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This case uses the concept of social entrepreneurship to analyze the entrepreneurial journey of Mr Suraj Prakash and his social enterprise, the Swasth Foundation. It further deepens our understanding of strategic decision-making by exploring the successful use of pivots.

The case was primarily developed through a series of interviews with the leadership team over a year. Secondary sources included literature about Swasth Foundation available on the internet and those shared by the founder.

In 2008, Suraj Prakash left McKinsey & Company after six and half years in the health and development sector as an engagement manager. Along with his friends, Aman Paul and Ankur Sharma, he established Swasth with the goal of building an ecosystem that delivered high-quality, affordable and accountable health services to low-income communities in India. Right from its inception, Swasth went through many fundamental shifts in terms of its business model, team composition and even the nature of its existence; however, this did not deter Suraj from pursuing his goal.

The case brings into focus the health-care system of India, especially in the context of the urban poor and the challenges they are facing, followed by the initiatives taken by Swasth Foundation and the impact it is trying to create. The remainder of the case delves into Suraj’s entrepreneurial journey and the three pivotal decisions that changed the course of his organization over 11 years. It will also provide a transpicuous view of the entrepreneurial decision-making process through the lens of pivoting. As Suraj and his team are trying to bring about the required changes through the third pivot, there remain some challenges that need to be addressed for a successful implementation.

The case is written for business management students and can be used in general management, entrepreneurship and strategy classes. The case can be used for discussions on leadership, social entrepreneurship and strategic decision-making. It is suited for both undergraduate and postgraduate levels.

Subject area – Marketing and strategic decision making. Study level/applicability – Undergraduate business and management programmes, particularly with advanced marketing modules; and MBA programmes incorporating strategic management. Case overview – Claudio Bedoya, founder of BioScience (BS) and CEO has decided to launch a new product line, BioMobile (BM), to enter the new telemedicine market. BS is an Argentine company, which develops and commercializes innovative diagnosis equipments since 1995. The BM is a device which sends vital signals (from a patient with a chronic disease) through the mobile phone to a recipient's cell phone (doctor and/or relative).Three market segments, the alternative value propositions and the suggested go-to-markets for each of them are suggested. A debate between Antonio, Claudio's partner and Ydavelis, the marketing manager, highlights the underlying disagreement on which segment to serve and on the choice of value proposition. Expected learning outcomes – The case has been written having a senior classroom in mind. The case works best when used towards the end of the course, as it allows integrating all the concepts discussed in the course as such it assumes that participants have acquired basic concepts of strategic management and marketing management. Thus, it is not in the scope of the case to introduce any new theoretical concepts and no specific reading material is assigned to it:

To apply prior knowledge to an emerging economy setting:

For example: the SWOT analysis, the identification of critical success factors (CSF) for each alternative, segmentation, pricing, or the new product adoption curves.

To calculate the projected revenues with limited data.

To foster critical thinking about a company's strategic planning. Specifically, to be able to identify the underlying business decision: BS needs to decide whether to focus on the B2B/B2C market.

Critically think on the differences between B2B and B2C business models.

The competitive landscape of the U.S. domestic airlines dramatically changed when the industry was deregulated in 1978. While airline traffic and revenues grew exponentially, aided by unfettered market competition and resulting efficiency, airline profitability had mostly stayed lackluster due to cost pressures, chronic oversupply of seats, and intense price-based rivalry to fill seats. Thirty-two years into deregulation, the major airlines were still searching for the Holy Grail that would defend them against industry threats and deliver sustained profitability. This case describes the evolution of the U.S. domestic airline industry over the years, the cost pressures and revenue uncertainties airlines faced at the beginning of 2010, and the strategic options they were contemplating to effectively deal with these issues. The options ranged from shaping the industry structure to achieving differentiation through service offerings. The exact choices they made would determine their survival and long-term success.

This case was developed from secondary sources. The secondary sources included company websites, social media and news reports. This case has been classroom tested in multiple executive master of business administration (MBA) courses on business model innovation and entrepreneurship.

