The Case for Cayman’s Health City (Part Two)

-- Meet Michael Lepley, a retired Tennessean with a bum hip. 

Five years ago, Lepley’s right hip went out. So he got a hip replacement in the United States. Five years later, his left hip started screaming for change.

Lepley, like most non-billionaires, couldn’t afford the exorbitant cost of another hip replacement in the U.S., so he decided to look elsewhere.

He looked at Southeast Asia… and Latin America… and, then, he stumbled upon a small hospital in the Cayman Islands called Health City. He contacted the hospital and, shortly after, ended up talking to doctors for 60 minutes.

“I had not had a five-minute conversation with a doctor in the United States in five years,” he told Medical Tourism magazine, “so I thought, ‘this is a good start.’

Though Lepley didn’t have health insurance, he said that the entire cost — including travel — was much lower than what he’d paid in the States for his first hip.

But the price isn’t what astonished him…

“I don’t think [savings is] the most important thing,” he said. “This place was just unbelievable — the quality of care, the quality of facilities, equipment, the nurses, the technicians, food — everything’s been top notch.”

On June 5, 2014, the hospital conducted its first surgery — a shoulder arthroscopic surgery. And just last week, Health City celebrated its 100th orthopaedic surgery.

In between that time, says Dr. Alwin Almeida, “we have had a wide range of cases from hip replacements, arthroscopic biopsy to multi-ligament reconstructions, and it is a proud moment for us to have achieved this milestone.”

On top of recently hiring a new top surgeon, Dr. Niranjan, the hospital is also investing in the latest high medical tech — computer navigation equipment. This equipment will help them monitor and analyze surgical procedures more efficiently and effectively.

--If you’ve been following us all week, you know we’ve been in Grand Cayman checking out Health City.  

Health City

Health City reception

Yesterday, we spoke about the big picture vision of Health City.

Today, we’re going to dig more into the details.

First, let’s back up to show you how Health City began…

As mentioned, in 2000, Dr. Devi Shetty founded the Narayana Hrudayalaya Hospital in Bangalore, India.

By 2008, the hospital’s 42 cardiac surgeons had performed 3,174 cardiac surgeons — just in that year. That’s more than double than any leading U.S. medical centers in the same year.

Narayana Health

Furthermore, Shetty’s crack team of pediatric surgeons operated on a total of 2,777 children in the same year. Also more than double at any leading pediatric hospital in the States.

Narayana alone has 1,000 cardiac care beds, 1,400 multi-specialty care beds, and a 300-bed eye hospital. The facilities, adjacent to one another, share centralized labs and blood banks for efficiency and savings.

And get this…

“Dr. Shetty’s family-owned business group, Narayana Hrudayalaya Private Ltd.,” says David Houle in his book, The New Health Age, “reports a 7.7 percent profit after taxes, which beats the 6.9 percent average for a U.S. hospital.”

Today, because the model is so mind-bogglingly successful, it’s grown limbs and is now off to a full sprint. In 15 years, the Narayana chain now has 6,594 beds spread across 32 hospitals in 19 different locations.

And speaking on quality: “Dr. Shetty reports a 1.4 percent mortality rate within 30 days of coronary artery bypass graft surgery,” says Houle, “one of the most common procedures, compared with an average of 1.9 percent in the United States in 2008.

“Dr. Shetty claims that his mortality rates would be even lower if he adjusted for risk, because his patients are often sicker than the average U.S. cardiac patient. Many of Dr. Shetty’s patients lack access to basic health care and suffer from more advanced cardiac disease before they finally have surgery.”

-- Our purpose in Grand Cayman is simple: to visit and report on what we see with our own eyes at Health City.

And, yes, the hype about Health City is warranted. As we said yesterday, we believe that Health City is ground zero for the future of global healthcare.

The current vision for Health City is to price procedures, both elective and necessary, at more than 50% less than what they cost in the U.S.

“We’re one of the few hospitals in the world to publish our prices as a bundled flat rate,” Chandy Abraham, Health City’s CEO said earlier this year at the World Medical Tourism & Global Healthcare Congress in D.C. “And that’s what you’ll pay, nothing more. You get one bill and you’ll never get another bill. It’s a model that gets a lot of attention when we talk with other healthcare providers.”

