Problem: current ambulance routing don’t optimize significantly on the contextual cases for stroke patients Stroke hospitals: PSC is smaller than a CSC. Previous work Routing methods— route all patient to nearest PSC, which is worse than route high risk patient to CSC, which is worse than always route to CSC This is counter-intuitive. How do we solve, given a stroke condition, available PSC/CSC locations, traffic, etc., for where and how to route a patient? Ambulance MDP formulation S: (location, symptom onset, known stroke type, stroke type) A: route to clinic, route to [specific] PSC, route to [specific] CSC will never be downrouted (for instance, if you are at a PSC you will always either stay or go to CSC) T(s’|s,a): location changes distance R(s,a): “probability of patient outcome” P(success|time) (Holodinsky, et. al. 2018) if stroke type is unknown, its a weighted average Solving Forward Search, depth of 2: patient will either get transported or bounced and transported. Results status quo: people near Stanford hospital/ChanZuck are better MDP: smoother gradient