Frugal innovation in healthcare | The Economist

in an Indian Hospital doctors prepare a two-year-old girl for potentially life-saving surgery she's going under the knife in the world's busiest cardiac hospital we do about 27 to 35 heart surgeries in a day we can't let people die but it's not enough two million people need life-saving heart operations in India every year only a fraction of who will get them globally an aging population and chronic long-term illnesses are placing an ever greater burden on health systems already struggling with mounting costs this world is running short of money the VA health care cost is escalating it is unsustainable patients worldwide could soon be paying the price but conductors find solutions that won't cost us our lives in this rural region of India most people are subsistence farmers telemedical almondy okatee estado male bond remot rachanna güell avert a la Graybar a la manga when moet Sarah airpo de Stewie roll go es about to embark on a life-saving journey doctrine K Delta 1 serie hearty akamaru Ibaka sole pidor DDD a holy Buddhist era de abajo chicka Martin Van endo Hospital oppression Mars taken tell T Daryl oppression Marley Oh a lady a good nan Madol without surgery little Chitra Zuri faces a lifetime of chronic illness breathing problems and potential heart failure but she's one of the lucky ones she's been given the opportunity to go to the city for the treatment she desperately needs globally there's a chronic illness epidemic that's increasing year-on-year illnesses like heart disease diabetes lung disease and some cancers now account for 70% of worldwide deaths with growing life expectancy comes rising populations and increased pressure on health systems to cope with this silent epidemic this is where Chitra zuri is heading for treatment Narayana cardiac hospital in Bangalore it's been set up by health pioneer dr. Devi Shetty life expectancy is going to reach under here soon when the life expectancy increases there will be lot more diabetics lot more patients with the heart problem brain stroke joint problems very cancer all kinds of problems according to dr. Shetty of the two million people who need heart operations in India annually only 5% will get them so he and his colleagues have taken a radical step to make it affordable it's an approach they call frugal innovation we have no money but we can't let people die so we have to come up with innovations busy heart hospitals in Western countries may do two or three heart surgeries on children a day but we do at least 10 to 15 of them this morning one of those operations will be Chitra Zuri's to repair the hole in her heart here surgeries like hers cost as little as 3% of those carried out in western hospitals that's the reason why we created hospital so today we are in a position to perform one of the largest number of heart surgeries in the world by doing large number of operations you utilize your infrastructure to the fullest extent we work six days a week 12 to 16 hours a day that is the only way you can reduce a cost the long hours help to maximize efficiency servicing a virtual conveyor belt of patients as Chitra zouri has taken to the operating theatre the surgical team there are still with their previous patient as she's anesthetized the medics are standing by to begin her operation the same seamless workflow is being duplicated by cardiac surgery teams in the hospital's 22 other operating theaters meanwhile dr. Shetty is consulting on dozens of other cases without even leaving his office teka teka apneic monitor or army angiography film dig pin for a decision Deven Takashi this is another piece of frugal innovation intended to minimize unnecessary and costly hospital visits you will be surprised within the next 10 years there may not be an outpatient program in most of the hospitals all the chronic diseases will be managed when the patient where the patient is at home and doctor is treating the patient from his home when managed like this hospitals are only used for critical treatments like Chitra Zuri's it's an approach that's starting to have resonance well beyond this hospital in India East Harlem New York City in this neighborhood more than one in five people suffer from chronic diseases like diabetes with mounting pressure on the local health systems an innovative new project is trying to cut hospital admissions by helping the most vulnerable patients in their own homes just a lot of questions I get them the whole thing is that she's super curious about what's happening these health coaches have no formal medical training but they meet weekly with their clients to help them understand and manage their conditions I have a new client tool that I'm working with there his family and um she was telling me how like this her son is more irritable and things like that then it turns out that they feed him a bowl of Cheerios at 6:00 in the morning and then he doesn't eat again until 2:00 p.m. yes ask me exactly exactly but it's just like they're so fearful of you know this diabetes Hilda matheus is off to see a client who's been battling with type 2 diabetes if left uncontrolled it's a disease that can lead to serious physical complications but simple lifestyle changes can dramatically reduce the risk of hospital admissions a large core of the work that we do is to prevent on our clients going through crises and crises meaning you know them having to walk into ER visit or spend a lot of time in in the hospital or waiting for doctors by walking in and it also saves a lot of money save thousands of dollars the doctors don't have enough time on them they get 15 minutes with a client every two to three months so us meeting them weekly and working with them for half hours or an hour really helps to prevent a lot of crises in recurring Helder and her fellow health coaches are recruited from the neighborhoods in which they work so they understand the challenges faced by the people here I watched my grandma you know go through a big struggle living with diabetes and then she went to the hospital and she never came out she just gave up at that point hi Shirley I want to prevent you know other people in the neighborhood um that I grew up in the community to not go through that it's this local connection that enables Hilda to motivate and educate their clients so it's 400 calories you did mention a sodium content in here the salt yeah which is very high we want to try to stick to 5 percent or lower and this is at 37 yeah that it's a diabetes is stable kind of watching that your passion yeah mm-hmm they want to increase medications but I know oh no lets me try you know okay put it in the controllers before you just give me some medicine yeah in just two years it's claimed this community initiative as averted emergency hospital visits for a quarter of their clients they're now working with New York's Department of Health to help redesign how it delivers care to patients with all kinds of long-term chronic diseases back in Bangalore little cheese rosary is in surgery to repair the hole in her heart she's attached to a heart-lung bypass machine as the surgeon carefully closes the gap the operation will take over four hours in India hospitals can benefit from light touch regulation cheap land and far lower labor costs in the West healthcare providers can't hope to replicate this model but they do need to implement their own frugal innovation one of London's oldest hospitals is working with a health innovation studio to save time money and lives it's not run by medical professionals but designers he looking at the measurement of chronic diseases we're focused on frugal innovation coming out with cost-effective solutions that don't have huge barriers to entry and that are scalable today they're testing a mobile phone app that could help over a million children in the UK manage another chronic condition asthma sit straight breathing as much as you can and exhale as fast as you can well done you caught the bug this child-friendly app is designed to encourage kids to monitor their condition and alert them to triggers in the hope it will avert hospital admissions this is your peak flow reading which is really good cuz you're in the green zone Britain's National Health Service spends 1 billion pounds a year treating asthma yet it's estimated that 75% of hospital admissions are avoidable cheap simple and effective innovations like this app could potentially have a huge impact on health budgets not just in the UK but around the world while pressure on healthcare systems varies from country to country they all share one common challenge to maintain standards while reducing costs people living in developed countries think that for every problem there is a solution but if a solution is not affordable it is not a solution chitra zoo is recovering after a four-hour operation she'll be able to return home in just a couple of days operation Agadez success either money or future buggy chronically India will prove to the world that wealth of the nation has nothing to do with the quality of health care its citizens can enjoy and once India does it rest of the world will follow medical pioneers alone can never solve the countless problems facing global healthcare but they can provide inspiration especially if saving money can help to save more lives you you


