Aravind Eye Care System: Eliminating Needless Blindless

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Aravind Eye Care System: Eliminating Needless Blindless

  1. 1. AravindEye Care SystemEliminating Needless Blindness
  2. 2. 80 %of  b lindness is   treatable
  3. 3. 200  mthan     Less   illion   need       10  %   eye  care   have  been   treated   in  India  
  4. 4. Patient Care: Manufacturing§  6 Eye Hospitals§  2 Surgical Centres Research§  7 Community Eye Clinics Consultancy§  40 Vision Centres§  2 Managed Hospitals Training
  5. 5. 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  
  6. 6. Sight Restoring Procedures 4.3 Million as of Dec 2011
  7. 7. What it took to get there The story of theAravind Eye Care System
  8. 8. Building Blocks of Aravind Value  System  Delivery  System   Innova3on   Dr.  G.  Venkataswamy  
  9. 9. The value system
  10. 10. Designing forNONCUSTOMERS
  11. 11. Making eye care accessible & affordable The PerspectiveNot charging a fee for care ≠ affordable cost to patient
  12. 12. Who coversthese costs?
  13. 13. Designing a cost-effective solution Reducing the Customers costs
  14. 14. Breaking the access barriers   Outreach  in  2010  –  2011 No.  of  Screening  Camps   1,381   PaJents  examined   312,129   Surgeries   76,175  
  15. 15. 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
  16. 16. Primary Eye Care Centers§  Staffed  by  technicians  §  Comprehensive  eye   examinaJon  for  each   paJent  §  Each  paJent  receives   telemedicine  consultaJon  §  Spectacles  are  provided  
  17. 17. 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  
  18. 18. Impact of Outreach§  Increased awareness§  Influencing health-seeking behaviour§  Creating access§  Community participation§  Growing the market (reaching the unreached)
  19. 19. Stretching ScarceResources
  20. 20. The delivery system
  21. 21. 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
  22. 22. Aravind (Wo)manpower500+ village high school girls selected each year
  23. 23. §  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  
  24. 24. PRODUCTIVITY  OF  AN  EYE  SURGEON   Indonesia ThailandBangladesh Aravind India 0 500 1000 1500 2000 2500 Surgeries per year
  25. 25. Surgical Quality Aravind, UK National Survey Adverse Events During Surgery Coimbatore N=18,472 N=22,912Capsule 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
  26. 26. §  The  paJent  decides  which   facility  to  use  §  Transparency  -­‐  fee  structure   and  systems  
  27. 27. Acataract patient today
  28. 28. Acataractpatient in the 80s
  29. 29. Established in 1992 to address the highcost of ophthalmic supplies which had to be imported
  30. 30. Making Quality Eye Care Affordable§  10 million people see the world through Aurolab s lenses§  Used in 120 countries§  7% of global market
  31. 31. 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
  32. 32. Attaining the Vision Eliminating needless blindnessDealing with Competitive Advantage Guard it zealously or give it away
  33. 33. Create Competitionto eliminate needless blindness     280 Eye Hospitals worldwide
  34. 34. PhilosophyNot to dominate but to create a movement
  35. 35. LAICO – a dedicated facility
  36. 36. 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 AfterEstimated 750,000 surgeries annually added worldwide
  37. 37. 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% Paying0 6-­‐ 07 08 -­‐0 9 Doing Good, Doing Well 10 -­‐1 1 Expense Revenue
  38. 38. Redefining…. Cost Quality Customer Constraints Competition
  39. 39. 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  

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