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One Mission, Multiple

Roads

Group B

Changes in the environment that impact


Reduced
Aravind
Eye care Changes in the
Cataract as
major cause
of blindness

In 2003, cataract

accounted for 62.6%


of blindness in India.
CSR figures : TN
9000, Bihar 600
compared to the
national average of
5000. This reflected a
wide gap and the

magnitude of work
needed to be done.
Standardization and
high productivity of
doctors allowed AECS
to provide free
surgeries
to 60% of
Doctors
salaries
patients
becoming highly
competitive
But AECS provided
opportunities to establish
their name amongst
peers
It allowed them to do
research, publish papers
to take part in
conferences and network
among peers
Such activities were
Expectation
believed to improve
s from
doctors competences
doctors and
and the visibility of their
other staf
hospitals

*CSR: Cataract Surgery

demand for
free
services

General
improvement in
living conditions;
requirement of free
medical services
coming down;
expectations of
people going up
Multiple Insurance
schemes, both
private and state
sponsored

New hospitals coming


up
They looked better ,
provided better room
and food services
They enticed doctors
with better pay,
though AECS ofered
better scope for
professional
advancement

Competition

demand and need


for other areas of
eye care

Areas of eye care such as


Diabetic retinopathy (DR)
emerged. This required
a) diabetes control
b)refraction correction, and
c)prevention/treatment of
glaucoma.
In India of 2003, 5m were DR
patients , 1.5m needed
treatment, 150k were blind

Of 45m blind people in the


world, 7m were in India
There was only one surgeon
for about 100,000 people
Paramedics were in short
supply, leading to surgeons
performing jobs like
refraction testing and pre
operative care.

Continued
incidence of
blindness in India

Impac
Impac
tt on
on
Aravin
Aravin
d
d Eye
Eye
Care
Care

Response of AECS to challenges

Reduced Percentage of Cataract Surgeries and Expansion into Other Areas

Cataract surgeries had decreased in terms of % of all surgeries.

Laser and LASIK surgeries had increased to 20% of AECSs surgeries

Other areas such as Trab and combined procedures , retina and vitreous surgeries,
lacrimal surgeries and other orbit and oculoplasty surgeries were also gaining in
importance
Reduction in Eye Camps

Number of camps by AECS levelled of

Number of patients in these camps coming down


Establishment of a Network of Vision Centres and Community Eye Clinics

Other Outreach Activities


Aravind Managed Eye Care Services (AMECS)
Upgradation of facilities
Emphasis on Research

Steps towards achieving the Companys


mission

Recommendations

The competitive advantage of Aravind Eye Care Systems lies in bringing down costs and
facilitating operational efficiencies
Catering to needs: The increasing demand for other services (such as Diabetes
Retinopathy, refraction correction and prevention and treatment of glaucoma)needs to be
catered to immediately
Cost decreasing innovation: High technical superiority of its doctors and research facility
should be leveraged to bring down costs and increase efficiency

e.g. the way AECS brought down costs by manufacturing IOLs (Intraocular Lenses) on
its own which allowed an $80 IOL to be procured at $5.

Similarly for other treatments such as Diabetes Retinopathy and glaucoma, innovative
cost efective solutions should be found out
Revenue generation system: With its free service camp programme firmly in place, AECS
needs to look beyond the free services

With rising income levels, the patients want better service and comfort if they are
staying

They want the hospital stay to be short, want private rooms and do not want shared
accommodation

Patients who are insured can be asked to pay for services provided by hospital.
Although this is difficult to implement, a method can be devised to facilitate this.
Attract new talent: AECS should try and attract new crop amongst doctors

They need to be made aware of the quality of work that they would be doing and the
amount of research that it entails

Improved salary levels (made possible by the revenue generation system) will ensure
doctor retention
Cultural chauvinism: While AECS management Is considering global opportunities, they
should get rid of cultural chauvinism and consider expanding services to North India as well
Clarity in how to achieve the mission:

The case presents good examples of convergence across its executives regarding the
basic mission

However there should be clarity regarding perceptions regarding the path of achieving
this objective.