Miracles do happen. A telemedicine network in rural Tamil Nadu uses technology for a 10 x 10 benefit. It has increased access to high quality eye care by ten fold while reducing the cost of access by the same amount.
Saturday mornings are relatively relaxed at the Aravind Vision centre in Rameshwaram, an island in the Indian Ocean, about 22 kilometres off the coast of Ramanathapuram district in Tamil Nadu. So, Liberty, who lives in Tangachi Mattam, a village four kilometers away, brings in her 10-year-old, bespectacled son, Timo, to the centre on a Saturday when he complains of irritation in his left eye.
The vision centre is manned by Namburani, a counselor, and Sasikala, a paramedic staff trained extensively by the Aravind Eye Hospital in Madurai. Sasikala examines Timo while pulling up records from a central computer located about 200 kilometers away at the tertiary eye-care hospital in Madurai. These records were created when Timo first went to the hospital as a one-year-old, with a complaint of watering eyes.
With the details in front of her, Sasikala checks his vision, does the necessary updates (Timo needs new glasses) and video-conferences in the doctor in Madurai. Examination complete, an order for new spectacles is registered and Liberty can pick up the new plastic lens for her son in three days. And so, 20 minutes after they walked in, mother and son are back on their way home.
Ordinarily, it would have taken them a whole day to bus it to Madurai and back, not to mention the cost of Rs. 200. At the vision centre, the ophthalmologist consultation cost a mere Rs. 20 and a couple of hours. At a cost lower than the price of a cup of coffee in a café, a young boy's eyes can return to his school books.
Ordinarily, it would have taken them a whole day to go to Madurai by bus and back, not to mention the cost of Rs. 200 for the round trip. At the vision centre, the consultation with the ophthalmologist cost them Rs 20. At a cost that less than the price of a cup of coffee in a hip café, one little's boy's eyes can finally return to his school books.
Timo is just one instance of the human effect of technology being leveraged by Aravind Eye Hospital..The hospital's broadband network and 23 vision centres have changed the economics of eye-care in rural Tamil Nadu for more than a million people - without changing the economics for the provider. Aravind's distributed model where specialized services are shared by many centres has resulted in an average return of 40%.
Healthcare for the bottom of the pyramid can be profitable. At Aravind, the average return on investment is around 40%
A utilization study by the hospital back in 1996 revealed that its multiple-location rural eye camps were addressing only 7% of those who needed eye care..This statistic prompted Aravind to seek out a permanent access model and they turned to telemedicine,
Broadband connectivity has enabled the hospital to put in place a sustainable, sophisticated, interactive model where health care delivery was broken down into two processes - examination and dispensation of medicines at the vision centre and online diagnosis by a specialist.
The power of the network-based model has accelerated the pace at which the hospital can offer eye-care by ten-fold and successfult addressed the healthcare paradox in a country which has a flourishing medical tourism on the one hand and lack of basic healthcare in rural areas on the other.
Before the vision centres were set up, only 7% of those who needed eye care actually got it.
So while Liberty may have never used a computer in her life, she just contributed one more chapter to the story one of the most compelling technology assisted healthcare delivery models to be seen in this country. After all, isn't that what the power of technology is all about? To help us make the connections that count.
Technology and affordable connectivity options have made Aravind's model economically justifiable, and hence sustainable.