Lean is a production practice that considers the expenditure of resources for any goal other than the creation of value for the end customer to be wasteful, and thus a target for elimination – Wikipedia
Delivering quality healthcare in countries like India is really challenging due to lesser affordability of patients with lesser doctors. Aravind Eye care made made its first attempt to radically change this by adopting McDonald’s hamburger approach to eye care. I have provided YouTube video below which talks about this innovation. Also in my innovation series, I called out Narayana Hrudayala who has taken similar approach to cardiac surgery. Recently I visited Shankara eye hospital in Bangalore, where I saw similar approach. Across all these healthcare organizations I see the following things in common:
- The hospital is primarily started as a charity by setting up basic infrastructure with the vision of providing quality healthcare at an affordable cost
- In order to make the operations in a sustainable, they need to ensure hospital cost is optimized to the maximum extent by reducing waste at all levels
- Since patients can be charged only minimal, they need to operate in volumes (ex: in terms of eye checkups, eye operations etc…) with quality built in every step. Number of doctors are limited, who anyways cannot handle higher volume.
- In order to handle the volume problem, doctor’s time spent with per patient needs to be optimized. This can only happen by making him as a key decision maker by looking into diagnostics information/data rather than starting with basic questions in each and every patient. In order to achieve this optimization (for example, in case of eye-care), the whole eye check-up, initial eye diagnostics, getting problem statement and checking medical history etc are handled by well trained para-medical staff so that doctor only spends time for decision. Thus every doctor will be able to see more patients per day, thereby addressing the volume problem.
- Since paramedical staffs are trained only on a specific activity very well and they only do that activity, quality is inherently built into the system. Paramedical staff salaries are lesser than doctors so the overall cost is also optimized
In summary by reducing non-core activities of doctor and optimizing it, multiple health care organizations in India are able to deliver affordable healthcare. In manufacturing world Lean manufacturing talks about various elements (like waste reduction, value creation, value stream mapping, Just-in-time production etc..), which is exactly getting implemented by Indian healthcare giants so consistently, so well! I would say this is a lean manufacturing approach to healthcare, not sure why this is not so popularly spoken about in the media.