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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.

Organisational behaviour; Leadership; Organisational development; Public–Private partnership; Health care management; Public health.

Masters students in Business Administration, Post Graduate Diploma, Clinical Training of Medical Professionals, Health Leadership Programme.

Prof Jannie Hugo, the protagonist in the case, was considering his dilemma of aligning the multiple partners involved in public health care. A high level of collaboration was required of a multitude of stakeholders in developing the Daspoort clinic into a pilot site for the Tshwane district’s implementation of the National Health Insurance system. In addition, the re-engineering of primary health care with the focus on the patient and community orientated approach were launched on this site.

Gaining insight into international and national landscapes and principles of health care systems. Critically analyse the role of technology in delivering innovative health and social services. Present judgment of Prof Jannie Hugo’s contextual leadership effectiveness in enhancing collaboration between the multiple stakeholders and recommend next steps.

2 × DVDs on Vimeo, Slides and teaching plan with discussion or exam questions with model answers.

CSS 7: Management Science.

The teaching objectives of the case study will enable the students as follows: to recognise the challenges of information technology (IT) implementation in the health-care sector associated with employee resistance, to apply the technology acceptance model for analysing the degree of employee resistance, to relate the utilisation of Kotter’s 8-step change management approach in successful IT implementation in the health-care sector and maintenance of employee productivity and to classify the leadership traits reflected by the leaders in training the 600 diverse employee population of Al-Ain hospital.

The case highlighted the predicament the government-owned Al-Ain City Hospital, United Arab Emirates, faced following the surge in the incidences of COVID-19 in the country in March 2020. The hospital management decided to initiate the work-from-home arrangement as a non-pharmaceutical intervention of handling the spread of the disease amongst its employees. Fatima Almur, the Information Technology Director in Al-Ain Hospital, asked the Application Support Manager, Aysha Shahwan, to deploy some IT tools significant for remote support to patient care within two weeks. Shahwan faced significant challenges in deploying the IT tools in two weeks given the diverse workforce, with the majority of them having limited knowledge in operating the tools, and hence, their apprehension in the usefulness of the tools. Besides, Shahwan had to deploy some advanced tools for easy and secured access to the electronic health record, telemedicine and telecommuting using mobile phones, tablets or PCs. The deployment of these advanced tools would be jeopardised by employee acceptance and consequent dwindling productivity. Considering the issue of employee acceptance of the change and their limited knowledge, Shahwan had, therefore, to develop training frameworks to boost the former’s perceived usefulness and ease-of-use of the IT tools. Will Shahwan successfully deploy the advanced IT tools to enable the hospital staff, including medical staff and departments, to ensure efficient patient care from a remote location? Will she be able to train the 600 employees across genders, ages and knowledge, use the IT tools and safeguard them from common software threats like email phishing and ransomware? Will the hospital be able to sustain its vision of quality patient care using advanced technologies through this new arrangement of remote support amidst the pandemic when patients are more?

Undergraduate business management.

Teaching Notes are available for educators only.

CSS 10: Public sector management.

Public Health; Leadership; Organisational Development; Organisational Behaviour; Public Administration Management.

Postgraduate level for honours or masters programmes in courses on public health; executive leadership and management programmes; MBA level.

The case unpacks decentralisation as a means to promote and improve local decision-making and accountability through community participation and engagements. Ayanda Nkele was a programme manager in a health district in South Africa. He was faced with many challenges when trying to implement his programme, most of which were related to local authority, responsibilities and decision-making abilities at his level. This case describes briefly the South African health system. and how it functions. It describes the proposed changes to the health system and its transformation towards Universal Health Coverage. The decision space analysis as discussed in the case illustrates the types of decentralisation in the country and how this also applies to Nkele’s level.

Understanding the concepts and principles of decentralisation within the context of strengthening district health services, the re-engineering of primary health care (PHC) and rolling out a National Health Insurance in South Africa. Applying the “decision space” approach to analyse the extent of decentralisation. Grasping the requirement of leaders to be “contextually intelligent” and identify the important contextual variables to take into account when analysing public health 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 7: Management Science.

This case study can be used at the graduate and executive levels.

This case study can be used in entrepreneurship, leadership, social entrepreneurship and human resource management.

Healing Fields Foundation is a non-governmental organisation (NGO) that was co-founded by Mukti Bosco to create an affordable and quality health-care ecosystem, primarily through women. The pragmatism of Mukti and her strong alignment with the core values of the foundation ensured that they emerged unscathed from past challenges. During the second wave of the pandemic in 2021, they employed bikers on a contractual basis to satisfy last-mile delivery demand in rural India. However, owing to the recovery post the second wave, the demand for their services dropped and subsequently their earnings. Being provided with four options by her COO, Mukti is cognisant of the social implications her decisions will have on all the stakeholders in the ecosystem.

A. Identify and prioritise key stakeholders of the organisation for effective decision-making. B. Differentiate effectual from causal reasoning and apply their right balance while making decisions. C. Delineate social entrepreneurs from their for-profit, non-mission-driven counterparts. D. Create value for the organisation’s stakeholders through the management of its diverse workforce. E. Formulate entrepreneurial solutions through the application of relevant concepts and frameworks.

CSS 3: Entrepreneurship.