The case traces the entrepreneurial journey of Dozee, a remote patient monitoring system in India. Dozee was manufactured by Turtle Shell Technologies Private Limited, cofounded by Mudit and Gaurav. The primary customers of Dozee’s offering were households with elderly citizens and health-conscious individuals who sought preventive health care. The cofounders identified the unmet need for a convenient and user-friendly contactless health tracker. Dozee team built a thin sensor-embedded sheet and module that can be placed beneath the mattress to track sleep patterns and health vitals. They also provided data analysis and data interpretation services. After four years of conceptualization, Dozee launched its product and service in 2019. Although the initial response was lukewarm, the onset of the COVID-19 crisis led to significant changes in the health-care industry. Demand for virtual assistance and contactless monitoring devices became increasingly important elements of COVID-19 treatment. Unlike other sensor-based fitness trackers, the sheet could be easily placed under the patient’s bed to capture health vitals. Choosing to pivot from a home-based individual customer segment to a medical-grade device provider for hospitals could significantly increase the scale and scope of the offering for Dozee, but it would also place Dozee in direct competition with other health monitoring devices from different business categories.

This case is appropriate for MBA and executive-level courses related to entrepreneurship and business model innovation. The case explores issues such as digital disruption and how start-ups can design a go-to-market strategy. The case works well in the classroom, even if people are unfamiliar with the health-care industry. Participants can certainly relate to the concept of adopting artificial intelligence–enabled devices for monitoring their health. The instructor should be able to quickly engage participants in a lively discussion about Dozee’s vision and the opportunities and challenges in adopting digital solutions in health care.

Executives at biotechnology firm Genzyme are debating funding a clinical trial for a new version of a medical device called Synvisc. The trial is expensive and the odds of success are not high, but the upside is substantial. The case presents a common business question: invest or not? The case forces students to think about customer insights, wrestle with a number of complex issues, and evaluate the financials of the decision.

The case is ideal for teaching financial analysis and decision making. It can also be used to teach marketing, new product strategy, and healthcare industry management.

The purpose of this case study is to illustrate how Dianne Savastano, founder and CEO of Healthassist, Inc., a US-based health-care advocacy firm, successfully led her clients and team through the COVID-19 pandemic of 2020. To gather the data for this case study, the authors interviewed the protagonists, the members of her team and two clients. The authors read Healthassist Newsletters and the firm’s documents; and in fact, they included one Newsletter and several documents in the Exhibits of the case study. The authors conducted a literature review for articles in newspapers and journals about the newly developing field of “health-care advocacy,” a field which Savastano helped to create.

The authors illustrate how Savastano, using the five practices of exemplary leadership by Kouzes and Posner, in The Leadership Challenge, led her team through the pandemic of 2020. This is a story of a woman leader, using traits such as warmth, empathy, analysis and decisiveness, keeps her small business afloat when so many other firms collapsed in 2020.

The authors conducted seven interviews and literature searches on the topics of health-care advocacy; women leaders; leading through a crisis; and COVID-19.

The case study illustrates how a woman founder and CEO can lead her firm through a crisis.

This is an example of how a woman leader managed through the 2020 pandemic.

CSS 3: Entrepreneurship

Dr. Juan Caicedo was educated in general medicine and surgery at Universidad Nacional de Colombia and practiced transplant medicine in Bogota. He determined that he would need to go to the United States to advance his training, and ultimately was awarded a fellowship in transplant surgery at Northwestern Memorial Hospital.

During his three years as a fellow, Caicedo was struck by the number of Hispanic patients on the kidney transplant waiting list. Not only were Hispanics the highest growth group on the transplant waiting list, they also waited longer for transplants and died while waiting at higher rates than non-Hispanic whites or African-Americans. Caicedo also was alarmed by Hispanic patients' lower utilization of living donors for transplantation they were underrepresented not only as live donor transplant patients, but also as donors.

As he neared the end of his fellowship in 2006, Caicedo wondered if the Hispanic population encountered unique barriers to transplantation and living donor usage, and began to think about creating a program to address these barriers.

Stan Kent, vice president of pharmacy at NorthShore University HealthSystem, is faced with the challenge of seasonal planning for the influenza vaccine. The supply received by the multilocation healthcare system is unreliable in terms of timing and quantity. As part of improved planning, Kent is contemplating a new contract with NorthShore's major supplier of flu vaccines. The options under consideration include fixing either the date of delivery or the quantity delivered. The main decision involved in either option would be how much vaccine to order. The case also provides details about the seasonal influenza epidemic in the United States, illustrates operational complexities of the U.S. flu vaccine supply chain, and provides a brief description of the various channels used to distribute flu vaccine to end consumers.

