Dr. Aravind Eye Hospital – A Rural Marketing perspective

Sumeet Das (04)Shikhar Acharya (32)

Shivpal Singh (49)Ketki Bhavsar (53)Saurav Kumar (59)

“To eliminate needless blindness by providing appropriate, compassionate and high quality eye care to all”

Dr.Venkatasamy’s Vision

About Aravind Eye Hospital

• Founded in 1976 by Dr. G. Venkataswamy• Mission to eliminate blindness for all• A charitable trust of Govel Trust• Serves 16,00,000 outpatients• Performed 2,25,000 surgeries • Housing 300 ophthalmologists and training

600 paramedical workers • Largest provider of eye care in the world

Aravind is more than an eye hospital…• A social organization committed to the goal of elimination of

needless blindness through comprehensive eye care services.• An international training centre for ophthalmic professionals

and trainees who come from within India and around the world to teach or to learn, to offer their skills and to acquire new ones.

• An institute for research that contributes to the development of eye care.

• An institute to train health-related and managerial personnel in the development and implementation of efficient and sustainable eye care programmes.

• A manufacturer of world class ophthalmic products available at affordable costs.

Rural market

• India shoulders largest burden of blindness• Estimated at 15 million people 1

• Cataracts being the leading cause• Followed by glaucoma and diabetic retinopathy• Offering affordable eye care to low-income groups• About 70% of its patients live in South India• Two-third patients are treated free of cost------------------------------------------------------------------------------------------------------

1. ORBIS International

Unsuccessful initiatives to reach rural markets

• Mobile vans having clinics– Cumbersome to plan– Required local sponsors to host– Not reachable in all area

• Installed technology in two permanent clinics in Theni– Technology had limited band width so poor video

quality– Expensive recurring maintenance costs– Limited network coverage

Integrating 4A’s with theCore Principles of Aravind Eye Care

Giving Value- Acceptability

Financial

Sustainability-

Affordability

Efficient Service- Availability

Reaching the People- Awareness

PATIENTCENTRED CARE

Reaching Rural Residents- Awareness

• Developed the concept of Rural vision center– Done by Intel and UC Berkeley– Primary eye clinics in rural India– Patients can be remotely diagnosed by doctor– Using high speed video conferencing – Get prescription glasses– Eye drops and blood tests– Referred to Aravind hospital if surgery required– Receive post operative care and advice

• Screening eyes camps– Teams works with local community leaders and

service groups – Conducted every day in week– Educates for proper maintenance of eyes– Makes efforts in reducing needless blindness– Project involves:

• screening for diabetic-related eye disorder• eye screening at schools • treatment of children suffering from refractive errors• strabismus and Vitamin A deficiency

• n-Logue– n-Logue uses technology developed by the Tenet

group of IIT, Chennai– Aims to connect rural areas with health centers in the

cities– Being used to provide telemedicine facilities– Patents can provide details about their symptoms

through a voice mail– Patents provide details about their symptoms

through a voice mail– Digital images can also be sent

Low Cost Wi-Fi 802.11b Connectivity (open spectrum)

Unidirectional antenna Line of Sight 4 MBPS Up to 75 KM

Collaboration with Univ. of Berkeley (PhD students)

• Principles:– Market driving

(reaching the unreached)

– Removing barriers– Community

participation• Impact:

– Creating access– Growing the

market

Wireless connectivity @

4mbps

Marratech Software for tele-conferencing

collaboration

Examination by Vision Centre Technician

Each patient examined at the Vision Centre is discussed with the Ophthalmologist through videoconferencing

Consultation with Ophthalmologist at Aravind

Eye Hospital

Primary Eye Care IT Enabled Centers – 30 in Tamilnadu

Integrating 4A’s with theCore Principles of Aravind Eye Care

Giving Value- Acceptability

Financial

Sustainability-

Affordability

Efficient Service- Availability

Reaching the People- Awareness

PATIENTCENTRED CARE

Paying Free Total

Out Patient visits

1,321,317(55%)

1,074,783(45%)

2,396,100

Surgery 122,900 (43%)

162,845(57%)

