Putting Patients First

Established in 1976, Aravind has emerged as the largest provider of ophthalmological services in the world, seeing approximately 4.1 million patients a year. In an interview with Subhajit Roy, Dr. S. Aravind, Chief Medical Officer, Aravind Eye Care Systems explained how Aravind has succeeded in creating a sustainable business model while delivering highquality, low-cost ophthalmological services. Interview excerpts:

Over the years, Aravind has become a role model in the field of eye care. What made it possible?

Aravind Eye Care System is one of the largest service providers in the world which provides eye care to 100 million population in the states of Tamil Nadu, Kerala and Andhra Pradesh. During last financial year 2017-18, the Aravind Eye Care System was able to extend its services to 4.1 million people and able to provide sight restoring surgical or laser procedures to 4,79,000 people. This is possible due to: Our founder Dr. G. Venkataswamy’s vision; relentless efforts of the founding team; Strong value system that shared culture of the organisation; efficient delivery process; leveraging the technology; and fostering innovation.

Apart from setting milestones in social entrepreneurship, Aravind Eye Hospital has succeeded in creating a sustainable business model. What’s the secret behind?

Our commitment to our mission and do the best for each patient, led to the development of a highly ethical and patient-centric organisation and systems that reflect it. We keep the patient as centre in all our key decisions. We are frugal and with cost consciousness. One of our challenge is to deal with this high volume of work with very limited resources especially the ophthalmologists. We designed a process that eliminates wastage of time and thus enhancing productivity. To build a compassionate workforce to support the ophthalmologists we started recruiting girls from the villages. Today we select about 500-700 girls each year. They really are the backbone of the organisation, carrying out all of the repetitive skillbased tasks, resulting in high quality and productivity at significantly lower costs. We have designed our hospital facilities in such a way which result in more efficiency and at the same time convenient to the patients. The early innovation which continues even today was to create community ownership to the problem of blindness and partner with them to reach into rural and poor communities. The overall impact has been one of growing the market by reaching the unreached, creating awareness and access, which led to changing the health seeking behaviour.

Could you enlighten us about your existing infrastructure and capabilities?

Currently we have 6 tertiary hospitals, 6 secondary hospitals, 6 community eye clinics, and 68 vision centres. In a given day we handle about 13,000-14,000 outpatients, perform 1,500 surgeries, conduct 5-6 outreach camps and classes for 300 doctors and paramedics.

What are the latest facilities and technologies being introduced towards making eye care affordable?

We are the early adaptors of any new technology or equipment in the field of eye care. We have now moved into Electronic Medical Records (EMR) which makes the documentation of patient details easier and faster and facilitates our patients to get the required care in any of our branch hospitals. We are now working with Google in the area of using Artificial Intelligence in diagnosing the eye problems of diabetic patients. The final piece of the puzzle was to make it affordable both to the community and to Aravind in a situation when most of the clients not only can’t pay but need additional support to access the care. We did this by giving away most of it free while the paying clientele pay no more than the market rates, often a lot less than the rates in bigger cities. We are helped enormously by the market inefficiency which sets the market price. Of course, the cross-subsidy model requires a mindset and this is part of the value system in place.

How would you like to replicate the ‘Aravind model’ across the country?

Ours is a conservative organisation and comfortable in the culture we have built-in over the last few decades. We are now expanding beyond our state of Tamil Nadu and we will be inaugurating a hospital in Tirupati, Andhra Pradesh in few months. One of the unit called Lions Aravind Institute of Community Ophthalmology (LAICO) is working with more than 150 eye hospitals in India and making them also productive by sharing our four decades of experience in running a successful high-volume eye hospital. LAICO has worked so far with 322 eye hospitals from 28 countries. This resulted in these voluntary hospitals doubling their output a year after the mentoring process and also move towards financial viability – also an indicator of quality and efficiency.

Do you have any overseas expansion plan in pipeline?

Yes. Currently we are working Tulsi Chanrai Foundation in Nigeria to start a tertiary eye hospital in Abuja, Nigeria. This centre will also have state of the art training facility to train ophthalmologists and paramedics for eye care.

Despite several efforts, blindness remains a permanent dark spot in India. How Aravind Hospital is committed to counter this?

The eye care scenario in India now far better than the situation in 90’s. There are many new eye hospitals chains in the country now. We have about 18,000 ophthalmologists in the country and through the combined effort of government and private hospitals the prevalence of Cataract, which is the leading cause of avoidable blindness, has come down. Now the focus is more on the diseases like Diabetic Retinopathy, Glaucoma which are on the rise.