Infinite Visions The Aravind Eye care experience

Sridhar Sundaram MDs Office

There are 12 million blind people in India one third of the worlds 37 million. 80% of this blindness is
preventable or curable.
You dont very often come across organizations wherein every employee works towards a single, unified and
impactful goal. Heres an organization that has been created on a strong foundation of understanding the lives of
its customers, and with the vision of improving them by each and every employee of the organization. The Aravind
Eye care model is a great case study on multiple areas Strategy, marketing, design thinking, leadership and
operations. All put together into a single organizationmaking Aravind the largest provider of eye care services
and trainer of eye care personnel in the world
I came across this quote in the book titled Infinite Vision, and felt it was so apt for any organization and individual
around the world When intuitive goodness is pitted against unthinkable odds, it stirs the imagination and
awakens possibilities.
What Aravind brings to the table?(Key Takeaways)
Strategy, purpose and Vision
The success of the model to a large extent has emanated from their strategy. The sense of purpose of the
organization has been very clear, not just in the minds of their founders, but has been deliberately been reinforced
into all its employees to cure needless blindness, mostly caused by cataract. This can be rectified by a minor 15
min surgery in most cases.

Building this sense of purpose and vision has meant that employees at Aravind work beyond the usual desire of
just making a career or earning an income. At every stage they see themselves as improving the lives of people and
bringing about a large impact to the society. The sense of passion and compassion can be seen amongst every
employee, when you take a random walk around the Aravind Hospital premises, or for that matter to their remote
vision centers that employ just two people and are typically located at remote villages.

Leadership
Leadership typically is the prerogative of senior executives at any organization. Its the extended sense of
leadership that makes Aravind unique.

Seen above is a nursing administrator at a Vision (Remote) center at a village 20 KMs from Madurai

There are small things when done right, allow employees to be accountable and empower them to lead the way in
their own respective work. Focus on small achievable and objective KPIs is one of them. Keeping them transparent
and constant feedback on the same is the other part of it. So, its not just imparting the strong sense of purpose,
but guiding and encouraging employees to achieve small goals to make the big vision happen. Whether its the
hospital reception, outpatient unit, operating theater, camps or vision centers each and every employee is
encouraged to achieve the set goals. Achieving (or not achieving them) do not directly affect their remunerations,
but provide clarity on how they are contributing towards achieving the organizations goal of preventing needless
blindness.
As an example, a nursing administrator is responsible for the eye care of a complete village. This loosely translates
into how many patients visit the vision center, how many are referred to the base hospital and how many follow
up for reviews. All these KPIs roughly impact the awareness of eye care, providing specialist care and general
(ophthalmic) health of the village. So, the nursing administrator in this case leads the cause of the organization in
the village to make the vision happen.
Marketing
Marketing is typically misunderstood, especially when it comes to non-profits. As much as carrying a vision,
everyone at Aravind contributes to the marketing of the organization. This, as a result spreads the vision of better
vision amongst the people. You can see the employees and the doctors advising on the best possible solution to
the patients this resulting in a very high level of association and customer loyalty towards Aravind and of course
a repeat customer base of close to 100%.

You could see three threads of how Aravind is marketed so well Vision, Viral and extended Channels. The vision
that the organization is built on and continued to be shared by the management does impact its own employees,
ecosystem, suppliers and whoever comes in contact with this. This contagious shared vision does affect how all the
stakeholders work and do business with Aravind including the customers. The built in Virality of the organization
that is ensured by all its employees enthusiasm and ability to tell a story makes you a proponent of the business in
a moment. This has ensured the global reach of the Aravind vision though it started humbly from a small obscure
town of Madurai. The distributed channels, namely the vision centers and the eye camps run by the NGO partners
ensure a steady flow of information to the patients and inflow to the Hubs this again to make sure that the reach
of Aravind Eye care is beyond its hospitals.
Above all this, the pricing is determined by the customer depending on the propensity to pay, the patient
decides which section to visit the paid or the subsidized (free). The only difference between these two being the
ambience and the aesthetic service levels!
Design Thinking
The day of any employee at Aravind begins and ends with direct contact with the end consumer. In fact, the IT
team at Aravind is seated beside their hospital facility giving them direct access to the patients and the end users.
So, by default empathizing with the consumer of their services comes very naturally to each employee. All the
processes, decisions and structures are designed around this single objective. The IT team, though could have been
tempted to take up complex process, systems and infrastructure, have stuck to very simple and objective solutions
for the most complicated problems. The whole IT infrastructure and services are handled by a team of 25
employees. This is more unbelievable when you consider that most of the solutions that they use are either
homegrown or built in partnership with them to fulfill their unique needs.
The solutions have been kept to the point to which they improve the business and help them scale and be efficient
in the future.

