Innovation

Orellana and Okhuysen were inspired by the Aravind Eye Care System in India, which is a non-profit organization acclaimed for its ability to cut the cost of cataract surgery to a fraction of what others hospital charge.

The founders felt they could create a scalable and profitable venture with a social impact model after Aravind using reverse innovation, which means an innovation seen or used first in the developing world, before spreading to the industrialized world. And they also felt they could carve a significant market share in Mexico if they could drive costs down and guide patients from diagnosis to health outcome at a very large scale.

Today, with their business model they have pioneered a small-incision cataract surgery in Mexico with success rates over 95%, recovery times of three to seven days, and restoration of vision immediately after recovery, yet it is less expensive to other techniques.

Thus, Salauno operates on cataracts at less than half the cost of other hospitals in Mexico City (approximately $533 USD) because the company recovered its fixed costs through other service options and partnerships, such as hospitals, foundations and governments.

They achieve their low cost through economies of scale, innovative surgical techniques and vertically integrated supply chain. Their cost position enables them to charge lower prices than their competitors and thus reach their target market.

To lower costs even more, they have become the Mexican distributor of Aurolab lenses, high-quality lenses manufactured by Aravind´s pharma division and lowered the cost of surgery by 40%. And that is how by 2015, they were operating five business lines that together treat 85% of the different types of visual impairments in Mexico.

The Salauno way:

• Operational efficiency- Focus on procedures, staffing protocols, facility design on making the most efficient use of ophthalmologist's time

• Excellent clinical outcomes- Use the most advanced surgical and eye care practices to ensure quality care and monitor outcomes to ensure they are on par with the highest international standards

• Patient-centric care- Design care from the patient's perspective, focusing on removing unnecessary steps, ensuring transparency, and minimizing wait times and time to treatment.

• Accessibility- Set an affordable price point to enable low-and middle-income patients to be able to access care. Use digital technologies to expand outreach.

Also, they are using technology as key to expand the company's role in making health care accessible and affordable to everyone by integrating digital and mobile solutions. They can now communicate with patients and schedule appointments using WhatsApp platform, two-way text messaging, and an artificial intelligence-powered chatBOT with Facebook.

Inspiration

In 2005, Orellana and Okhyusen were two aspiring entrepreneurs working as investment bankers in Madrid. Orellana, originally from El Salvador, and Okhyusen, from Mexico, were both trained as engineers but shared an ambition to one day build a company that could “do well by doing good.”

“We are dedicated to our mission of Eliminating Needless Blindness in Mexico. But not all our investors understand our hybrid model of doing good, which means creating social benefits for our patients first, rather than profitability for our shareholders. But I am a sole believer that you can generate social and economic value simultaneously”, Okyusen said.

Javier also mentioned, that to be a successful social entrepreneur you must find a mission that drives you crazy. “You must find an intellectual challenge that moves your heart - something that when the tough times come, you continue working towards your goal and not abandon it that easily”, he said. As an example, Javier shared that his income is a tenth part of what he earned as an investment banker, but amazingly enough, it rewards him more as it impacts other aspects of his life, such as having a sense of purpose and transcendence.

On that note, Okyusen stresses the importance of everyone feeling invested in the company's mission. Salauno has created a strategy that keeps the entrepreneurial spirit alive with four principles:

1. Do well by doing good

2. Continuous evolution

3. Service delivered with quality and effort

4. Team work based on discipline and trust

At last, Javier shared they are working on creating a $200 million USD fund, that will allow them to replicate the Salauno way and network to resolve other potential areas, such as maternity, cardiology, and other high specialty health issues. The Salauno way would be their legacy to guarantee a healthy life and promoting well-being for everyone.

Overall impact

Since its founding, the company has provided eye care to over 230,000 people and grown from one surgical center in Mexico City into a network of ten mid-sized Diagnostic Centers with a staff of over 200, offering a range of services throughout the Mexico City Metropolitan Area and the broader Valley of Mexico.

The Salauno network:

• 10 Diagnostic Centers- with a capacity of24,000 consultations per year

• 1 Surgical Center (5 additional planned for 2018)- with a capacity of13,000 surgeries per year each

• 1 Surgical Hub- with a capacity of35,000 surgeries per year

Tracking performance is critical to ensuring a positive patient experience and a high level of efficiency. The company works with Design Thinking, Lean and Six Sigma tools to continually improve. Their key indicators are:

• Patient wait time

• Number of patients screened per day

• Screening process errors

• Number of surgeries per day

• Cost per surgery

• Net Promoter Score

• Conversion rate to treatment

• Operating room process errors

Salauno is well on its way towards its goal of becoming Mexico's leading surgical eye care provider, one which would treat 500,000 patients and perform 25,000 surgeries each year. Currently, the company sees 7,000 patients each month and has plans to open surgical hubs in five more cities in Mexico and increase its staff to 600.

Business benefit

Regarding their business benefits, Salauno has been EBITDA positive since its second month of operation proving the success of economies of scale.

On the other hand, they are major generators of employment, as they offer their doctors a competitive salary and an opportunity to learn a new surgical technique not used by other Mexican providers and to improve their skills with a high volume of surgeries- up to 500 per year, compared to 100 they might perform in private practice. They also developed a nursing program offering a specialization in ophthalmology. This allows the health industry professionals to have a better income, improving the quality of life. These impacts ensure an inclusive, equitable, and quality education and promote lifelong learning opportunities for all, including technical, vocational and higher quality training. Thus, guaranteeing technical and professional skills, to access employment, decent work and entrepreneurship impacting Sustainable Development Goal 4: Quality Education.

Finally, when their patients can start seeing again, they can start working again, impacting positively their quality of life as they perceive higher incomes, as well. Therefore, we think that the Sustainable Development Goal 8: Decent work and economic growth, is impacted as Salauno aims to encourage sustained economic growth by achieving higher levels of productivity and through technological innovation.

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Social and environmental benefit

Salauno ensures healthy lives and promotes well-being for all, impacting directly Sustainable Development Goal 3: Good health and well-being as it cures blindness. By targeting blindness, they also focus on prevention and treatment, education, detection campaigns, and accessible healthcare. Their bold commitment to eradicate blindness and provide eye health coverage, and provide access to safe and effective medicines and procedures for all.

Salauno operates on cataracts at less than half the cost of other hospitals in Mexico City, which benefits mostly patients in the D+, D or C socioeconomic levels, those of whom live in poverty and earn less than $899 USD per year. These patients are no longer disabled with poor health, visual impairment or blindness. Therefore, the disability-adjusted life year (DALY), expressed as the number of years lost due to ill-health, disability or early death, is impacted positively by extending the potential years of life of patients with a healthy life. We believe that Salauno also impacts Sustainable Development 1: No poverty as it is targeting those living in vulnerable situations, increasing access to basic resources and services to eliminate poverty in all forms and dimensions.

Also, they are creating a Foundation that will specialize in identifying, diagnosing, treating and operating patients that have no means to pay for their treatments that will help them replicate their impact further.

Interview

Javier Okhuysen, Co-CEO