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Dr. Devi Shetty Chairman Narayana Hrudayalaya, Bangalore Asia Heart Foundation, Kolkata 1 Dr. Devi Shetty Chairman Narayana Hrudayalaya, Bangalore Asia Heart Foundation, Kolkata 1

100 years after the first heart surgery less than 8% of the world’s population 100 years after the first heart surgery less than 8% of the world’s population can afford it. 2

If a solution is not affordable it is not a solution 3 If a solution is not affordable it is not a solution 3

India requires 2. 5 million heart surgeries a year. India does 60, 000 heart India requires 2. 5 million heart surgeries a year. India does 60, 000 heart surgeries a year 4

Narayana Hrudayalaya, Bangalore 5 4 Narayana Hrudayalaya, Bangalore 5 4

6 Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata 5 6 Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata 5

Narayana Hrudayalaya institute of cardiac sciences l 23 heart surgeries a day l Heart Narayana Hrudayalaya institute of cardiac sciences l 23 heart surgeries a day l Heart surgery for Rs. 65, 000 l Coronary angiogram for Rs. 4500 l World’s largest pediatric cardiac surgery unit. 7

l In an Industry where disposables comprise 45% of the cost, it is the l In an Industry where disposables comprise 45% of the cost, it is the number game. l Large number reduces the cost and improves result. l Two Health City projects of 5000 beds each. 8

Technology gives the rich what they already have but it gives the poor what Technology gives the rich what they already have but it gives the poor what they can never dream of having. 9

Converting the atoms into bytes 10 Converting the atoms into bytes 10

Telemedicine l Less than 1% of the sick requires an operation l If you Telemedicine l Less than 1% of the sick requires an operation l If you do not need to operate, you don’t need to touch l If you don’t need to touch, you don’t need to be there 11

Telemedicine 12 11 Telemedicine 12 11

6 hours following the heart attack is the golden period 13 6 hours following the heart attack is the golden period 13

Telemedicine l. A joint venture of Indian space research organization, Asia heart foundation Narayana Telemedicine l. A joint venture of Indian space research organization, Asia heart foundation Narayana Hrudayalaya and various state governments l 22 telemedicine centers l Over 16, 000 patients treated free l Free telemedicine software from SN informatics 14

15 Telemedicine Center with CCU at Agartala, Tripura 14 15 Telemedicine Center with CCU at Agartala, Tripura 14

Trans Telephonic ECG Network 16 16 Trans Telephonic ECG Network 16 16

17 Digital X-ray – a Joint Venture with Texas Instrument 18 17 Digital X-ray – a Joint Venture with Texas Instrument 18

Free MRI Scan 18 Free MRI Scan 18

Mobile Diagnostic Lab 19 21 Mobile Diagnostic Lab 19 21

Yeshasvini l “Bengal Famine was not due to lack of food, it is the Yeshasvini l “Bengal Famine was not due to lack of food, it is the lack of paying capacity to buy food” – Amartya Sen 20

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Poor people in isolation are weak but together they are very strong 22 Poor people in isolation are weak but together they are very strong 22

Yeshasvini micro health insurance l Unless you address the problem of paying capacity building Yeshasvini micro health insurance l Unless you address the problem of paying capacity building hospitals is not going to solve the health problem l High interest rate l 35% occupancy l Rural indebtedness is mainly because of health problems 23

Yeshasvini Micro Health Insurance l. A joint venture of the Karnataka State Co-operation Dept Yeshasvini Micro Health Insurance l. A joint venture of the Karnataka State Co-operation Dept and Narayana Hrudayalaya/ Asia Heart Foundation. l 1. 7 Million farmer members in the first year. l 2. 5 Million farmer members in the second year. 24

Yeshasvini in 20 months l 85, 000 farmers had free medical treatment l 22, Yeshasvini in 20 months l 85, 000 farmers had free medical treatment l 22, 000 farmers had free surgeries l 1400 farmers had heart surgeries 25

All for 5 rupees a month 26 All for 5 rupees a month 26

Arogya Raksha Yojana l l l l A comprehensive Health scheme for Anekal Taluk, Arogya Raksha Yojana l l l l A comprehensive Health scheme for Anekal Taluk, Bangalore Joint venture of Narayana Hrudayalaya, Biocon and ICICI Free OPD consultation Diagnostics at discounted rates 3 days inpatient treatment Cashless surgical facility Generic drugs at 30% of the market rate. 27

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Disassociate healthcare from affluence by using modern economic and technical tools. l Provide a Disassociate healthcare from affluence by using modern economic and technical tools. l Provide a vehicle for the common man to contribute a tiny amount of money every month to cover his healthcare. 29

Generic drugs 30 33 Generic drugs 30 33

Dissociate academic credentials from ability 31 Dissociate academic credentials from ability 31

Congenital heart surgery separates the men from the boys -Christian Bernard 32 35 Congenital heart surgery separates the men from the boys -Christian Bernard 32 35

Break up complex task into many islands of excellence 33 Break up complex task into many islands of excellence 33

Replacing the moving parts of a medical equipment to PCB’s can reduce cost to Replacing the moving parts of a medical equipment to PCB’s can reduce cost to any level 34

35 Signing of MOU with Indira Gandhi National Open University (IGNOU), New Delhi 35 Signing of MOU with Indira Gandhi National Open University (IGNOU), New Delhi

IGNOU Diploma in Community Cardiology Diploma in Community Nephrology Diploma in Community Neurology Diploma IGNOU Diploma in Community Cardiology Diploma in Community Nephrology Diploma in Community Neurology Diploma in Community Endocrinology 36

Year 2008, India world’s largest mass healthcare provider l We produce the largest number Year 2008, India world’s largest mass healthcare provider l We produce the largest number of doctors, technicians and nurses in the world l Policy changes l Pharmaceutical capacity l Of course by default 37

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