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Individuals in health systems around the world are unambiguously committed to meeting the challenges of COVID-19. An uncountable number of people are working tirelessly, often at risk of their own health and lives. But success requires far more than individual effort. The authors argue that organizations throughout the health system must systematically split up the burden of response in order to deal effectively with immediate needs - as well as those lurking around the corner. The authors argue for four distinct teams: an immediate challenges team; a remote services team; an external coordination team; and a scenario planning team. They describe each in detail and show that embracing this model will lay down a base for longer- term gains, both in healthcare and in health itself.

Verily Life Sciences, an independent subsidiary of Alphabet, Inc., set out to harness machine learning in the health care field. The company sought partnerships with academic research institutions, legacy life sciences companies, and hospitals and health systems to develop tools to collect and organize health data, with the goal of creating platforms that utilized the insights from that data to enhance patient care. The case study discusses these broad partnerships and goals, the illness-specific health monitoring and care tools in Verily's project pipeline, and efforts by competitors like Apple and Amazon- as well as a growing number of start-ups. The case provides insights into decision making in the largely uncharted territory of machine learning in the health care industry, providing an in-depth look at Verily's diabetic retinopathy project, which screened for eye disease.

Spreadsheet supplement for case OIT120.

Health care management requires careful planning for efficient operations, in an environment where technology, best practices, and patient demands continue to change rapidly. This case study presents an operations management decision at a large academic medical center in response to falling demand for cardiac catheterization (CATH) procedures and growing demand for electrophysiology (EP) procedures, and requires students to consider all angles of the decision. Merging two currently separate but clinically similar labs into a contiguous physical space would allow for more efficient scheduling and operational efficiency in the shared space, as well as affect clinical outcomes, and patient and staff satisfaction. In this case study, students analyze the operational decisions required to plan the merger of the two labs to achieve operational, financial, and clinical hospital objectives, using a dataset too large to analyze manually. The case asks students to create compelling visual representations of these data, use a discrete event simulation (DES) model, and present their results as if to hospital leadership.

The Palo Alto Health System had three hospitals, 1,600 physicians, and over 1 million patients each year - and a new risk-based model that incentivized the prevention of illness, as well as early intervention in patients with chronic illness. Engaging with patient populations involved clinical interventions, but also involved a marketing approach to encourage patients to adopt health behaviors and keep following those practices. This case study investigates this marketing aspect of health care, and looks at ways in which Amazon's Alexa, an interactive speaker that connected people to the Internet and the cloud-based Alexa voice service, could enhance health care efforts. With patient permission, Alexa could collect specific health-related information, and could help schedule patients for medical screenings and then report back important laboratory results. One early adopter was the U.K. National Health Service, which contracted to use Alexa to provide health-related content to patients - the same information that was available on the public website. The case study considers health care privacy issues, and asks students to consider whether a marketing approach to health care, in this case using Alexa or another Internet personal assistant, would be a successful strategy for the Palo Alto Health System.

Kaiser Permanente (KP) is the largest managed care organization in the US with over 10 million members. KP evolved from a pre-payment or capitation model that focuses the organization around the efficiency of care and the health of the population it serves. This financial model is in stark contrast to the fee-for-service payment model for other health care organizations. Given the epidemic of obesity in the US, KP is facing an enormous potential liability from future costs of obesity and diabetes. Given low turnover in health plan membership, how should they respond to this crisis? How should they invest in the health of their covered population, their employees, and the communities they serve? The case details the origins and development of KP.

This case explores the development of a business plan for a mobile health application for diabetes care. The case depicts a student team excited about the opportunity to improve the care of patients with diabetes by contracting an app. They go through a rigorous evaluation of the FDA regulations, the existing market, and potential commercial competitors to try and identify a market opportunity. Since diabetes care involves behavior change, the case then moves to an exploration to concepts from behavioral economics that could help build a sustainable platform for the app. In the end, the case questions ask the team to decide on a basic business and financing strategy if they want to go forward, or offers them the opportunity to "fail-fast" by quitting at this stage.