Predictive Analytics the chart at each hospital entrance gives an approximate idea about the number of
patients that are expected each day of the year. The forecast accuracy surprisingly is around 90%

The chart that you see here is a forecast of expected patients at a hospital premise on any day of the year. How the
numbers are arrived at common sense and logic based on festivals, auspicious dates (people do check good days
for surgeries), seasons and holidays. It is quite noticeable that this is right at the entrance of the hospital and can
be viewed by all the staff and the patients alike. What this results in is amazing as an operational setup and
mentally. Operationally all the processes, leaves and equipment are set to achieve this, and so are peoples mind.
Another benefit as well is that the patients are aware when the days that will be low on traffic are. Typically
forecast is information that is guarded very closely within any organization!
Again, the small things they have done right has as well contributed in a big way to their volumes. The patients
who are referred to the base hospital from the eye camps are provided transport and food free of cost for follow
up on the next day. All this ensures a higher level of desirability for their services and as well as the viability for
Aravind and its consumers.
Operations
Consider a small fact - Aravind's surgeons conduct 2,000 operations a year, on an average. The number in the U.S.
is just 125. Reflect on this considering the quality of its surgeries the failure rate of surgeries at Aravind is less
than half that of UK! The scale at Aravind is built by simply driving the sense of vision & compassion, coupled with
a high level of operational efficiency.

Each doctor stands between two operating tables, while a patient gets operated upon on a table the other table
gets set.

A fine example is how they have managed to use the most expensive resource and bottleneck in the system the
doctors and surgeons. Each surgeon works on two operating tables, a set of nurses prepares the patient while the
surgery is conducted, and by the time the surgery is done with one patient the other patient is ready to be
operated upon. This ensures that the surgeons time is effectively used by eliminating the bottlenecks and he or
she can focus on high value addition. The same philosophy is followed in each and every department of reducing
the low value added activities by the most expensive resources.
You could also see nurses and the administrative staff closely monitoring the patient queue in each of their
section, and ensuring that none of the patients spend more than couple of hours inside the hospital. Also, the
focus is on having highly trained resources versus highly qualified ones!
Aravind eye care also happens to be the only healthcare provider in the world which is vertically integrated right
from manufacturing to distributed outlets, which provides them a huge cost arbitrage over others.
This model of eye care cannot work without the dedication and effort put in by each individual in that system. No
wonder Aravind also faces challenges of expanding their reach beyond the states of Tamil Nadu and Kerala you
can expand infrastructures, but not the values and the culture amongst its people. Despite this they continue to be
the largest eye care provider in the world, given the enormity of the problem. Theres a lot more to learn from
such organization the biggest of them all being the ability of passion and compassion to bring about a change.

About Aravind Eye Care

Aravind Eye Care Hospital is an ophthalmological hospital with several locations in India. It was founded by Dr.
Govindappa Venkataswamy in 1976. Since then it has grown into a network of eye hospitals that have seen a total
of nearly 32 million patients in 36 years and performed nearly 4 million eye surgeries, majority of them being very
cheap or free. The model of Aravind Eye Care hospitals has been applauded all over the world and has become a
subject for numerous case studies.
The problem of avoidable blindness rapidly escalating remained a major cause of concern in the Indian healthcare
scenario. In a developing country the government alone cannot meet the health needs of all owing to a number of
challenges like growing population, inadequate infrastructure, low per capita income, aging population, diseases in
epidemic proportions and illiteracy. Realizing this, Dr. Venkataswamy wished to establish an alternate health care
model that could supplement the efforts of the government and also be self supporting.
Aravind now has branches at Theni, Tirunelveli, Coimbatore, Pondicherry, Dindigul and Tirupur. Some of the
hospital are said to serve as many as 2000 patients per day. The hospitals provide high quality and affordable
services to the rich and poor alike, yet be financially self-supporting. The hospitals attract patients from all over the
world who are willing to pay the market price for their treatment and surgeries. The profit generated from these
patients is then used to cross-subsidize and fund free surgeries for poor people. At Aravind patients have a choice
of whether they want to pay or not.

In pictures

Patient Statistics tracked by all attendants at the hospitals

The team at Aurolab Aravinds low cost manufacturing facility. The facility helped bring down the cost of Intra
Ocular lenses from $ 100 to $ 10.

A typical vision (remote) center