First case study! Inside Dr. Mohan's diabetes treatment centers in South India

The Center for Health Market Innovations [partners]( are conducting case studies on particularly promising program models in their countries. ACCESS Health International, based in Hyderabad, India, has several insightful case studies in the works. The first one to go public is on an integrated diabetes management program. We asked the case study's author, [Vasanth Kumar](, for key insights on this model.

*1. Why did you choose to focus a case study on Dr. Mohan's Diabetes Specialty Centre? What were the components of the program that interested you, from the beginning?*

The reason for choosing [Dr.Mohan’s Diabetes Specialities Centre]( (DMDSC) is, diabetes affects many part of human body and Dr. [Viswanathan] Mohan’s diabetes specialty centre is a unique model in India that is equipped to diagnose and treat all diseases caused by diabetes under one roof. Dr.Mohan’s Diabetes Specialities centre treats diseases like heart attacks, kidney diseases, Neuro and diabetic retinopathy that are caused by diabetes. India being a [diabetic capital of the world]( and the care provider needs to examine all parts of the body, DMDSC is considered as an appropriate model to tackle diabetic threat. Apart from the clinical care DMDSC is also involved in awareness creation whereby it educates the patients through awareness camps, mass exhibitions and organise events during world diabetes and world health day. Since diabetes is considered as life style disease and the care providers have to focus as much as attention on behavioural change among public, DMDSC is very well involved with it.

*2. How does Dr. Mohan's delivery organization differ from other diabetes organizations in Hyderabad and Chennai?*

The treatment of diabetes at DMDSC follows well-established protocols with ample scope for individualisation depending on the type of diabetes, whether the patient has other active medical problems, whether the patient has complications of diabetes, and age and general health of the patient at time of diagnosis. Care is delivered by a diabetes management team comprising Diabetologist, Ophthalmologist, Cardiologist, Nephrologist, Neurologist and Nutritionist. Since all care is provided under one roof, the patient receives comprehensive care at DMDSC. Similarly the work load is divided among many cadres of staff, and nutritionist shares the major work of communicating to the patient, on any given day a consultant may see 20 to 30 patients.

*3. Do you think Dr. Mohan's financing model is dependent the fact that diabetes is a disease of lifestyle, as you point out in the case study -- that the majority of customers (~80%) can pay out of pocket, or have private insurance?*

Currently DMDSC supports the poor and needy patients thought DIRECT, the non-profit charitable wing of DMDSC. It conducts educational activities on diabetes for health care personnel (general physicians), for the public and organise large scale free screening for diabetic patients through DIRECT. Apart from this, with the state health insurance schemes in Tamil Nadu ([Kalaignar Health Insurance Scheme]( and other state-level schemes, DMDSC believes more people will be able afford their services.

*4. Do you think this model can be replicated across India - to the east or north for instance? Why or why not? Will the protocols for maintaining the highest levels of quality be transferable?*

The model is very much replicable in other parts of the country as DMDSC has all the protocols and implemented the same in couple of cities. Given that it requires Diabetologist to run the model and there are very few are available in the country it could be a bottleneck. To overcome that DMDSC has started a two year fellowship in diabetology for post medicine candidates. Till now it has trained 100 such people. Dr.Mohan, the chairman of DMDSC believes in dedicated team and don’t want to dilute the image of DMDSC which is known for quality care, they are not in a hurry to expand this model.

*5. Do you think the telemedicine component of this project drives much of his business? If not, what is the biggest source of new business?*

DMDSC uses the mobile telemedicine unit to do basic screening in the rural areas. New business is created through word of mouth, awareness camps, mass exhibitions and events organised during World Diabetes Day and World Health Day.

[Watch]( a short interview with Dr. Mohan, then read Vasanth Kumar's case study [here](

Learn more about the [CHMI Roadmap]( including the development case studies and other analytical products on the horizon.