Innovations that radically redefine how a service is delivered can create tremendous value for customers and for providers. But they require deep insight into clients' needs and the revising of basic assumptions. It's possible, for example, that a doctor can treat more than one patient at a time. Organizations can redefine service delivery along four dimensions. A change in one may unlock--or block--possibilities for innovation in the others. 1) The structure of the interaction. Sometimes the service becomes more valuable to clients if they share it with others or if multiple providers coordinate closely to deliver it. 2) The service boundary. If a segment of clients uses the same complementary services and has trouble accessing them, a provider might consider integrating them into its offering. 3) The allocation of tasks. Who actually delivers the service? Employees' expertise might not match their assigned tasks. 4) The delivery location. This should be defined by the client's needs, not the provider's.
The Joslin Diabetes Center in Boston, Massachusetts is a leading center for diabetes care, clinician training, and research. The incidence of diabetes is rising precipitously worldwide, challenging quality of life with its complications and rapidly accelerating health care expenditures for employers and governments. The Joslin's multispecialty, team-based care and patient education programs provide opportunities to examine integrated practice units, early-stage and preventive care, and clinical coordination along the full care cycle. The focus on diabetes also enables discussion of what services need to be included in integrated practice units serving patients with complex, chronic diseases. However, despite its renown, the Joslin's clinical operations lose money, raising the challenge of how to align financial success and clinical success in health care delivery. The case can be used to teach strategy in health care delivery, value creation, outcome measurement, reimbursement, and strategic alliances.
The Cleveland Clinic's health care services are internationally renowned for quality. In 2008, The Clinic began to restructure the organization into teams defined around patient needs, rather than traditional medical specialties."Patients First! takes shape as the teams measure and report outcomes, coordinate care, and develop to support improving value for patients. In addition to restructuring care delivery in the hospitals and throughout northeastern Ohio, The Clinic has investments, facilities, and staff in several other states in the U.S. as well as in Canada and Abu Dhabi. Now in 2015, as the Clinic's domestic and international footprint continues to expand, its leadership is also focused in maintaining the Cleveland Clinic brand and providing optimal clinical care. Students can explore strategy transformation, geographic expansion, the process of introducing new measurement approaches, alignment of activities with strategic goals, and issues in leading change both within a company and across an economic sector.
The U.S. health care system is in bad shape. Medical services are restricted or rationed, many patients receive poor care, and high rates of preventable medical error persist. There are wide and inexplicable differences in costs and quality among providers and across geographic areas. In well-functioning, competitive markets, such outcomes would be inconceivable. In health care, these results are intolerable. Competition in health care needs to change, say the authors. It currently operates at the wrong level. Payers, health plans, providers, physicians, and others in the system wrangle over the wrong things, in the wrong locations, and at the wrong times. System participants divide value instead of creating it. (And in some instances, they destroy it.) They shift costs onto one another, restrict access to care, stifle innovation, and hoard information--all without truly benefiting patients. This form of zero-sum competition must be replaced by competition at the level of preventing, diagnosing, and treating individual conditions and diseases. Among the authors' well-researched recommendations for reform: Standardized information about individual diseases and treatments should be collected and disseminated widely so patients can make informed choices about their care. Payers, providers, and health plans should establish transparent billing and pricing mechanisms to reduce cost shifting, confusion, pricing discrimination, and other inefficiencies in the system. And health care providers should be experts in certain conditions and treatments rather than try to be all things to all people. U.S. employers can also play a big role in reform by changing how they manage their health benefits.
Although more consumers are answering questions about where they purchased merchandise in the United States with "I got it at Wal-Mart," the retail behemoth has questions it needs answered about the current, international issues it faces. Where, when, and how can it use its capabilities in other countries? And how can capabilities and knowledge developed in one part of the globe be used in North America, South America, Asia, and Europe to repeat its success? The case provides a strategic analysis of the problems of international expansion as Wal-Mart dreams of hearing the I-got-it-at-Wal-Mart answer spoken in many languages.
Two entrepreneurs face a tough decision when confronted with disappointing test results from the medical application they have chosen to commercialize their innovative process technology. They must decide whether to redesign the technology's current lead-application or to change applications altogether.
The dramatic shifts of the imaging industry from analog to digital technology is creating emerging markets in 1995. How can a competitor position itself to enter the market successfully? This case describes the key technologies, market segments, competitors, and strategic issues in the emerging digital camera market. Focuses on the emergence of business and consumer segments for desktop personal computer imaging--the so-called "descent to the desktop." Competitors profiled are Apple, Canon, Dycam, Eastman Kodak, Fuji, and Sony.
When is a product ready for the market? In this case, engineers present a prototype medical device product to the CEO for approval. The product, developed under a tight deadline, is essentially identical to the main competitor's product, but that competitor is temporarily off the market due to regulatory problems. The CEO must decide whether to take the product quickly to market to take advantage of the window of opportunity, or to send the engineers back to the lab to develop a more distinctive product that could differentiate Zoll more in the long term.
This case follows the development of a firm's first product, the public presentation of research results, and the stock market reactions. In spite of successful research, the stock price falls dramatically. Asks why this happened, how concerned the CEO should be, whether management could have prevented it, and what the firm should do now.
Health care reform in the United States is on a collision course with economic reality. Most proposals focus on measures that will produce one-time cost savings by eliminating waste and inefficiency. But the right question to ask is how to achieve dramatic and sustained cost reductions over time. What will it take to foster entirely new approaches to disease prevention and treatment, whole new ways to deliver services, and more cost-effective facilities? The answer lies in the powerful lessons business has learned over the past two decades about the imperatives of competition. In industry after industry, the underlying dynamic is the same: competition compels companies to deliver constantly increasing value to customers.
Genzyme Corp., one of the largest biotechnology companies, has succeeded in developing, manufacturing, and commercializing its first therapeutic, a treatment for a rare genetic disease. Analysis of the case requires students to identify and understand how Genzyme has designed its strategy to effectively manage, mitigate, or exploit the uncertainties it had faced in the past. In 1993, the company faces challenges in managing future uncertainties involving the product's market, manufacturing, and pricing.
Describes McCaw Cellular Communications, Inc.'s investment decision and strategic plans in 1990, following the situation in the (A) case. Outlines the competitive situation in other types of mobile communications in the United States and the United Kingdom in 1991.