L.V.

PRASAD EYE INSTITUTE:

INNOVATING THE BUSINESS OF EYE CARE

SG 5 - SLEMBA BPOM
29320072 Ely Rahmawati
29320050 Akhmad Kurnia
29320196 Taufiqurrohman
29320149 Fadhila Nurfida Hanif
29320219 Edi Priyo Yunianto
 Outline
A B
Introduction
About L.V. Prasad Eye
Institute
C D
Question 2
What are the innovation
paradoxes it has faced over the
years? Briefly explain, how LVPEI
resolved these paradoxes
Question 1
What are the key strategy paradoxes?
How might these challenges play out
over the next 30 years?
Question 3
Could the LVPEI model be applied to other
medical subspecialties?
What are the deterrents and key success
factors for other medical subspecialties in
implementing the LVPEI model?
 Introduction
A
About L.V. Prasad Eye Institute
 LV Prasad

About LV Prasad Established in 1987, it was a comprehensive eye

health facility with its main campus located in
Hyderabad, India.
Purpose
To ensure that even the most destitute person in the
areas where it operated had access to world-class
eye care and was treated with dignity.

Challenges for next leaders

Have to strike a delicate balance between sustaining
excellence in its existing activities and discovering
new growth avenues.

The services
comprehensive patient care, sight enhancement,
rehabilitation services, and high-impact rural eye
health program, scutting-edge research and provided
training in human resources of ophthalmic personnel

Vision:
To create an excellent and equitable eye care system that reaches all those in need.
 Question 1
B
What are the key strategy paradoxes that the LVPEI
leadership grappled with in its 30-year journey? How
might these challenges play out over the next 30 years?
The Strategy Paradox
The strategy with the greatest possibility of success also have the greatest possibility of failure
Resolving this paradox requires a new way thinking about COMMITMENT and UNCERTAINTY

CAN’T ADAPT
Most competitive environments are
characterized by multiple rates of
? CREATE-DELIVERS-CAPTURE
THE VALUE

 To CONNECT with customer’s need

CHANGES (slow-fast)
 To REACH a wide range
CAN’T PREDICT  RESISTANT to imitation by
No one can make accurate prediction competitors
about RANDOMNESS of the FUTURE
SOCIAL BUSINESS MODEL
DOING WELL while DOING GOOD

LVPEI as pioneered innovative business model

• Provide high quality eye care to all economic

level
• Healthcare provision model that reached out the
rural area
• Balance between financial and social outcomes

Excellent Equitable
High quality High impact
world-class eye rural eye care
institute
 Key Strategy Paradox
that the LVPEI leadership grappled within its 30-year journey

VALUE VALUE VALUE

PROPOSITION CREATION APPROPRIATION
Consumer involvement, The development of human
Profit and social equation
and defining service resources and the use of
solutions that adequately strategic partnership with operational
respond to consumer’s need excellence and efficiency
Organizational
Co-creation strategy: excellence through Cross-subsidization
PYRAMID MODEL human resources Quality Management
 Emphasized the right  Education programs  Rich patients cover
care at the right place for both clinical & non- the cost of poor
 The creation of clinical staff patients
sustainable  Research as integral  Build credibility to
Figure 1. Traditional triadic framework: permanent facilities part of service delivery attract donation and
how within communities  International center for partnership
an organization creates, delivers and  Raised awareness of advancement of rural  Research program
captures value eye health eye care managed by two
NGOs: HERF & HEI

Source: Angeli, Federica, and Anand Kumar Jaiswal. "Business model innovation for inclusive health care delivery at the bottom of the pyramid.“
Organization & Environment 29.4 (2016): 486-507.
THE FUTURE CHANGES and CHALLENGES

Competition with new player Leadership Succession Plan

Strengthen the LVPEI brand as world-class The new leader had to bring fundamental
eye care institute. The competition in eye care change without affecting organizational core
will increase due to economic factors that values and cultures, and improve its ability to
impact the growth of health care in India influence and affect eye care globally

