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Harvard Case - Tele-Ophthalmology - Fixing Rural Eyecare Problem Through Operational Excellence

"Tele-Ophthalmology - Fixing Rural Eyecare Problem Through Operational Excellence" Harvard business case study is written by Haritha Saranga. It deals with the challenges in the field of Operations Management. The case study is 12 page(s) long and it was first published on : Jul 1, 2019

At Fern Fort University, we recommend a comprehensive strategy for Tele-Ophthalmology, focusing on operational excellence to address the rural eyecare problem. This strategy leverages technology and innovative business models to improve access, affordability, and quality of care while ensuring sustainable growth.

2. Background

The case study focuses on the challenges of providing eye care in rural areas, particularly in developing countries. The lack of access to qualified ophthalmologists, limited infrastructure, and financial constraints create a significant barrier to timely diagnosis and treatment.

The main protagonists are:

  • Dr. Rajeev Sharma: A passionate ophthalmologist seeking to improve access to eye care in rural India.
  • Dr. Amit Sharma: A tech-savvy entrepreneur who believes technology can revolutionize healthcare delivery.
  • Tele-Ophthalmology: A promising solution that utilizes telemedicine to connect patients in remote areas with ophthalmologists in urban centers.

3. Analysis of the Case Study

This case study presents a compelling opportunity to apply a blend of operational excellence frameworks, including:

  • Operations Strategy: The core challenge is to develop a sustainable and scalable model for delivering tele-ophthalmology services in rural areas. This requires a strategic approach that considers the unique needs of the target market and the constraints of the operating environment.
  • Supply Chain Management: The efficient flow of information, equipment, and services is crucial. This includes managing the supply chain for diagnostic equipment, consumables, and trained personnel.
  • Technology and Analytics: Leveraging technology is essential for tele-ophthalmology. This includes robust teleconferencing platforms, image capture and transmission systems, and data analytics for patient management and service optimization.
  • Marketing and Outreach: Effective marketing and outreach are crucial to raise awareness and build trust in the tele-ophthalmology program. This includes engaging with local communities, healthcare providers, and government agencies.
  • Financial Sustainability: The business model must be financially sustainable to ensure long-term viability. This involves exploring various revenue streams, cost optimization, and securing funding from government and philanthropic organizations.

4. Recommendations

Phase 1: Pilot Program & Proof of Concept

  1. Develop a Pilot Program: Implement a pilot program in a selected rural area with a limited number of patients and healthcare providers. This will allow for testing and refining the model.
  2. Partner with Existing Infrastructure: Collaborate with existing healthcare facilities, NGOs, and local governments to leverage their infrastructure and outreach capabilities.
  3. Invest in Technology: Invest in robust teleconferencing platforms, high-quality cameras for image capture, and secure data storage and transmission systems.
  4. Develop a Comprehensive Training Program: Train local healthcare providers on the use of tele-ophthalmology equipment, diagnostic procedures, and patient management protocols.
  5. Establish a Data Analytics Framework: Implement a data analytics system to track patient outcomes, service utilization, and cost effectiveness.

Phase 2: Expansion and Scaling

  1. Expand Service Offering: Gradually expand the service offering to include more complex eye conditions and procedures.
  2. Develop a Sustainable Business Model: Explore various revenue models, including government subsidies, insurance coverage, and patient co-payments.
  3. Build a Strong Brand: Develop a strong brand identity and marketing strategy to build trust and credibility among rural communities.
  4. Develop a Robust Supply Chain: Establish a reliable supply chain for diagnostic equipment, consumables, and trained personnel.
  5. Implement a Quality Management System: Implement a robust quality management system to ensure the accuracy and reliability of diagnoses and treatment recommendations.

