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The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and Woerner, 2015) and is referred to as the W & W framework. This approach provides a useful structure for thinking through the strategic options facing environments ripe for digital transformation.

Research for this case was conducted through face-to-face interviews with the protagonist, as well as through a review of their business planning documents and other data and documentation provided by the founder. Some of the market and industry data were obtained using secondary research and industry reports. Interviews were digitally recorded and transcribed to ensure accuracy.

The case follows the story of Kurt Waltenbaugh, a Minnesota entrepreneur who shared the dream of using data analytics to reduce costs within the US health-care system. In early 2014, Waltenbaugh and a physician colleague founded Carrot Health to bring together their personal experience and expertise in both consumer data analytics and health care. From the beginning, they focused on how to use data analytics to help identify high-risk/high-cost patients who had not yet sought medical treatment. They believed that they could use these insights to encourage early medical interventions and, as a result, lower the long-term cost of care.

Carrot’s initial success found them in a consultative role, working on behalf of insurance companies. Through this work, they honed their capabilities by helping their clients combine existing claims data with external consumer behavioral data to identify new potential customers. These initial consulting contracts gave Carrot the opportunity to develop its analytic tools, business model and, importantly, to earn some much-needed cash flow during the start-up phase. However, they also learned that, while insurance companies were willing to purchase data insights for one-off market expansion projects, it was much more difficult to motivate them to use data proactively to eliminate costs on an ongoing basis. Waltenbaugh believed that Carrot’s greatest potential lay in their ability to develop predictive models of health outcomes, and this case explores Carrot’s journey through strategic decisions and company transformation.

This case is intended for either an undergraduate or graduate course on entrepreneurial strategy. It provides an effective introduction to the unique structure and constraints which apply to an innovative start-up within the health-care industry. The case also serves as a platform to explore the critical criteria to be considered when developing a digital transformation strategy and exposing students to the digital business model developed by Weill and Woerner (2015) at MIT (referred to in this instructor’s manual as the W&W framework). The case was written to be used in an advanced strategy Master of Business Administration (MBA) class, an undergraduate specialty health-care course or as part of a health-care concentration in a regular MBA, Master of Health Care Administration (MHA) or Master of Public Health (MPH). It may be taught toward the end of a course on business strategy when students are building on generic strategy frameworks and adapting their strategic thinking to the characteristics of specific industries or sectors. However, the case can also be taught as part of a course on health-care innovation in which case it also serves well as an introduction to the health-care payments and insurance system in the USA. Finally, the case can be used in a specialized course on digital transformation strategy in which case it serves as an introduction to the MIT W&W framework.

The case is particularly well-suited to students who are familiar with traditional frameworks for business strategy and business models. The analysis builds on this knowledge and introduces students interested in learning about the opportunities and challenges of digital strategy. Equally, the case works well for students with clinical backgrounds, who are interested in how business strategy can influence changes within the health-care sphere. Finally, an important aspect of the case design was to develop students’ analytical confidence by encouraging them to “get their hands dirty” and to carry out some basic exploratory data analytics themselves. As such, the case requires students to combine and correlate data and to experience the potentially powerful combination of clinical and consumer data. Instructors should find that the insights from these activities give students unique insights into the potential for of data analytics to move health care from a reactive/treatment ethos to a proactive/intervention ethos. This experience can be particularly revealing for students with clinical backgrounds who may initially be resistant to the use of clinical data by commercial organizations.

MBA.

Master’s level in Change Management, Organizational Leadership and Human Resource Management.

Mr Sharma, the dynamic and entrepreneurial Chief Executive Officer (CEO) of the newly formed Soni Manipal Hospital (SMH), Jaipur, and Unit Head, Manipal Hospitals [Manipal Health Enterprises Pvt Ltd. (MHEPL)], in a meeting with SMH’s Head of Human Resources and the Head of the Nursing Management, Mr Yaduvanshi realised the exponential growth of employee resistance, their lack of skills and technological advancements for documentation hindering the hospital's transformation goal. The case study highlighted the challenges the protagonist faced when taking charge as the CEO after nine months of acquisition and the factors contributing to them.

