When Brian Navalinsky, an architect from Georgia, suffered massive heart failure, his American doctors thought heart surgery would be too risky for him. He decided his best chance of treatment lay 9,000 miles from home, in Bangalore.
He went to Narayana Hrudayalaya, which is the largest cardiac surgery hospital in the world and offers treatment at a fraction of the price of its American counterparts. It’s attracting growing numbers of “medical tourists” from all over the world, partly because of the savings, but also because of the expertise.
Navalinsky said that in America, doctors thought surgery would be too risky for him. Not at the NH. Navalinsky said he felt his experience was different than it would be at an American hospital. “Everything was so open and transparent compared to being a patient in the US,” he says. “As a patient you were considered part of the team, unlike in the US where concerns about litigation and risk block the system. In India they’ve got a different philosophy towards health and the patient.”
(Below is a testimonial Navalinsky gave to the NH hospital)
India is primed to become one of the main beneficiaries of an estimated global medical tourism budget of $50 billion. But the hospital which treated Navalinsky is taking the phenomenon to new heights by applying Henry Ford’s principle of mass production.
Narayana Hrudayalaya Hospital a spectacular success
The hospital was started by Dr. Devi Shetty, a cardiac surgeon, who once treated Mother Theresa, and who became frustrated by the fact that many Indians couldn’t afford treatment. His solution was to build a huge “medical city” of hospitals, on a 25-acre site, slashing costs through economies of scale and improving performance by giving surgeons wider experience. The Narayana Hrudayalaya cardiac hospital is part of a large medical campus built over the last decade.
Shetty has had spectacular success, by all accounts. The area, which was once scrubby marshland on the edge of Bangalore, has been transformed into a vibrant district of guesthouses and markets, buses and taxi services catering to the needs of patients, doctors and their families. At its center lies the medical city: a collection of hospital buildings rising several stories above the jacaranda and palm trees. Inside the main reception area, people wait patiently for attention, watched over by a statue of Vishnu, the Hindu god of moral order.
Cardiac center a world leader
The NH is recognized as one of the world’s leading cardiac centers. In 2010, the hospital staff performed 50 percent more open heart operations than the Cleveland Clinic, America’s foremost heart facility. The scale allows the hospital to source many of its own medical supplies; expensive equipment is used five times more frequently than in equivalent American hospitals and doctors, on fixed salaries, perform more operations than their American counterparts.
Greater experience appears to lead to better results, with considerably better mortality rates achieved in certain procedures than in U.S. hospitals, despite the fact that many of the cases treated are often the most complex. Financially, the figures are remarkable too. In America, open heart surgery costs on average between $20,000 and $100,000: but at the Narayana Hrudayalaya, the average is $1,800. Even with a round trip ticket to India at $1,600, it would take a lot of time and money spent convalescing (the ‘tour’ in medical tourism) to hit even the bottom part of the U.S. range.
Shetty’s mission is “to enable every man, woman and child to have access to high-tech health care within the next 10 to 15 years, including in the poorest regions of the world.”
To achieve this, he has added other disciplines. The medical city now also offers neurology, organ transplantation, reconstructive surgery, orthopedics, vision and dental care. A telemedicine unit allows specialists to examine cardiograms, X-rays and medical reports remotely, reducing the need for patients to travel from rural areas. Within India, Shetty is building similar health cities, with plans to increase bed numbers tenfold in the next five years, which, he believes, will slash costs further. Patients from more than 70 countries have sought treatment at NH.
The Pediatric Intensive Care unit, the largest in the world, has 80 beds, each with its own designated nurse. Doctors and technicians move swiftly between the tiny patients attached to drips and monitors. Many of the children treated here have traveled from abroad because of the inadequacies of their own health-care systems.
Yogendra Rawat, vice president of the hospital’s International Division, told Latitude News that the hospital last year gained special accreditation from The Joint Commission, whose accreditations are used by many U.S. states as a basis for licensing hospitals. He called it an “American health care stamp of approval, and we’re using it to promote ourselves in America.”
“Overall, medical tourism is growing at a rate of about 25 percent in India,” Rawat said, “but at this hospital it’s 100 percent. Lots of patients come from Africa or the Middle East, but we’d like to be able to help more Americans.” And there are plenty of them out there. The Wall Street Journal, in a feature article on Shetty and the hospital, reported in 2009 that about six million Americans in 2010 intended to seek medical treatment outside of the U.S.
The Narayana Hrudayalaya model is being studied by other countries. Dr. Tim Jones, a British futurist, believes it is setting the pace. “The Narayana Hrudayalaya is increasingly seen as the global poster child for integrated business models and process innovation. It has almost single-handedly kick-started mass medical tourism for serious healthcare services,” Jones said.
Coming soon to North America
Now, it’s moving closer to the States. In April, Shetty finalized a partnership with Ascension Health, America’s largest nonprofit hospital chain, to build a health city in the Cayman Islands, an hour’s flight from Miami. The hospital is due to open in 2013, initially with 100 beds, but with plans to provide up to 1,000.
The Cayman Islands, a small British territory in the Caribbean, are best known as an offshore financial center. Their government is keen to develop medical tourism and has been negotiating with Shetty and his team over the last two years to recognize Indian medical qualifications and lay the legal groundwork for the hospital. Initially, Indian medical staff will service the facility, but the campus will include a training college for local staff. The assumption is that most of the patients will come from America. Patients like Brian Navalinsky, who would be considered too risky to treat in the States, and perhaps children for whom the journey to India would prove too arduous.
“What health care needs,” Shetty said, “is process innovation, not product innovation.”
Click on these links to read more from the Indian media about Shetty and the work he’s done:
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