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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.

In March 2007 C. James Prieur, CEO of insurance provider Conseco, was faced with a crisis. The front page of the New York Times featured a story on the grieving family of an elderly woman who had faithfully paid for her Conseco long-term care (LTC) policy, only to find that it would not pay her claims. Her family had to pay for her care (until her recent death), which unfortunately resulted in the loss of the family business. The family was now very publicly pursuing litigation. For a company that depended on thousands of employees, investors, and independent agents who sold the insurance plans, this reputational risk was a serious threat. On top of this immediate crisis, all signs in the industry were pointing to the fact that the LTC business itself was not viable, yet over the years Conseco had acquired a number of LTC insurance providers. Students are asked to analyze not only what Prieur’s priorities should be in addressing the immediate crisis but also the risks inherent in the LTC industry and how this might affect Conseco’s success as a business moving forward

After reading and analyzing the case, students will be able to:

• Analyze the risks in the long-term care insurance industry

• Distinguish the various types of risk that caused a company’s crisis and recognize the potential for contagion

• Brainstorm how the risks faced by Conseco could have been avoided or better contained

• Recommend the first steps C. James Prieur and the Conseco leadership team should take to rectify the New York Times article crisis

Analyze the risks in the long-term care insurance industry

Distinguish the various types of risk that caused a company’s crisis and recognize the potential for contagion

Brainstorm how the risks faced by Conseco could have been avoided or better contained

Recommend the first steps C. James Prieur and the Conseco leadership team should take to rectify the New York Times article crisis

This case is suitable for courses in entrepreneurship and growing enterprises and management communication. It follows the step by step process of growing a business built on a strong culture that fosters high employee engagement and loyalty. The result for Leaders was low employee turnover, long-term relationships based on communication and trust, and being a finalist on the Wall Street Journal's 2008 Top Small Workplaces list.

Leraning outcomes are as follows: demonstrating how companies in the Indian market are using competitive advertising; giving participants an overview of the regulatory framework for advertising in India; highlighting the complexities arising out of the multiplicity of advertising regulations and institutions in India; appreciating the legal and ethical perspectives of advertisements and self-regulation; and evaluating the stance taken by both the parties in this particular case to develop multi-stakeholder perspective.

A recent advertisement by international conglomerate Hindustan Unilever Limited was severely criticized for insulting Indian values by Baba Ramdev, promoter of India's largest Ayurvedic Company selling Indian indigenous and natural alternate medicinal products. It was in a complete reversal of the scenario between 2015 and 2018 when other Indian consumer goods companies complained against advertisements released by Patanjali. Indian fast moving consumer goods sector is witnessing a trend of competitive advertising in which companies are downplaying and criticizing the competitors. Though quite old, this trend caught momentum when Patanjali Ayurved Limited, a new player in the market, started advertising aggressively in 2015–2016. It resulted in many complaints by the aggrieved parties in the industry bodies and different courts of law in India. A part of the confusion comes from the diversity of advertising regulations across different Indian platforms and the absence of a clearly defined institutional framework for resolving such disputes. Consequently, most such disputes land up in the court of law in India. The case study builds an understanding of the legal framework within which companies are governed for brand promotions and creates a contextual ethical dilemma to drive the discourse on advertising through self-regulation in India.

This case is meant to benefit students pursuing a graduate or upper-level undergraduate degree in management or law/business law.

Teaching notes are available for educators only.

CSS 8: Marketing.

‘Saksham’, a corporate social responsibility (CSR) initiative of one of the largest public sector companies in India, the Gas Authority of India Limited (GAIL), provides specific training in skills required for plastic industry to low-income communities potentially affected by GAIL's business operations. Unlike a typical GAIL CSR programme, which directly targets communities affected by GAIL's operations, the Saksham programme serves the needs of one of GAIL's main customers - the small and medium scale plastic industry. Although the programme is a huge success and has completed three batches, all the students of which were placed in plastic manufacturing companies, Shamasundara, Zonal General Manager of GAIL is still not sure about the future of the programme. He wondered what should be the metrics to evaluate whether a programme can be classified as a CSR initiative by a firm.