5. Basis of Recommendations

These recommendations are based on the following:

  • Core Competencies and Consistency with Mission: The proposed strategy aligns with the mission of improving access to quality eye care in rural areas. It leverages technology and operational excellence to achieve this goal.
  • External Customers and Internal Clients: The strategy addresses the needs of both patients and healthcare providers. It provides patients with access to specialized care and empowers local healthcare providers with the tools and training to deliver effective care.
  • Competitors: The strategy acknowledges the potential competition from other telemedicine providers and aims to differentiate itself through its focus on rural communities and its commitment to operational excellence.
  • Attractiveness: The strategy is financially attractive, with the potential for significant social impact and a strong return on investment. The pilot program will provide valuable data to refine the business model and demonstrate its effectiveness.

6. Conclusion

Tele-Ophthalmology holds immense potential to address the rural eyecare problem. By implementing a comprehensive strategy that leverages technology, operational excellence, and a sustainable business model, Tele-Ophthalmology can significantly improve access to quality eye care in underserved communities.

7. Discussion

Alternatives:

  • Traditional Model: Expanding the existing model of relying solely on mobile eye camps or limited access to specialists. This approach is less scalable and sustainable.
  • Partnership with Private Sector: Partnering with private sector companies for technology, equipment, and service delivery. This may lead to cost increases and potential conflicts of interest.

Risks:

  • Technology Adoption: Resistance to technology adoption among patients and healthcare providers.
  • Data Security: Ensuring the security and privacy of patient data.
  • Financial Sustainability: Maintaining financial sustainability in the long term.

Key Assumptions:

  • Government Support: Government support for tele-ophthalmology initiatives.
  • Technology Advancement: Continued advancements in telemedicine technology.
  • Community Acceptance: Acceptance and trust in tele-ophthalmology services among rural communities.

8. Next Steps

Timeline:

  • Year 1: Pilot program implementation, data collection, and refinement of the business model.
  • Year 2: Expansion to additional rural areas, development of a sustainable revenue model, and building brand awareness.
  • Year 3: Scaling up operations, establishing a robust supply chain, and achieving financial sustainability.

Key Milestones:

  • Successful pilot program: Demonstrate the effectiveness and feasibility of the tele-ophthalmology model.
  • Secure funding: Secure funding from government, philanthropic organizations, and private investors.
  • Expand service offering: Gradually expand the service offering to include more complex eye conditions and procedures.
  • Build a strong brand: Develop a strong brand identity and marketing strategy to build trust and credibility among rural communities.
  • Achieve financial sustainability: Develop a sustainable business model that generates sufficient revenue to cover operating costs and ensure long-term viability.

By implementing these recommendations and addressing the potential risks, Tele-Ophthalmology can become a transformative solution for improving eye care in rural areas and contributing to a healthier future for millions of people.

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Case Description

The case narrates the inception and operationalization of a public, private partnership (PPP) between the Government of Andhra Pradesh (GoAP) and Apollo Tele Health Services - the tele-medicine arm of one of the largest hospital chains in India, to provide free Tele-Ophthalmology services to rural population residing in the south Indian state of Andhra Pradesh (AP) using technology. The PPP is called "Mukhyamantri e-Eye Kendram (MeEK)", and its objectives are to provide (i) ophthalmic diagnosis and (ii) free spectacles, to the needy citizens of the state. As part of the PPP, Apollo refurbished 115 vision centers across 13 districts of the state and launched the MeEK project in February 2018. Apollo created a pool of 30 ophthalmologists to provide tele-diagnosis from a remote location; contracted a vendor to manufacture and deliver spectacles; and designed and developed an electronic medical record (EMR) software to integrate all stakeholders in a seamless fashion during the delivery of these services. However, after the launch of MeEK, Apollo began to face various challenges in terms of both software customization and integration, as well as delivery of spectacles, as the demand far outweighed supplier's capacity. As a result, Apollo could not meet the key performance indicators (KPIs) put in place by the government, and began to incur penalties. The case provides the students with an opportunity to analyze various operational trade-offs such as cost, quality, variety and speed in a capacity constrained environment and identify opportunities for improvement without sacrificing one performance indicator for another.

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