Lean Healthcare

Streamlining Eye Surgery: Innovation in India

By Jon Miller Published on November 2nd, 2004

In the October 11, 2004 issue of BusinessWeek (The Innovation Economy issue, page 176) there was an interesting article providing an example of Lean thinking applied to healthcare.
India has a high number of well-educated engineers and scientists. India is becoming a providers of services such as call centers and software development, and leading the way in innovation, and perhaps in designing Lean processes.
The Aravind Eye-care Centre is able to provide cataract surgeries, assembly line style, for $50 to $300 per operation compared to $2,000 in the United States. This low cost is in part due to the lower-cost locally manufactured lenses, but certainly also due to the superior design of work flow and patient flow.
The large volume of surgeries and the efficient systems the doctors have developed help make this process Lean and lower cost. At this hospital, 80 doctors perform 50 surgeries per day. Four doctors work on patients in one operating room, side by side. The next day the patients return home and are visited by paramedics who complete postoperative care. The quality is excellent according to well-known ophthalmologists.
This is more of an example of Kaikaku (transformation, radical improvement) than mere kaizen. This innovative thinking by Indian doctors and engineers has resulted in a radically improved process. It is a combination of this type of radical redesign of processes and many small and incremental kaizens that makes an enterprise Lean. This is Lean thinking at its finest, enabling the larger number of poor people to benefit from high quality healthcare.

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