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Interesting post! This highly standardized model of care reminds me of Aravind Eye Care System in India. This system is an extremely efficient “assembly line” model with high quality measures. The idea is to only use doctors for the actual surgery portion of cataract surgery (which takes about 5 minutes), and to have doctors perform an incredible large volume of cases so that they can become experts at the surgery and so that surgeon utilization is close to 100%.

The following quote in particular highlights this model: “Doctors are hard to find and expensive, so the surgical system is set up to get the most out of them. Patients are prepared before surgery and bandaged afterwards by Aravind-trained nurses. The operating room has two tables. The doctor performs a surgery — perhaps 5 minutes — on Table 1, sterilizes her hands and turns to Table 2. Meanwhile, a new patient is prepped on Table 1. Aravind doctors do more than 2,000 surgeries a year; the average at other Indian hospitals is around 300. As for quality, Aravind’s rate of surgical complications is half that of eye hospitals in Britain.” (http://opinionator.blogs.nytimes.com/2013/01/16/in-india-leading-a-hospital-franchise-with-vision/?_r=0)

And this highly efficient model has allowed them to be sustainable. They actually use the profits from the payments of patients who can pay to fund surgeries for individuals in poverty who can not afford eye surgery.

Now they are expanding into telemedicine to reach and diagnose patients in locations far from their hospitals and possibly bring those in need to their hospitals. The idea of standardization for increased efficiency and lower cost is an interesting one, and it is something that I believe will be explored more and more in the United States as we continue to focus on ways to reduce the cost burden of health care.

Very interesting post! However, I wonder if the recent public health concerns surrounding Chipotle seem to indicate that their operating model may actually be working against their business model of providing “high quality food.” A recent piece in Forbes highlighted the following quote from Chipotle: “‘We may be at a higher risk for food-borne illness outbreaks than some competitors,’ the company admits in its filings with the Securities and Exchange Commission, ‘due to our use of fresh produce and meats rather than frozen, and our reliance on employees cooking with traditional methods rather than automation.'” This may indicate that practices that they formally highlighted (such as the fact that food is made directly in front of you and is not frozen) may actually be a key contributing factor in the multiple disease outbreaks they have had this year. Just some food for thought.

http://www.forbes.com/sites/henrymiller/2015/12/14/chipotle-the-long-defeat-of-doing-nothing-well/

On December 14, 2015, SPS commented on Roche Holdings AG :

Great post! This semester, I have been hearing a number of biotech companies talk about Roche as an acquirer or as an investor in their business. This at first surprised me until I found out that Roche has a venture fund arm. The decision to support a venture fund seems to support even further their excellent alignment of operating and business models. In order to further their commitment to the generation and dissemination of innovative biotechnology they have not only focused on their own R&D, but also on promising initiatives outside of their own company. This furthers not only a financial interest to capture returns on these investments, but also allows them to be involved in the management and strategic decisions of these companies. If you are interested, here is more information on the venture fund: http://www.roche.com/venturefund.htm