285,745

Cataract Surgery: 70% is free

Efficient Service- Availability

• 6000 Outpatients in hospitals

• 4-5 outreach screening eye camps – Examining 1500 people

– Transporting 300 patients to the hospital for surgery

• 850 – 1000 surgeries

• Classes for 100 Residents/Fellows & 300 technicians and administrators

Making Aravind the largest provider of eye care services and trainer of ophthalmic personnel in the world

ProductivityProductivity

Ensuring Efficiency & Quality

Practices• Clinical Protocols• Standardization of procedures• Usage & Balancing of Resources• Surgical Techniques & Technology• Quality & reliability of resources• Medical records• Staff Training & Discipline

State-of-art technologies in surgery

• Less energy required for doctor

• Greater safety• Ease of use

Planning for Expected load & Monitoring

• Yearly/Monthly Planning• Planning for the next day –scheduling

patient, staff & equipment• Planning for supplies & spares• Ensuring that resources match

expected workload– Expected Patient load– Weekly report– Monthly report

• Consulting fee– Poor Patients : Rs. 0 (free)

– Paying patient : Rs. 50 / US $ 1(valid for 3 months)

• Cataract Surgery with IOL (70% of all surgeries)– Poor patients : Rs. 0 (- Rs.250)

– Subsidized rate : Rs. 750 (15$)

– Regular rate : Rs. 3,500 – 6,000

– Phaco Surgery : Rs. 6,500 – 12,000

Affordable fees - Aimed at Middle Income group

53%22%

25%

Financial Sustainability- Affordability

• Financial Viability achieved through

- Trust - Attracts paying patients

• Trust – Focus on good care regardless of

paying capacity

• Transparency in billing

• 70% of the paying patient know the services

through word of mouth

• Comprehensive speciality eye Care

• Early adoption of relevant technologies

• Skills & Perspectives upgraded through international visits and exchanges Exchange of

Residents with the leading US institutions

Continuous improvements based on patient & employee feedback

Giving Value- Acceptability

• Using emerging technologies to reduce the response time to patient complaints

• Quality Assurance process

• Gathering evidence

• Regular review & follow-up on decisions

Use of Wi-Fi PDA’s by Housekeeping staff

Teaching & TrainingOphthalmologistsTechnicians Administrators

Affiliations: MCI, NBE, RCO-UK, JACHPO-USA, MGR Medical & MKU Universities

Turning apparent disadvantages into realized opportunities

Mission & Objectives• Produce quality products

• Provide at affordable cost

• Support avoidable blindness effort

• Self sustain and grow

•In eighties all surgical consumables were imported & expensive

•Aurolab was started in 1992 to produce intraocular lenses (IOLs)

Backward Integration

Intraocular Lens Division

Pharmaceutical Division

Suture Division Blades Division

InstrumentsDivision

Making Eye Care Affordable

Exported to 120 countries

Impact: Price of IOL came down from $ 80 to $ 4 making cataract surgery affordable

• ISO 9001/CE Mark/US FDA approval

• 7% of global market share in IOL • 5 million people see the world

through Aurolab implants• Patents

Sharing makes you strongerLions Aravind Institute of community Ophthalmology

To contribute to the prevention and control of global blindness through Teaching, Training, Consultancy, Research, Publications & Advocacy

Aravind Medical Research Foundation

Community based

Genetics

Microbiology

Epidemiological surveys

Clinical trials

New Research Facility

•Inaugrated on 1st Oct 2008 by Past President APJ Abdul Kalam

Aravind Eye Care System

Eye Bank

Hospitals

Aurolab

Out Reach

Research

“Aravind Eye Care System”

LAICO

IT

Training

Recognitions• WHO Collaborating Center

• National Resources Center for the Govt of India for paramedical training

• Resource & Training center for International Agency for Prevention of Blindness

• Champalimaud Award, Portugal - 2007

• Bill Gates – Global Health Award - 2008

Pursuing Our MissionEliminating needless blindness

much has been done and much remains to be done . . .

“Intelligence & Capabilities are not enough. There must be the joy of doing something beautiful..”

Dr.V