Changing needs of patient Organization life cycle

LVPEI should improve its ability to conduct
high-impact community eye health
programs. Because patients had more
choices and demanded quality care
The growth of the institution need more
delegation process. LVPEI need to build
managerial competence to deal with
maturity life cycle while keep maintaining
higher quality service
How might these Vision
To create an excellent and equitable eye care system
challenges play out over that reaches all those inneed

the next 30 years? Mission

To be a center of excellence in eye care services, basic
and clinical research into eye diseases and vision-
threatening conditions, education, product
development, and rehabilitation for those with incurable
visual disability, with a focus on extending equitable
and efficient eye care to the under-served population
in the developing world.

Core Values
LVPEI is built on five cardinal principles: excellence,
equity, integrity, togetherness, and patient first

The social business model innovation strategy carried out by LVPEI may still be relevant to the 30
year challenge.
In addition, this strategy can be developed for other broader geographic areas (both in India and
outside India).
Things that need to be maintained: the effectiveness of the pyramid and maintaining Vision, Mission
and Core Values (balance between financial and social returns).
 Question 2
C
Given that LVPEI has been extraordinarily successful
as an innovator, what are the innovation paradoxes (as
distinct from strategy paradoxes) it has faced over the
years? Briefly explain, using examples, how LVPEI
resolved these paradoxes.
Innovation Paradoxes
Innovation Paradox is an innovation that seems to contradict (contrary) to public opinion
or truth, but in fact contains the truth. some of the key innovation paradoxes:

The paradox of flexibility

On the one hand, organizations want structures, maps, models, guidelines, and systems.
On the other hand, that's all too often the stuff that kills innovation, keeping it out off the door.

The paradox of failure

innovation always implies taking risks and if you want to avoid risk you better
do not innovate

The paradox of business success

In order to bring a radical innovation to the market, you need to invest in its development,
which may guarantee your long-term success but probably reduces your shortterm success.

The paradox of knowledge

Having too much knowledge often locks you inside a perceptual tunnel (''expert syndrome’’)
that prevents you from gaining novel insights in your business challenge.

The paradox of strategic alignment

the alignment of strategies in various lines with common goals sometimes becomes an
obstacle in the innovation process
NO TYPE PARADOX RESOLVE
01 The paradox of Against In general, to get employees, the company will look for a professional.
flexibility organization however LVPEI take young people from poor backgrounds in villages and
structures, train them for optometry, housekeeping, and as ophthalmic nursing
maps, models, assistants.
guidelines, and
systems. Initially, health was only the responsibility of the Government, however,
for an LVPEI created a system that involved the community and external parties
innovation in
improving health

Doctors are given the authority to determine the course of action for the
patient and whether the patient should pay or not

- -
02 The paradox of Innovation Take on a high cost business with a bad patient segment. Resolved by
failure always implies cross subsidies system, Donations, Grants and CSR program
taking risks
and if you want
to avoid risk
you better
do not
innovate
 TYPE PARADOX RESOLVE
The paradox of For long term Strategic collaboration and partnership with university, industry
03 business success
success sustainability
The paradox of -
04 -
knowledge
When a patient They apply a system of differences in payment policies between central
could not and regional units. The institute was committed to providing 50% of its
afford to pay, services free of charge, the ratio of free patients as a proportion of total
doctors were patients fluctuated from month to month. At the main campus, as many as
The paradox of given the 90% of the patients might be paying patients, while most rural centers
05 strategic authority to treated a higher proportion of non-paying patients. The services at the
alignment write off the primary centers, i.e., the vision centers, were provided 100% free of
charges, no charge, as most of the patients who visited them could not pay. Overall, in
questions the network, the ratio of paying to non-paying patients held at around
asked 50:50, with a bias towards non-paying patients.
 Question 3
D
Could the LVPEI model be applied to other medical
subspecialties? Which one and why? What are the
deterrents and key success factors for other medical
subspecialties in implementing the LVPEI model?
Could the LVPEI model be applied to other medical subspecial
ties? Which one and why?
Based on the case, LVPEI offer its model (LVPEI’s Eye Health Pyramid model) for providing eyecare in ophthalmology.
LVPEI model can be applied to other medical subspecialties such as cardiology, for providing treatment on cardiovascular
disease. There are similar condition in cardiology treatment to ophthalmology treatment.
A lot of cardiology cases. In 2016, India reported Cardiology requires sub-specialties experts, as like
63% of total deaths due to Non-communicable Advanced heart failure and transplant cardiology,
Disease (NCDs), of which 27% were attributed to Cardiovascular disease, Clinical cardiac
Cardiovascular Diseases (CVDs). Meanwhile, electrophysiology, and Interventional cardiology.
Indonesia reported 73% of total deaths due to
NCDs, of which 35% were attributed to CVDs

