part of our work involves training paramedics, building readiness for mass emergencies, and creating long-term value in care delivery.

Today’s global risks — from pandemics to potential conflicts — highlight the need for emergency preparedness, not just transport. Unfortunately, financial evaluations rarely consider this aspect. But we remain hopeful. The sector is evolving, and as companies like ours demonstrate value across multiple states, investor perception will also change.

IBT: Looking ahead, what trends do you see shaping India’s emergency medical services? And what’s next for Hanuman Care?

Dr. Niraj: We aim to lead the emergency care space while expanding into other healthcare services. Technology is transforming healthcare rapidly — AI, internet penetration, and digital tools are reshaping how care is delivered.

There’s a shift even in medical education — today, anesthesia is more in demand than general medicine. I believe emergency medicine will become a top specialty in the next few years. As AI enables doctors to treat more patients efficiently, EMS will need to grow, especially in rural areas. Our presence there positions us well to support this growth.

Importantly, technology helps reduce medical errors, especially in high-pressure environments like ambulances and emergency rooms. By adopting advanced tools thoughtfully, we can improve both speed and safety of care. Our goal is to be ready for this shift and to expand responsibly, continuing to innovate in both service and care delivery.

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Dr. Neeraj Jha is the Founder and CEO of Hanuman Care, a tech-enabled emergency medical services platform transforming how critical care reaches people in India. With over 20 years of experience in healthcare management, hospital operations, and technology integration, Dr. Jha has been at the forefront of reimagining emergency response systems. Before founding Hanuman Care, he played key roles in streamlining healthcare delivery across institutions and pioneered several innovations — including India’s first e-rickshaw ambulance and train-based long-distance patient transfers. Widely recognized for his impact, Dr. Jha has received honors such as the Atal Samman, Medicaid 40 Under 40, and the Six Sigma Oscar for Healthcare Services. He is regarded as a leading voice in digital EMS innovation in India.