The main objective of the case is to illustrate supply chain decision making when there is an unreliable supply (in contrast to the usual case of uncertain demand). A secondary objective is to make students think about appropriate internal (within sector) and external (other sectors) benchmarks to evaluate the performance of a health commodity supply chain.

This case study is designed to enable students to analyze the competitive landscape of a business impacted by technological disruption; evaluate the viability of an organic growth strategy using stakeholder analysis; evaluate the revenue and cost structure of Apollo 24/7 and decide on the future investment strategy; and analyze funding strategies of traditional hospitals versus pure digital players.

To extend its reach, Apollo Hospitals Enterprise (Apollo Hospitals), a leading private sector brick-and-mortar hospital chain in India known for using state-of-the-art technology, launched a unified virtual mobile platform Apollo 24/7 in February 2020, 45 days into the COVID-19 pandemic. The management believed that the digital platform had a unique ecosystem that could not be replicated. The analysts were optimistic about the impact of the decision on the future performance of Apollo Hospitals, as it was expected to lead to higher penetration and increased revenue. They also anticipated the unlocking of value, as and when the venture capitalist (VC) would invest in Apollo Hospitals. However, with increasing operating expenses on account of burgeoning technological and marketing expenses, things did not seem to go going as planned. Three years later, in February 2022 after the Q3 of financial year 2023 results. Suneeta Reddy, the company’s managing director found herself pondering whether the digital platform could boost Apollo Hospitals’ profitability in addition to expanding its reach and increasing affordability when the company missed the analyst estimates. In India, which was then the second most populous country, “incremental access” and “affordability” were what mattered to the patients, However, for the investors and analysts, it was quarter-on-quarter performance. The change in the macroeconomic environment stalled the company’s plan of raising money from VCs.

Furthermore, the financing dilemma also plagued Reddy. She knew there was a difference between financing for conventional businesses that for digital businesses. She also had to take decide between short-term profitability with which investors were obsessed versus long-term sustainability, which involved taking care of stakeholders’ interests.

This case study is basically aimed at postgraduate courses and executive management courses.

Teaching notes are available for educators only.

CSS11: Strategy.

By reading and understanding the case study, Students will be able to link the importance of healthy life style and the physical exercise to the fitness industry in the UAE society, to reduce the growing percentage of obesity and related diseases; identify the main challenges of Tone Fitness Ladies’ Studio (Tone); explore the market segmentation of fitness centers in UAE based on a benefits segmentation of fitness industry; identify the demographic segmentation of Tone Fitness studio and the effects of considering gender and age; and develop individual perspectives of how Tone Fitness ladies’ studio may overcome the challenges to compete in the UAE fitness market.

Three sisters from the United Arab Emirates (Hind, Mariam and Amna Mohamed Omer) have established a fitness studio for women in Al Maqta’a (formerly known as Bain al Jasrain) on the eastern side of Abu Dhabi. Each of them shared a passion for sport, which led them to realize their business idea of setting up a fitness studio specifically for women. An understanding of Emirati culture and the needs of women in their society inspired them to think of a special place where women could find relief from work and life demands while also exercising pursuant of a healthy lifestyle. They launched Tone Ladies’ Fitness Studio (Tone) in September 2014, the first fitness studio for women in Al Maqta’a. The studio is in the same building as a cooperative hypermarket – a very good location because it is visited by many people and has ample parking spaces. Partly due to growing interest among Abu Dhabi residents in fitness and health, new fitness studios opened nearby in 2016, with competitors offering excellent services at reasonable prices. While the demand for fitness and healthy lifestyle pursuits is high in the region, the market has also expanded greatly to meet this demand, with many high-quality options becoming available. As a result of this, businesses such as Tone are facing serious threats to their sustainability. Thus, first, how can the Omer sisters sustain their business and strategize to maintain customers in their market segment? Second, what could they do to improve the market position of Tone in the UAE fitness market?

This case study is suitable for advanced level of diploma certificate in marketing or undergraduate student of marketing field.

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

CSS 8: Marketing