LV Prasad Eye Institute, Hyderabad

Supported by two not-for-profit trusts- the Hyderabad Eye Institute and the Hyderabad Eye Research Foundation, the Eye Hospital of LVPEI started offering eye care services since 1987. With bed strength of 73, LVPEI sees about 700 patients in the OPD everyday, about half of which are non-paying.

Significant Achievements in the Last One Year

One new secondary-care centre and 12 new primary-care centres have been established. Over 900 eye-care professionals at different levels were trained and more than 3,000 corneal tissues were harvested and nearly 900 transplants were done. A district eye health initiative was launched in Prakasam district of Andhra Pradesh.

New Initiatives

"We have been experimenting with pooled risk models and revenue generation schemes" - Dr G N Rao Chairman LV Prasad Eye Institute Hyderabad

Major innovation has been the development of the pyramidal model of eye-care service delivery, which integrates advanced tertiary care with secondary eye-care at the district level, with each secondary centre linked with ten primary centres, each serving a rural population of about 50,000.

Biggest Challenges

The availability of trained human resources for the social sector, particularly developing staff for the rural centres has been one major area of challenge for the institution. Garnering the support of large donors has been another demanding area. "Non-paying patient care is taken care of through a cross subsidy model, but new initiatives require fresh capital," agrees Dr G N Rao, Chairman. One way in which LVPEI is addressing the human resource challenge is by identifying people from the community for training and then deploying them at the rural centres. "This not only provides employment in resource poor areas, but also fosters community ownership. We have been experimenting with pooled risk models and revenue generation schemes such as sale of spectacles to make eye-care centres at this level sustainable," opines Dr Rao.

Adoption of New Technology

In research and patient care, LVPEI is at the forefront of developing and testing new materials for contact lenses, new treatment regimens including genetic and molecular biology applications, stem cell research and use in treatment. In education, it make use of new technologies to deliver training, and most recently introduced a video conferencing system that allows all its tertiary centres to participate in seminars and meetings.

Quantum of Investment

Most recently, the Champalimaud Translational Centre for Eye Research was set up with a grant of one million euros from a major Portuguese foundation. This centre will build upon the institute's earlier work in stem cell research and therapy. "We have done pioneering work in developmental glaucoma, where genetic markers have helped us identify and therefore counsel families at risk of congenital glaucoma. The teleconferencing system was set up with an investment of nearly one crore to link all the centres," states Dr Rao.

Quality and Patient Friendliness

The entire patient care system is organised around the patient's needs and comforts. For instance, the patient remains in one examination room while the doctors move around, so even when several specialists have to be consulted, the patient does not need to move but the doctors come to him/ her. A lot of emphasis is placed on the patient counselling process. "The sliding scale of payment allows those who are willing to pay higher rates to subsidise non-paying patients, to enjoy a slightly higher level of comfort in terms of waiting areas. The quality of medical care, however, is the same for all categories of patients, no matter how involved or complex the treatment or surgery," states Dr Rao.

Long Term Vision

LVPEI wants to replicate the pyramidal model in as many disadvantaged regions as possible, and to advocate for the establishment of such networks across the country, with a set of at least 10 centres of excellence across the country. LVPEI would also like to set up a community development institute that addresses not only blindness but other issues of livelihoods and health.