In January 2005 Dr. Mean Chhi Vun, director of the Cambodian National Center for HIV/AIDS, Dermatology and STDs (NCHADS), needed to decide how to control the spread of HIV/AIDS and save the lives of thousands of Cambodians who were dying from it each year. In the seven years since Dr. Vun had been appointed director, NCHADS had built an organization that was transparent and efficient, had implemented a nationwide 100 percent Condom Use Program, had established a system that allowed individuals to voluntarily seek confidential counseling and testing, and had instituted a set of guidelines and procedures for staff at health facilities to refer HIV-positive patients to treatment clinics and link them with NGOs providing financial and psychosocial support. Now, however, Dr. Vun faced decisions about three initiatives that were critical to expanding care and treatment programs in his country. First, he needed to decide how to quickly and cost-effectively improve the national HIV/AIDS laboratory support infrastructure. Second, Dr. Vun needed to improve logistics and supply management in order to get the best prices and ensure patients had access to life-saving medicines. Finally, he needed to figure out how to provide sustainable care and treatment to the thousands of Cambodian children living with HIV/AIDS.

Create innovative solutions for large-scale, socially relevant challenges. Understand how to start, scale, and lead cross-sector public health initiatives, or any initiative requiring behavior change by a range of players on a large scale over the long term. Discover and implement operating models that balance the needs of for-profit, non-profit, and government organizations. More effectively manage situations where required resources are not under one's direct control.

The subject area is entrepreneurship.

Graduate and executive education level in leadership, entrepreneurship and strategic management are used to discuss leadership, entrepreneurship and strategy in health services.

This case talks about the passionate journey of a pediatrician practicing in the Mumbai city of India, who as an individual private practitioner is contributing to the fulfilment of the global health agenda and the fourth Millennium Development Goal (MDG) – “reduce child mortality”. His vision is to make quality and affordable expert pediatric care accessible to all the individuals, right from pre-birth to adulthood. Surya Mother and Child Care Hospital (SMCH) is being strengthened as a nation-wide network of mother and child hospital offering patient/consumer-centric integrated collaborative quality care, and it needs to be seen how this model can be made sustainable as it enlarges in scale for the future.

The case is structured to achieve the following learning outcomes: to understand about effectuation as a logic for entrepreneurial success through the lens of Dr Avasthi and his venture SMCH; To understand and apply Porter’s Principles of value transformation that essentially focus on outcome-driven cost-efficient work practices in a collaborative integrative fashion, where transformation must come from within (some practices suggested can be applied to the Indian Healthcare Services Delivery systems); to critically analyze the overall strategic position of SMCH as an organization and its competitive environment; to discuss the factors influencing health-care delivery capacity build up, given the MDGs 2015, Every Newborn Action Plan and Indian Newborn Action Plan framework, as applicable to India; and to discuss and analyze mechanisms for future sustainable service delivery options for SMCH. Although each of these principles is important, possibly, the instructor could emphasize and encourage more discussions on potential models of shared partnerships that can help quality health-care services reach the unreached and the incorporation of technology in achieving this. The learning process can also facilitate discussions about leadership qualities in the creation of health-care entrepreneurs, for the “Change That They Would Want To See”.

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:3 Entrepreneurship.

In mid-February 2009, amid the global financial crisis, the news was grim. The U.S. economy had been in recession since December 2007. If the downturn lasted into early spring, it would become America's longest postwar recession. The economy had shed 3.5 million jobs over the previous 12 months, the worst 12-month period on record. Bank lending was plummeting; the few banks with funds available were holding onto them. With this massive shift into liquid assets (cash and cash equivalents) and away from lending of any sort (even for productive uses or, in many cases, the working capital firms needed to survive), the economy would likely grind to a halt. On this brisk mid-February day in Washington, Timothy Geithner and Ben Bernanke rolled up their sleeves and reevaluated their plans to address the nearly impossible task of righting the ship. In terms of monetary and fiscal policy, were they doing all they could to halt this epic slide? Were they doing too much?

To develop the case, the authors used secondary sources including company annual reports, industry reports, news articles, social media sites, academic journal articles and company websites. This case has been classroom tested with students in the MBA Program and Master of Science in Management and Technology Program, and with undergraduates in an operations management course.

Movado Group, which has been a fierce competitor in the luxury watch market, has been facing unprecedented challenges posed by consumers’ enthusiasm for smartwatches and by their love of shopping online. The arrival of the COVID-19 pandemic has intensified these problems and brought new setbacks. This case examines these challenges to the company’s current business model. It then explores opportunities that could transform Movado into an innovative, digitally oriented organization capable of reaching consumers in a dynamic market while combating intense competition from the smart wearable devices that threaten traditional watch companies. The case also discusses the importance of building a robust supply chain through the lens of Industry 4.0 to guard against future supply chain disruptions.

Instructors can use this case in operations and supply chain management classes at the undergraduate and graduate levels. The focus of the case aligns with discussions of supply chain management and Industry 4.0. In particular, the case uses supply chain innovation theory to investigate the implications of Industry 4.0 in the watch industry and dovetails into discussions of omni-channel experience and virtual reality in retail that integrate multiple points of contact to reach consumers efficiently.

Strategic Management.

MBA, Executive MBA.

This case deals with Harsh Mariwalla’s struggle to develop an innovative company from scratch. The journey of innovation is not an easy one. Marico was forced to compete with multinationals in many markets where it operated. Constant pressure from rivals has made the company develop a new innovative business model, which is expected to generate profitability and sustainable competitive advantage.

Students will be able to appreciate the business models, understand the competitive moves by rivals, understand strategy formulation and implementation, understand product innovation and competitive advantage and understand the ability to tackle competition with innovation.

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 11: Strategy.