But the larger vision, Shomari Scott, Health City’s marketing director said during a Caribbean Summit, “is to continuously reduce the cost so everyone can afford [care]. The funny thing is medical tourism is going to be the by-product.”

Yesterday, you might recall, we discussed our meetings with the surgeons, the CEO, and the staff at the hospital. After we sent yesterday’s missive along, we were able to visit the hospital’s go-to hotel and resort.

So, if you ever seek Health City out for a future operation, here’s where you’ll have the option of staying and healing…

Wyndham Hotels and Resorts

Beach at Wyndham Resort

Pool at Wyndham Resort

-- Aside from the incredible attention to every detail of the patient’s experience, what’s most fascinating about Health City is how readily it has embraced the use of technology…

According to Robert Pearl, executive director and CEO of the Permanente Medical Group, the largest integrated healthcare system in the U.S., Health City is bringing together the “healthcare service of Bangalore and the technology of Silicon Valley.”

Next to each bed, as one example, there is an iPad with Health City’s iKare System installed. This system constantly monitors each patient’s clinical data and recommends specific protocols. The system also monitors the patient’s vitals. If they fall beyond the accepted range, it will immediately alert the staff.

“In virtually all hospitals in the world today,” says Francisco D’Souza, CEO of U.S.-based multinational company Cognizant, “the patient data in ICU is captured on paper. That is error-prone and does not lend itself to automation and intelligence.”

The iPad, he says, “will keep their history and vital statistics, but also create a single window into the patient’s information.”

There’s also the patient portal called “My Health City,” which can be accessed by the patient.

This portal allows the patient to quickly see test results, upload medical records, and message his or her doctor. Also, it gives the patient access to a private app store with games and entertainment and Skype to contact friends and family members back home.

But not only is Health City the first to have iPads at every bedside, it’s also the first to have its own medicinal garden…

Medicinal Garden

-- The list goes on of things that set Health City apart…

A superior ventilation system that blocks potentially contaminated air from reaching beyond the rooms of infectious patients…

A system that allows Health City to create its own medical grade oxygen by pulling it out of the air and distilling it in-house.

Automated air-conditioning that cuts energy consumption costs by monitoring foot traffic and only gives air where needed…

A solar farm that reduces the hospital’s energy consumption by almost 50%…

Built-in power redundancies that allow for 10 days of 100% power, independent of the grid.

“Health City Cayman Islands,” the hospital’s website reads, “was built with sustainability and safety in mind. The hospital building was constructed to be extremely energy efficient and include hurricane protection standards.

“The following provisions were built into the facility to ensure both:

Building Structure

  • Insulated Concrete Form (ICF) Walls
  • High efficiency Insulated Roofing System
  • High efficiency Mechanical Units
  • High efficiency Hurricane Protection Windows

Onsite Incineration

“Health City is working with the Cayman Islands Government to allow the installation of an incineration facility for medical waste. Onsite incinerations will not only eliminate additional transportation and processing of potentially harmful biological materials, but also reduce the overall volume of solid municipal waste.”

SWAC (Salt Water Air Conditioning)

“SWAC (Salt Water Air Conditioning) is a cutting edge “green” technology that is extremely efficient and is very environmentally friendly.   It will reduce the power demand by approximately 50%. A by-product of SWAC is non-potable water which is used for irrigation and flushing water.”


“Health City is designed to handle and treat sewage generated from the development on site. The treated effluent can be used for irrigation, again reducing water usage.”

-- If you’re interested in learning about what procedures Health City currently takes on, check out their interactive body map…

Interactive body map

Click here for the interactive body map

And if you’re interested in learning more about other affordable healthcare solutions, stay tuned.

Tomorrow and Friday Jud Anglin will be joining us to talk about why healthcare doesn’t have to be a headache — and how you can have high-quality, affordable healthcare at a fraction of the price you’re paying now.

Even in the United States.

More on that, though, tomorrow.

Until then,

Chris Campbell

Chris Campbell

Written By Chris Campbell

Chris Campbell is the Managing editor of Laissez Faire Today. Before joining Agora Financial, he was a researcher and contributor to