NEW DELHI: Devi Shetty, the Indian cardiac surgeon renowned for making cutting-edge medical care affordable to the masses, is set to begin his overseas innings this week.Health City Cayman Islands will start receiving patients this week as the first leg of Shetty’s Caribbean venture becomes operational with a 104-bed multispecialty tertiary hospital.It cost $70 million to set up. Abig advantage of the Cayman Islands facility is its location: near the American shore, but off the stringent US regulations. Shetty, the founder of Narayana Health (formerly Narayana Hrudayalaya) is awaiting American patients as well. And, he promises to offer top-quality services at lower costs.“The best location to build a hospital on the planet today is a ship that is parked in the US waters just outside its territory,” Shetty said. “The site at the Cayman Islands is the closest approximation that fits the bill.”“The healthcare models in the US are considered the ultimate and keenly studied by the entire world, but the regulatory restrictions in that country are so stifling that innovations in healthcare delivery are very difficult to implement,” Shetty told ET.“By building such a healthcare institution in a British protectorate right outside the US regulatory structure, which can work with US doctors and experts for the US patients, one can show what is possible in healthcare even in the developed world and at what cost.” The Cayman Islands facility would start by offering about 30% discount to the US rates on healthcare services. But deeper cuts in prices can be expected in future.The entire health-city plan envisages 2,000 beds, a medical university and an assisted-living centre over the next 10 years with a total investment of $2 billion. The British Caribbean territory changed some of its regulations to accommodate Shetty’s vision. The most significant was recognising the Indian medical degree and doctors.“The government of Cayman Islands is the second after the Indian government globally to recognise the Indian medical degree. We were very clear that to begin with we wanted to have a team of Indian doctors, nurses, technicians to replicate our model of affordable healthcare,” Shetty said.A team of 70 Indian doctors, technicians and nurses would be in charge of operating the facility in the first phase, while much of the administrative and support staff would be drawn from the locals.“As we go along and expand doctors from the US and Cayman Islands would join in,” he added. The facility at the Cayman Islands is the first Shetty is building on the fringes of the US.He is already scouting for more suitable locations in the Caribbean region. Narayana Health has an ambition of growing into a 30,000-bed organisation over the next five years.Currently, it has just over 6,300 beds. Shetty wants one-fourth of its net additions to be overseas. Shetty is in talks with authorities in some European and African countries, pressing them to recognise Indian doctors and degrees. Until now, that has been his condition for venturing into overseas projects. But, he believes, if not today, developed countries would have to look at Indian healthcare models in the next seven-eight years to contain costs. “Healthcare is a sticky issue for most countries, even in the developed world, and each one is looking for a solution.Just that they are yet to arrive on the brink of desperation and when that happens, Indian models will definitely have a few lessons to offer.” Meanwhile, Shetty plans to use the time difference between Western countries and India as an advantage. “Nowhere in the world, patients even in the ICU are attended to by top doctors in the middle of the night, but that would be possible now with senior doctors in our Bangalore hospital connected to the Cayman facility.”While Narayana Health’s overseas foray may be happening only now, according to Shetty his team has been preparing for it for five to seven years. “Cost is our strength and quality is their demand and I knew that a balance would have to be struck as we venture abroad,” he said. “Two of our hospitals have been JCI (Joint Commission International) accredited for a few years now. None of our patients ever asked for it but that was our way to understand the needs of the developed world and brace for our journey there,” he said.The organisation keeps a close watch on its financial health. “For instance, at the end of every month, all our top doctors and senior administrators get a detailed account of the financial parameters of all 27 locations we operate in, and we do a post-mortem of finances,” Shetty said.“But our investment in best-in class software also ensures that every day afternoon all of them get an SMS on revenue, expenses and other financial indicators for all the locations, which is what we call our diagnostic tool.” This helps Narayana Health self-correct on a daily basis.