Cardiology requires high technology and

Researchs improve the effectiveness of cardiology
sophisticated medical equipment, as like
treatment.
ECG/EKG/Electrocardiograph, Cardiovascular
surgical instruments, and Defibrilator.

Patient’s aspect. Many patients didn’t know the
CVDs’ symptoms, so they only go to the doctor
after the situation worsens. It is also about
patient’s ability to pay the treatment due to its
expensive treatment.
There are several non-profit organization which
provide donation in CVDs, as like Indonesia Heart
Foundation and several company which provide CSR
budget in CVDs, as like Pelindo III which provide IDR
600 million.
In 2016, India reported 63% of
total deaths due to Non-
communicable Disease (NCDs),
of which 27% were attributed
to Cardiovascular Diseases
(CVDs).
Meanwhile, Indonesia reported
73% of total deaths due to
NCDs, of which 35% were
attributed to CVDs

Source : World Health Organization - Noncommunicable Diseases (NCD) Country Profiles, 2018
Proposed Pyramida Model for Cardiology
Center of Excellence
Provide Cardio Tertier facilities plus conduct research. Top Management set up the heart
CoE care policy.
Cardio Tertier
Provide Cardio care facilities plus cardiovascular surgery, complete cardiovascular
rehabilitation, cardiovascular specialist, supported specialist, Intensive coronary care
Cardio r
Tertie unit, complete medicine for CVD.
Cardio Care
Provide Cardio center facilities plus caridovascular specialist, intensive care
unit, essential medicine for cardiovascular disease.
Cardio Care Cardio Center
Provide general practitioners, essential medical equipment as like
Electrocardiogram and Chest X- Ray, basic medicine for
cardiovascular disease.
Cardio r
Cente Cardio Guardians
Social worker trained with basic knowledge related
cardiovascular disease, facilitated with basic medical
s equipment as like tensimeter.
Cardio ian
Guard
Deterrents for other medical subspecialties
in implementing the LVPEI model
Geographic dispersion
Variable geographic location causes different levels of difficulty in
providing health service facilities. The large number of remote areas
that are difficult to reach will obstruct the application of the LVPEI
model
Human resource quality
The low availability of health human resources both in quantity and
quality will hinder the application of the LVPEI model

Government
Lack of support and licensing from the government can make the
LVPEI model inapplicable.

Cultural issues
The unhealthy diet and lifestyle of the community have decreased the
success of the program (the LPVEI model) in the management of
cardiovascular disease.
Number of specialist doctors
A shortage of cardiologists and vascular specialists, especially in rural
areas will hinder the implementation of the LVPEI model.
Key Success Factor for other medical subspecialti
es in implementing the LVPEI model
Leadership
Leadership that upholds social values, nurtures employees, and builds
good networks is needed for the successful implementation of the
LVPEI model.

Funding
The large number of parties who make donations will greatly assist the
implementation of the LVPEI model.

Health service system from the government

The tiered government health service system assists the
implementation of the LVPEI model.

High contribution from society

Community contributions such as volunteering, community
acceptance of the program, and community adherence to treatment
will increase the success of implementing the LVPEI model.
Thank you