From the Heart: Healthcare Transformation from India to the Cayman Islands

The objective of technology is to drive down cost and the commoditization of a product makes it cheaper. That said healthcare doesn’t necessarily need to be a hand-crafted masterpiece. Masterpieces are beautiful, but how many people can afford them? In healthcare, people need affordable processes, procedures and results that they can attain, afford and use to improve their lives.

These are the prevailing sentiments depicted in a new colorful, moving documentary film produced by Health Catalyst. The 29-minute film, “From the Heart: Healthcare Transformation from India to the Cayman Islands,” premiered at the Healthcare Analytics Summit in Salt Lake City late last summer.

The film tells the story of Dr. Devi Shetty of Bangalore, India, who describes his multi-year mission to deliver radically lower-cost heart surgeries to those who cannot afford them in India, allowing families to choose life rather than almost certain death because of the condition. Doing so allows parents to receive affordable care that empowers them to save their young children with heart defects rather than watching them die.

“A hundred years after the first heart surgery, less than 20 percent of the population can afford it. For 80 percent of the worlds’ population, if they ever require a heart operation, they’re going to die. This is unacceptable. Healthcare has to be available to everyone on this planet with dignity and that is what we are trying to do. And it’s going to happen, I’m convinced of that. It’s going to happen in our own lifetime,” said Dr. Devi Shetty, chairman and founder of Narayana Health.

Narayana’s average cardiac hospital to perform thousands of heart surgeries per year for less than $1,400 per case – about 2 percent of the average cost for heart surgery in the US.

“Henry Ford proved that the commoditization of a product makes it cheaper, makes it better and makes it more efficient,” said Dr. Shetty. “I strongly believe that we have to commoditize the delivery of healthcare, and that is the model that Health City represents for the world.”

Dr. Shetty, who was Mother Teresa’s personal physician, replicates his work in India and takes it to the Cayman Islands where the film takes viewers where this year Shetty, in collaboration with business and government leadership on the island, opened a similar, state-of-the-art hospital, Health City, at a fraction of the U.S. cost, producing better outcomes and higher patient safety.

The initial target patient population of Health City is the Caribbean and bordering countries and, by the spring of 2015, it will actively market its services to U.S. patients, employers, insurers and the U.S. government.

Dr. Shetty

The film asks a simple question: Can the Cayman Islands model be replicated in similarly sized communities in the U.S.? According to the film, yes, and likely traditional care delivery systems here will either feel inspired — or threatened — by this film documentary.

“Health City has a unique model of delivering health care, and one of the unique aspects of it is that we offer a truly bundled pricing model. And our pricing model gives patients a single, flat-rate price for a procedure. That is a completely bundled rate. Patients get one single bill and that’s it. You never get another bill,” said Gene Thompson, Health City’s director.

An overwhelming issue is addressed in the film:

“Anyone who doesn’t believe that healthcare is being disrupted outside the boundaries of the U.S. is not watching what’s happening in the Cayman Islands, and they’re not watching what’s happening in India. If you don’t believe that’s happening, you’re going to lose out on the opportunity to participate in this next wave and you may become disrupted yourself,” said Dale Sanders, former CIO Health Services Authority of the Cayman Islands who currently works for Salt Lake City-based healthcare IT company, Health Catalyst.

Eschewing the profit-center approach of U.S. hospitals, in which key departments, such as the operating room bill patients separately, Health City has only one profit center – the hospital. That arrangement aligns incentives to cut cost from every process. And to further simplify costs, the medical center provides an all-inclusive flat rate for every procedure covering every service.

“We’re one of the few hospitals in the world to publish our prices as a bundled flat rate,” said Chandy Abraham, MD, Health City’s facility and medical director. “And that’s what you’ll pay, nothing more. You get one bill and you’ll never get another bill. It’s a model that gets a lot of attention when we talk with other healthcare providers.”

Another interesting point: A large provider of charitable care, Narayana Health gives its executives a daily profit/loss statement so they can see exactly how much care they can give away to patients.

“We’re never going to match India and their costs,” said Health City director Gene Thompson, referring to Narayana Health. “But we feel we can show that in a high-cost destination we can provide high-quality low-cost healthcare if we think outside of the box. It’s about saving lives and providing the highest quality healthcare to the most people at an affordable price, because humanity deserves it.”

Dr. Shetty added, “We’re all living in a global village. Healthcare has to be available to everyone on this planet, with dignity. We know it can be solved and I’m convinced it’s going to happen in our own lifetimes.”

The movie is simple, moving and inspirational. It concludes that better, cheaper care for all is possible. Perhaps only passion and heart are all that it takes to accomplish this goal. Common sense-based ideas, innovative and disruptive models are helping to successfully tackle some of healthcare’s largest issues while dramatically reducing cost and improving quality, and to show why this matters so deeply and broadly.

From the Heart is about the heart; the film has heart and is full of heart, and all of us in healthcare and everyone looking to improve quality and care outcomes may need to begin looking for new ideas in places not often known for their innovation, until now.

For more information about the movie or the movement, visit: From the Heart.

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