The World’s Most Innovative Healthcare: Narayana Hrudayalaya, “God’s Compassionate Home”

April 15, 2011 at 2:46 pm 1 comment

By Leonie Shanks

Narayana means ‘God’s compassionate home’, and is the name of an innovative hospital in Bangalore which specialises in cardiac procedures. The brainchild of Dr. Devi Shetty, who worked as a cardiac surgeon at the world-renowned Guys and St Thomas’ Hospital, the hospital is based on a healthcare model which Shetty has sometimes described as the ‘Walmartisation’ of cardiac care. However, as the name suggests, Narayana is about much more than cutting costs while improving and increasing output: it also has a clear social mission, offering procedures at heavily subsidised rates to those who can’t afford it and conducting extensive outreach in rural communities across the world in order to enable more people to access first-rate healthcare.

Economies of scale are at the core of Shetty’s vision. Because of the size of the original Narayana hospital (it now contains 1000 beds, compared with 160 beds in the average US hospital) and the fact that it focuses only on cardiac procedures, this gives rise to a number of benefits:

–         Better purchasing power – Dr Shetty is India’s largest purchaser of heart valves

–         Machines are used at a higher rate than in other hospitals, offering better value for money

–         Surgeons become more efficient at procedures, meaning that they can often become experts in specialised types of heart surgery – one surgeon, Dr Colin John, has performed nearly 4000 instances of one particular, complex paediatric procedure over a 30-year career.

Narayana also benefits from the fact that India trains more doctors than any other country in the world, and can thus draw on a large pool of highly qualified medical professionals. Additionally, the country’s high level of manufacturing and expertise means that Naryana does not have to rely on expensive multinational suppliers, instead sourcing their equipment from more affordable Indian suppliers.

Not only is the quality of Narayana’s work outstanding (mortality rate within 30 days of coronary artery bypass surgery is 1.4%. at NH, compared with 1.9% in the US), but it reduces the cost of average cardiac procedures by a minimum of 50%. In the UK, where cardiovascular disease was estimated to cost £13.6 billion in 2006, this would mean cost savings of around £6.8 billion.

What I particularly like about Narayana Hrudayalaya, however, is its preventative approach to treating the rural poor, not only in India but in other countries such as Malawi and Afghanistan: through centres known as Coronary Care Units (CCUs), patients undergo basic consultations and their data is then shared with experts at Narayana Hrudalaya, with 1% of the most acute cases then being sent to the hospital for treatment.  This is possible because of a compelling ‘sci-fi’ dimension to Dr. Shetty’s hospital: through a partnership with the Indian Space Agency, Narayana can connect remotely with CCUs free of charge. His ambition now is to develop a network of (wonderfully-termed) ‘health cities’ in India, which will apply Narayana’s healthcare model to a range of other health conditions (they have very recently opened a cancer hospital in Bangalore).

Shetty also hopes, through developing a cardiac centre in the Cayman Islands and in Britain, to challenge the dominant view in the Western world that the cost of healthcare must necessarily rise as quality increases. Narayana has already attracted the attention of  some of Britain’s leading politicians, with Vince Cable describing his visit to the hospital last year as “overwhelming. It combines what we always see in a good health system, which is humane humanitarian behaviour, with sound economics.”

You can read more about Narayana by referring to our Radical Efficiency report, or by visiting the hospital’s website.


Entry filed under: Health, Innovation Worldwide, Public Services, World's most innovative healthcare.

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1 Comment Add your own

  • 1. alecpatton  |  April 26, 2011 at 10:10 am

    I really like this example – partly because I’ve got two prosthetic heart valves so I take a personal interest in cardiological innovation, and partly because it confounds my general prejudice that ‘smaller is better’ in public service institutions.


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