Aravind Vision Centres, have grown in the last two decades to a network of 100+ centres covering a population of 10 million. This has evolved as a key strategy to provide permanent and sustainable access to the unreached. To date (March 2023), the VC network has handled 6.8 million outpatient visits, delivered 872,000 spectacles and facilitated 235,000 cataract surgeries. Going by the annual performance of now handling close to 1 million outpatient visits, the Aravind Network of Vision Centres are probably the largest provider of primary eye care in the world. In order to strengthen this network, it is important for us to reflect on what went well, what needs to improve and where we need to focus further. Towards this during the proposed one-day strategic workshop, we will reflect on the flowing areas to take our VCs to the next level.
Focus on variations and outliers
- Performance (April to March,2023)
( performance segregation of VCs based on OP , IP , Specs and Specialty)
LVPEI data Vs Aravind
Adherence to clinical protocol (magnitude of the problem)
- Refraction
- IOP monitoring in 40 and above age group,
- Fundus imaging in 40 and above age group,
- Blood sugar & BP measurement in 40 and above age group,
- % of patients undergoing teleconsultation
Addressing current pain points in running VCs
- Human resources
- Attendance –
- Plan for HR from the local area and new recruits in proposed locations
- Enlarging the pool of VT by training OP, OT, and ward staff (E see)
- Volunteers to do fundus
- Other issues – List the pain points (Things to do: Talk to the Chief medical officers and stakeholders who run vision centres to understand the paint points and also probable solutions)
Review of new technologies and their relevance to our Vision centres, towards
coming up with new common standards for equipment and technology in VCs
- Fundus imaging (for DR & Glaucoma)
- Portable Perimeter
- Photo slit lamp camera
- Auto-refactor e-See
- Artificial intelligence in DR, Glaucoma and other areas
- Distributed Telemedicine in the Base hospital (show some evidence of not adding more load to the patients) – work on login doctors availability
Redefining the service area based on actual patient access data ( as information)
We started with the assumption that patients will come from a radius of 7 to 8 KM. Based on this we identified the villages that defined the service area of each VC. Our current data shows that consistently about 50% of the VC patients come from outside of these villages. This suggests that the actual reach of the VCs is beyond our original assumption. Thus, we need to redefine the service area for each VC based on the actual access data. With the use of Village-level GIS (Geographic Information System), we can address this scientifically. We need to do this for the following reasons …
- Know the actual population covered by VCs
- Using the above the follow-up for several conditions of the patients from the revised service area can diverted to concerned VC – likely to improve compliance of chronic conditions and follow-up in general
- Establish “Denominator-based” goals and targets for eye care delivery
In addition to the reach that we do support tertiary care and de bottle necking
- Same day surgery with 1st day follow up in VC (??)
- Registry for chronic conditions to enhance the compliance