Introduction

• 180 million people suffer from blindness world wide

• 50 million people in the world are bilaterally blind

• 90% of the blind live in Developing Countries

• 60% of which reside in Sub Saharan Africa, India and China

• In Africa one in every 100 people are Blind

• In European nations it is 0.33% per 1000

Reference- “Low vision assessment” -By Jane McNaughton, Jane McNaughton (MCOptom.)
The Arvind Eye Care
• VISION :
• To Mass Market Cataract Surgery on a Global perspective
• Offer quality eye care at reasonable cost
• Provide services to rich and poor alike

DREAM- “Eradication of Needless Blindness” by creating a private, non

profit eye hospital that would provide quality eye care
• CHALLENGES AND ISSUES
• Large % of people are poor and people do not have health Insurance
• Government Infrastructure is poor to provide adequate health Services
• Lack of Incentives to promote excellence and concern for the poor
• International and local non governmental organization depend on donations for Operating Cost ,they find it
difficult to finance and expand services
• When the organization is tied into the charitable mentality for their fund raising appeals, they often lack the
skill and attitude to earn money
• Lack of business planning skill to raise money
• The outpatient facilities at the free hospital were not well organized
• There was a temporary shelter at the free hospital’s entrance
• Those who came for a return Visit were directed to different lines
• Less administrative assistants helping patients and guiding them sequential flow
• Operating theatre appeared to be more crowded and cramped
• Only 1 or the other operating tables was equipped with an operating Microscope
• Free hospital did not have “beds” in which to recuperate and recover
• Need of Organized Camp, Need to Create Propaganda, and Organizing of Logistics
• Requirement of consistent set of procedures and common set of Principles
 • APPROACH
• Carry out a high quality process at low cost
• Followed the idea of reproducibility
• Achieving High productivity by a significant process innovation driven
by close analysis of value adding time
• Economically self sustaining Model- By generating enough Revenue
from the paying Patients to recover the cost of providing eye care free
of cost services to the Majority

Reference: ©2005 Joe Tidd, John Bessant, Keith Pavitt www.wileyeurope.com/college/tidd

 INSPIRATION FROM Mc Donalds
• Systematic
• high volume production of a range of meals offered at low cost
• Idea of reproducibility
• All McDonalds outlets operate on the same model
• Staff are trained in a core set of skills which are common to all its operations

McDonald's success can be attributed to the following:

• Defining the basic premise of the service they offer
• Breaking up the labor into constituent parts, and then continually
• reassemble and fine tune the many steps
• System works without a hitch, to the degree that such operations maintain
• quality control, and cherish customer satisfaction, profits flow
Reference: 2005 Joe Tidd, John Bessant, Keith Pavitt www.wileyeurope.com/college/tidd
Carrying Out high Quality Process at Low cost
• Cataract unlike most surgical procedures is the same procedure
performed repetitively with Little Variation
• Per unit surgery cost vary very little, allowing for very accurate cost
projection
• Same procedure performed repetitively hence facility set-up, Training
procedures can be standardized
• Cataract is procedure oriented and curative. People are generally
willing to pay for cure but unlikely to pay for preventive services
• Because of large number of people requiring Cataract surgery in
Developing Countries, it is one of the few health care procedures that
has the potential to pay for itself through user fees.
 High Quality. +
Large Volume =
Low Cost

Programme
planning for People
standardized Capacity to Pay
approach

Cost
Recovery
Compassiona Principles Multi-Tiered
te Capitalism Pricing

Changing the
Mindset and
Accountability
Practices of
Surgeons
Factors assisting Arvind Eye Hospital- Eye
camp Model

AEH draws its patients to eye camps

through organized local Business units

Several facilitating
factors helped AEH Organizations bear the publicity costs
make its business and other costs incurred
model sustainable

Organizations also pay for expenses related to

transportation and meals
INITIATIVES
• The Government of India launched a cataract blindness control programme with World
Bank funding and offered a subsidy for the camp patients. In stages, the number of beds
increased to the present 1468 beds (1200 free and 268 paying) in the hospital at Madurai.
• Multiple "camps" were conducted every week, to propagate more and more about the
services. Skilled and technically qualified personnel were brought in solve out these issues.
• The use of mats enabled better utilization of floor space —about 30 patients could be
accommodated in one room.
• Establishment of complete Arvind Eye care system, helped in Eliminating the Major Issues
Concerned, to provide quality eye care, Keeping in view the requirements of every patient,
so as to instill a satisfaction within them as far as the services were concerned.
• The Arvind Eye Hospital, had build up an excellent IT system that kept track of all the
patients. The system generated daily schedules taking into account the load on that day,
patients’ preferences for doctors, and the pending work. This enabled the hospital
administration to keep track of the workload in different units.
• The Aravind management kept a very close track of the intra-operative as well as post-
operative complication rates. The major complications were very much under control and
were considered highly satisfactory, according to the doctors at Aravind
 Concluding statement
• Eye to Future : (As per Dr. Venkataswamy)

One of our key strategic future steps is to develop dual specialties

among our doctors. We would like to retain and get the best out of our
doctors. One way may be to provide more meaning to their work. We
are trying to help doctors to develop at least one other specialty. We
can then also involve them in the running of the Aravind Eye Care
System. We also need to find resources to fund our research projects.
We need to build more linkages with other eye care institutions all over
the world.

Reference: Aravind Eye Care System: Giving Them The Most Precious Gift (R1)