ER-ACO: A Real-Time Ant Colony Optimization Framework for Emergency Medical Services Routing and Hospital Resource Scheduling

Ant Colony Optimization (ACO) is a widely adopted metaheuristic for solving complex combinatorial problems; however, performance is often deteriorated by premature convergence and limited exploration in later iterations. Eclipse Randomness–Ant Colony Optimization (ER-ACO) is introduced as a lightweight ACO variant in which an exponentially fading randomness factor is integrated into the state-transition mechanism. Strong early-stage exploration is enabled, and a smooth transition to exploitation is induced, improving convergence behavior and solution quality. Low computational overhead is maintained while exploration and exploitation are dynamically balanced. ER-ACO is positioned within real-time healthcare logistics, with a focus on Emergency Medical Services (EMS) routing and hospital resource scheduling, where rapid and adaptive decision-making is critical for patient outcomes. These systems face dynamic constraints such as fluctuating traffic conditions, urgent patient arrivals, and limited medical resources. Experimental evaluation on benchmark instances indicates that solution cost is reduced by up to 14.3% relative to the slow-fade configuration (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>γ</mi><mo>=</mo><mn>1</mn></mrow></semantics></math></inline-formula>) in the 20-city TSP sweep, and faster stabilization is indicated under the same iteration budget. Additional comparisons against Standard ACO on TSP/QAP benchmarks indicate consistent improvements, with unchanged asymptotic complexity and negligible measured overhead at the tested scales. TSP/QAP benchmarks are used as controlled proxies to isolate algorithmic behavior; EMS deployment is treated as a motivating application pending validation on EMS-specific datasets and formulations. These results highlight ER-ACO’s potential as a lightweight optimization engine for smart healthcare systems, enabling real-time deployment on edge devices for ambulance dispatch, patient transfer, and operating room scheduling.