Iwas carrying little more than a phone number when I boarded a plane to Bangalore, India, in August 2012. After a day of flying and a memorable first encounter with India’s traffic, I found myself
sharing lunch with one of my heroes, cardiac surgeon Devi Shetty,
MD, founder and chairman, Narayana Health (NH). The media, including the Wall Street Journal, have compared Dr. Shetty to Henry
Ford, and NH has been called the Walmart of hospitals because of
their shared mission to mass-produce heart surgery at prices most
Indians can afford.*† I would have the privilege of spending the following year helping Dr. Shetty and the staff at NH design a software
product that is now being used for patient care at NH. In addition
to the project management skills I learned as a result of this experience, I also came to understand some of the difficult realities—and
surprising benefits—of operating a health care institution on a limited budget.
A unique opportunity
Many surgery residents spend a year or more doing full-time research.
At Stanford University Hospital, CA, we refer to this time away from
clinical duties as “professional development” because the program is
open to residents pursuing unconventional learning opportunities,
rather than strictly conducting bench research. Instead of joining a
traditional lab, I went to India.
NH administrators and Dr. Shetty have developed a growing
worldwide reputation for providing sophisticated cardiac surgical
care at a low cost. Dr. Shetty founded NH with a vision of expanding
access to heart surgery to India’s medically indigent population. Seeking a professional development experience that would build on the
business administration degree I earned in medical school, I decided
to help Dr. Shetty build a customized electronic health record (EHR)
for heart surgery patients. I wanted to learn something from his organization that I could bring back home.
During my initial discovery trip to Bangalore, Dr. Shetty and I
agreed that I would help create a smart EHR. At this stage, the product
existed purely in our imagination, and starting from scratch sounded
like a fun challenge. Because this task required deep knowledge of
postoperative patient care, I was well-suited to the job.
*Anand G. The Henry Ford of heart surgery: In India, a factory model for hospitals is cutting
costs and yielding profits. November 25, 2009. Wall Street Journal. Available at: www.wsj.com/
articles/SB125875892887958111. Accessed January 30, 2015.
†Rai S. Indian surgeon known for Walmart-izing heart surgery brings affordable health care
closer to Americans. Forbes. February 2, 2014. Available at: www.forbes.com/sites/saritha-
healthcare-closer-to-americans/. Accessed January 30, 2015.
A nurse at NH works with an EHR on a tablet
V100 No 3 BULLETIN American College of Surgeons
• Describes how the author
became involved in an effort to
develop EHR for patients at a
hospital in Bangalore, India
• Offers details on the process
and teamwork that went into
creating the software
• Describes the leadership skills
that the surgeon champion
of this project demonstrated
and how they were useful in
keeping the initiative on track
• Provides insights into how
a hospital can implement
technology on a budget