Students reading this case are expected to understand leadership theories, strategic and quality management approaches, and theories of social behaviour, such as Herzberg’s two-factor theory and social exchange theory (SET) and the application of these concepts in acquired organisations to develop healthy leadership–employee relations and change management theories.

Teaching notes are available for educators only.

CSS 6: Human resource management.

After completion of the case study, students will be able to appreciate the challenges in managing a pharma sales team by learning the nuances of business hygiene, learn how new managers taking over a pharma sales team analyze data of a sales territory by balancing both quantitative and qualitative factors, evaluate the challenges of performance management of sales teams and balancing the expectations of various stakeholders, understand the approach of sales and effort hygiene – correlating data points that may not be directly connected but have a dependency and learn to forecast and build a business projection

Innov-Health’s dermatology (skin and hair) division in West Bengal, an Eastern state of India, recently hired Pradeep Vir as the area business manager. Innov-Health, a leading 100-year-old global healthcare player, was headquartered in the USA, with categories spanning oncology, immunology, neurosciences, metabolic, dermatology and pain management. Its brand Acnend, an acne cream, the only product in the division, was a market leader in India. Acnend required doctors’ prescriptions to be bought and was sold by pharmacies via distributors. In India, Acnend was doing well at the end of the first quarter (January–March) of 2022 in a highly competitive product category. Vir had just joined the West Bengal territory with four major cities, each with a district manager (DM). The position had been vacant for the past three months, but the DMs had done well in their sales performance for Quarter 1. All of them had achieved their targets, so Quarter 2, when he joined, started on a high note. But Salil Govind, the regional sales manager, his boss, was very concerned that a territory that had no manager had been consistently doing so well. He was concerned that the territory had far greater potential than the Quarter 1 projections had laid out. Govind now wanted Vir to re-work the Quarter 2 projections of West Bengal on priority since April had already begun. As Vir started working on the data, he was perplexed. While at a very obvious level, all four DMs were outperforming, there were gaps in varying degrees in the effort levels of each. The cumulative key performance indicators such as inventory, call average and doctor coverage and the data essentials for business hygiene[1] were worrisome and needed to be addressed. In addition, the doctor coverage, resulting in conversion, left a lot to be desired. However, he was conscious that he was new to the organization and would have to tread carefully. He wanted to do well. Vir got down to analyzing and taking action.

This case study is suitable for use in graduate-level management programs. It can be useful in courses such as sales management, marketing strategy and marketing analytics. The case study is also well suited to introducing students to the basics of sales, sales productivity, territory management, managing a team and business forecasting. The case study provides students a step-by-step understanding of business hygiene, and how just looking at overall sales numbers may not be conclusive, but a deep dive into effort and productivity is far more useful for forecasting.

Teaching notes are available for educators only.

CSS 8: Marketing.

The learning outcomes focus on enabling higher-order learning for students to critically assess Agile project management in philanthropic settings, specifically compare and contrast Agile project management versus traditional project management in the context of a non-profit organisation (The Solidarity Fund) during a crisis; discuss and evaluate the role and contribution of philanthropy during times of crisis; rate the value additions and contributions of Agile approaches in philanthropy; evaluate the phases of Agile (unconventional) project management executed by The Solidarity Fund; and develop a review of the impact of the work done by The Solidarity Fund in terms of the approach that the Fund used. How effective/not effective was it?

Chaos, crisis and confusion: the three “C”s that succinctly condense the status quo during the COVID-19 pandemic. The roles and contributions of non-profit organisations gained recognition as countries worldwide responded to the crisis to save lives and livelihoods.

In South Africa, there was a sense of urgency and considerable pressure for a multi-stakeholder approach led by the government to save as many South African lives as possible. The conditions, however, were the opposite of traditional project management methodologies that advocate for the management of the triple constraints, namely, cost, time and scope.

How could cost be managed in a project without a set budget and which was reliant on philanthropy? How could time be managed without a set deadline and while tackling an invisible enemy – a virus that changed dynamics on a daily basis and – how could scope be managed in a context where the future was increasingly uncertain?

This case study can be useful for students undertaking postgraduate diploma in business, master of business administration (MBA), master of management courses.

Teaching notes are available for educators only.

CSS 11: Strategy.