The Aravind Eye Care System is a non-profit provider of comprehensive eye care in India. It operates 6 eye hospitals, 2 surgical centers, 7 community eye clinics, 40 vision centers, and 2 managed hospitals. On a typical day, Aravind performs 850-1000 surgeries and sees 6000 outpatients. It also conducts 5-6 outreach camps. Aravind has restored sight for over 4.3 million people as of 2011. Through innovative approaches like task shifting to paramedics, efficient workflow processes, and low-cost manufacturing of lenses and medicines, Aravind has dramatically increased access to affordable, high-quality eye care in India and globally.

1. Aravind
Eye Care System
Eliminating Needless
Blindness

3. 80 %
of
b lindness
is
treatable

4. 200
mthan
Less
illion
need
10
%
eye
care
have
been
treated
in
India

6. Patient Care: Manufacturing
§ 6 Eye Hospitals
§ 2 Surgical Centres
Research
§ 7 Community Eye Clinics Consultancy
§ 40 Vision Centres
§ 2 Managed Hospitals
Training

7. A Typical Day at Aravind...
§ 850
–
1000
surgeries
§ 6,000
Outpa3ents
in
hospitals
§ 5-­‐6
outreach
camps
§ 1500
examined
§ 300
transported
to
base
for
surgery
§ 500
–
600
Telemedicine
Consulta3ons
§ Classes
for
100
Residents/Fellows
&
300
technicians
and
administrators
Making
Aravind
one
of
the
largest
providers
of
eye
care
services
and
trainer
of
eye
care
personnel
in
the
world

8. Sight Restoring Procedures
4.3 Million as of Dec 2011

9. What it took to get there
The story of the
Aravind Eye Care System

10. Building Blocks of Aravind
Value
System
Delivery
System
Innova3on
Dr.
G.
Venkataswamy

11. The value system

13. Designing for
NON
CUSTOMERS

14. Making eye care accessible
& affordable
The Perspective
Not charging a fee for care ≠ affordable
cost to patient

15. Who covers
these costs?

16. Designing a cost-effective solution
Reducing the Customers costs

17. Breaking the access barriers
Outreach
in
2010
–
2011
No.
of
Screening
Camps
1,381
PaJents
examined
312,129
Surgeries
76,175

18. Effectiveness of screening camps?
• We
reached
only
7%
of
those
in
need
of
eye
care1
• Those
with
rarer
eye
condiJons
were
not
addressed
1 Low uptake of eye services in rural India ; Fletcher et al; Archives of Ophthalmology Vol 117, Oct 1999

19. Primary Eye Care Centers
§ Staffed
by
technicians
§ Comprehensive
eye
examinaJon
for
each
paJent
§ Each
paJent
receives
telemedicine
consultaJon
§ Spectacles
are
provided

21. Primary Eye Care Centers
§ 40
centers
covering
a
populaJon
of
2.6
million
§ 800,000
paJent
visits
§ 40%
penetraJon
within
the
first
year
§ 91%
of
problems
are
resolved
locally

22. Impact of Outreach
§ Increased awareness
§ Influencing health-seeking behaviour
§ Creating access
§ Community participation
§ Growing the market (reaching the
unreached)

23. Stretching
Scarce
Resources

24. The delivery system

26. Managing the Bottleneck
Scenario A B
Surgeon 1 1
Tables 1 2
Scrub nurse 1 2
Instrument sets 1 6
Surgeries/hour 1 6-8

27. Aravind (Wo)manpower
500+ village high school girls selected each year

28. § Perform
most
of
the
rou3ne
clinical
tasks
§ Doctors
can
focus
on
diagnosis
&
surgery
§ Higher
quality
and
produc3vity,
lower
cost
§ The
lives
of
these
young
women
are
vastly
improved

29. PRODUCTIVITY
OF
AN
EYE
SURGEON
Indonesia
Thailand
Bangladesh
Aravind
India
0 500 1000 1500 2000 2500
Surgeries per year

30. Surgical Quality
Aravind,
UK National Survey
Adverse Events During Surgery Coimbatore
N=18,472
N=22,912
Capsule rupture and vitreous loss 2.0% 4.4%
Incomplete Cortical Clean up 0.75% 1.00%
Iris Trauma 0.3% 0.7%
Persistent Iris Prolapse 0.01% 0.07%
Anterior Chamber Collapse 0.3% 0.5%
Loss of nuclear fragment into vitreous 0.2% 0.3%
Choroidal Haemorrhage ------ 0.07%
Loss of intra Ocular lens into vitreous 0.01% 0.16%
Aravind s complications are less than half of
those in UK
2 Fortune at the Bottom of the Pyramid by C. K. Prahalad

31. § The
paJent
decides
which
facility
to
use
§ Transparency
-­‐
fee
structure
and
systems

33. A
cataract
patient
today

34. A
cataract
patient in
the 80s

35. Established in 1992 to address the high
cost of ophthalmic supplies which had to
be imported

36. Making Quality Eye Care Affordable
§ 10 million people see the world through Aurolab s
lenses
§ Used in 120 countries
§ 7% of global market

37. Ensuring affordability:
§ For the patient & the community
§ For Aravind (to be sustainable)
§ When most can t pay
What Aravind did:
§ Gave away a lot of it free
§ Charged market rates for those who
can pay
§ Were helped by market inefficiency
§ Had the MINDSET

38. Attaining the Vision
Eliminating needless
blindness
Dealing with Competitive Advantage
Guard it zealously or give it away

39. Create Competition
to eliminate needless blindness
280 Eye Hospitals worldwide

40. Philosophy
Not to dominate but to create a movement

41. LAICO – a dedicated facility

42. Impact of Capacity Building Process
Cataract Surgery (40 Hospitals)
100000
Capacity
80000 Building
91,445
60000 76,995 Cost
Recovery
90%
40000 52,506
Cost
20000
Recovery
60%
0
1 yr Before 1 yr After 2 yrs After
Estimated 750,000 surgeries annually added worldwide

43. 10
15
20
25
30
35
40
0
5
80
-­‐8
1
82
-­‐8
3
84
-­‐8
5
86
-­‐8
7
88
-­‐8
9
90
-­‐9
1
27%
92
24%
-­‐9
3
Free Direct
Free Camp
94
-­‐9
5
96
-­‐9
7
98
-­‐9
9
00
-­‐0
1
02
-­‐0
3
04
-­‐0
5
49%
Paying
'0
6-­‐
07
08
-­‐0
9
Doing Good, Doing Well
10
-­‐1
1
Expense
Revenue

44. Redefining….
Cost
Quality
Customer
Constraints
Competition

45. When
you
grow
in
spiritual
consciousness
We
identify
with
all
that
is
in
the
world
So
there
is
no
exploitation
It
is
ourselves
we
are
helping
It
is
ourselves
we
are
healing
-­‐
Dr.
G.
Venkataswamy