The Congregation of the Blessed Virgin Mary (CBVM), a Catholic order founded in the early 1800s, was faced with a series of strategic concerns, including an aging clerical population, a changing laity, reduced finances, very limited vocations, and an evolving mission. Some of these concerns faced the Catholic Church in America as a whole (including sexual abuse, not discussed in this case) and several of these issues were also facing the Catholic Church worldwide. The serious matters facing them were threatening the continued viability of the order in America, and the guidance they were receiving from Rome - instruction to decide which of three suggested models for restructuring they would adopt - seemed to back them into a corner, requiring selection from among several strategies not devised by their membership and commitment to the selected strategy going forward. Change was necessary, but one of the major concerns of the order was that it remain consistent with its stated mission while adapting to a new environment and “operating system.” Their decisions were driven by Rome, but the decisions were not made by Rome; the CBVM was as autonomous in its decision-making as any decentralized international organization.

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.

The subject areas are business communication, human resource management and health care.

The case was designed for use in a first-year MBA-level course in business communication but would serve well in a course for executives or for advanced undergraduates. It might also be assigned in general management courses to evoke discussion on communication skills required in sensitive and critical situations; human resource courses; and course on health care.

Palliative care is a specialized medical care focussing on improving the quality of life of patients suffering from life-threatening illnesses. It addresses symptom management and psychosocial and spiritual concerns of the patient and its caregivers. With the intent to alleviate the sufferings of terminally ill patients, Rajbala Foundation, a non-government organization (NGO), works at the psychosocial and spiritual levels. While training their volunteers in effective palliative care communication, it often encounters challenges such as socio-cultural variations, organizational challenges, appropriate verbal and nonverbal communication, etc. This teaching case focuses on the communication challenges faced by the volunteers of Rajbala Foundation. It would lead to a broader discussion on communicating empathically during critical situations. The case has a focus on NGOs, and non-profit organizations, public sector management, health-care management and human resources management. There is significant literature on communication skills for medical practitioners in palliative care. As an increasing number of NGOs step in to provide the second level of care to critically ill patients in non-physical domains, there is a need to understand the role of effective communication for such care providers. This case deals with non-medical care providers in palliative care; the issues of communication they face as they interact with patients; and the skills they require to address the emotional and spiritual needs of patients and their families.

The aim of this case is to raise awareness of the complexities involved in the communication process during an emotional and sensitive interaction. It aims to encourage volunteers involved in palliative care to reflect on good communication practices when communicating with patients and family members. After reading this case, the students should be able to discuss the complexities involved in the communication process when communicating in situations with high emotional involvement; understand the core elements of emotional interactions for effective practice; and emphasize the need for the development of communication skills within palliative care.

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 6: Human Resource Management

After completion of this case study, students will be able to describe the funding path for start-ups, including the amounts and profiles of the usual investors or sources of funds, according to the moment in their life cycle and the characteristics of the initiative; highlight the challenges faced by start-up founders in weak entrepreneurial ecosystems and risky institutional environments; and argue in favor of or against different modes and typical instruments of venture capital (VC) investments in the early stages of new businesses, each of them different regarding dilutions, valuation potential, depth of negotiations and term sheets.

Asistensi, a technology and telemedicine start-up founded in 2020 in Venezuela by three entrepreneurs (Andrés Simón González-Silén, Luis Enrique Velásquez and Armando Baquero), raised US$3m in less than a year in a seed round in which it attracted the attention of professional VC funds such as Mountain Nazca, Alma Mundi Ventures and 468 Capital. Everything was set for launching operations in Mexico and the Dominican Republic in April 2021. However, a series of difficulties led to higher expenditure than planned, prompting the entrepreneurs to seek additional capital. The decision on the financial instrument to be associated with the potential valuation and shareholder dilution figures has been posed as a dilemma.

The case study focuses on understanding the start-up financing process. It can be used effectively in management- and finance-related subjects for graduate students taking introductory topics in entrepreneurship and entrepreneurial finance, as well as introductory executive education courses in entrepreneurship, entrepreneurial finance and VC.

Teaching notes are available for educators only.

CSS3: Entrepreneurship

This case is best taught in a first-year MBA finance course and with a series of cases based on cash flow analysis. Its primary objective is to portray the major differences in project analysis for nonprofit organizations compared to for-profit companies and to highlight the unique issues relevant in a health care environment. Students must decide, based on cash flow analysis and nonfinancial factors, whether or not to propose a long-term acute care hospital (LTAC) project to the board of directors of the U. Va. Health System. Students must use the assumptions outlined in the case to create a cash flow analysis and then compute a net present value (NPV) calculation and internal rate of return (IRR) for the project. After assessing the base-case results and sensitivity analysis of the assumptions driving those results, students must decide if the project should be taken to the board of directors.