  1. I have seen god in pictures and status but felt that god is near me when I met Dr Devi Prasad Shetty. He is really a role model for every person who wants to serve humanity. After Mother Teresa if any one is there who serves mankind without any selfishness, I think he is Dr shetty. May God bless him with long life to serve mankind

  2. Too bad Economist did not explain how girl's heart operation was paid for? Despite the savings in labor, land, and materials; a four hour heart operation and recovery is a huge amount of specialized resources. How was it all paid for?

  3. Dr.Shetty's vision and healthcare model are definitely contributing in the Indian hospital system. His hospital is providing the best of facilities & services.

  4. Dr.Shetty's mission to make world-class treatment available to all is going to be successful, he and his team of doctor's dedication towards health care are commendable.

  5. a lot of the medical equipment is expensive. manufacturers are looking for profit. I have a hard time believing that we can't build a defibrillator for less than $1000. These prices are probably due to a lack of competition

  6. People ought to rule out all the malicious genetic defects that could be passed down to the offspring. Designer babies if you will, but done by a controlled global medical institute, that will answer to UN. I don't mean we should engineer completely new types of human beings. If we are all healthy, how much more productive can humanity be? Improved quality of life and also financially.

    People that have the interest can concentrate on other technologies for the betterment of mankind; rectifying problems of the world, understanding the universe instead of concentrating on how to treat new illnesses, although there will be a lot of research needed to improve in geriatrics.

    It's without a doubt that "naturally" rare illnesses become more common when people that wouldn't otherwise survive childhood get to reproduce and pass down mutated, faulty genes, for the detriment of the gene pool.

  7. for every problem there is a solution but if this solution is not affordable , it's not a solution . well-said

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