PharmAccess is an Amsterdam based NGO working to support the development of the private health care market in Africa. This work is critical as over 50% of care is delivered through the private sector, but well-intentioned efforts to address global health through the public sector have the unintended consequence of crowding-out capital formation in the private sector. PharmaAccess is working to crowd-in funding instead through the development of a three-pronged effort in Kenya. They are working to address supply through efforts to improve the quality of health care facilities through education and through a micro-lending program. At the same time, they are working to address demand through the development of the M-TIBA mobile health wallet. The critical question for this case is whether these efforts, in essence the development of a novel platform simultaneously addressing supply and demand, will be enough to change the dynamics of the private health care market. The case provides a background on private health care in Africa and in Kenya.

Shisong Cardiac Center in Kumbo, Cameroon, is a regional cardiac referral center in central Africa. As the continent transitions from communicable to non-communicable diseases, there is a critical shortage of surgical care required to treat these conditions. This case describes an innovation solution to the shortage of professional skills, an international collaboration between a hospital in Milan and a hospital in Cameroon. The case highlights the challenges of building and staffing the facility, and then discusses the ongoing operational and financial challenges of operating a heart center in Africa. Can this model be sustained? Can Cameroon develop their own capability to deliver advanced cardiac services domestically? These are critical questions to consider. In spite of these challenges, Co-Founder Sr. Alphonsa finds hope in her favorite African proverb, "Your heart can take you where your feet cannot."

On 2012, Gary Taubes lunched the Nutrition Science initiative (NuSI), a not for profit organization aiming to question the mainstream scientific paradigm regarding obesity and dietary recommendations. This case provides a brief scientific background on obesity and its causes, comorbidities and the economic cost of this epidemic. It then discusses the two main hypotheses of diet, and the formation of NuSI. Finally, it describes the unique challenges and hurdles NuSI has faced both with funding and with impacting the mainstream scientific community. Could this NGO model of funding the "right" clinical trials be successful? Could it be duplicated across other scientific areas? What can be learned from NuSI's experience? And what is the roadmap for NuSI going forward?

Spreadsheet supplement for case 317014.

Genentech, long the darling of the biotechnology industry, was acquired by Swiss pharmaceutical company Roche in 2009. The combined company retains the name Genentech in the US, but must now move to achieve the promises made at the time of this merger-to build from made Genentech great. One of the key tasks for Genentech CEO Ian Clark and CFO Ashraf Hanna was to implement a new portfolio management process for the combined entity. This case explores the goals of the portfolio management process, and allows students to actively participate in the portfolio management exercise. The case includes cost and income projections for 12 products that need to be reviewed and approved.

Steve Healy, the President of Zimmer Spine, has to transform his organization into a market leader. Zimmer is a major medical device firm, but the Spine division has underperformed and it's core technology did not get the expanded FDA label that had been expected. The case reviews the industry, the competitive landscape, and the potential growth strategies for Zimmer Spine to consider.

This teaching note offers an approach to the evaluation of health care markets globally. The note prepares students with a set of questions about the organization of core elements of the health care system. The organization of these elements can vary across markets, and can vary in terms of the different roles of the public and private sector in financing and delivery of health care services. Overall, the framework provides an opportunity for a structured analysis of any market in health care, and provides students with a comprehensive approach to assessing the current health care market. Students can build from this framework with their own assessments of potential opportunities for business or policy innovation within the market.

AbbVie made headlines in March 2015 when it announced its $21 billion acquisition of Pharmacyclics. AbbVie, a research-based pharmaceutical company was founded in 2013 when Abbott split into AbbVie and Abbott Laboratories. Pharmacyclics is a biotechnology company that had received FDA approval in late 2013 for its flagship asset Imbrivica (ibrutinib), a biologic treatment for chronic lymphocytic leukemia and two other even rarer blood malignancies. Entering it's second year on the market, Imbrivica was considered a breakthrough, with revenue expectations of $1 billion in 2015. At the time of the acquisition, AbbVie received more than 60% of its sales from the biologic drug Humira, a biologic agent used to treat several autoimmune diseases and malignancies. However, Humira would soon lose patent protection and face competition from the new class of follow-on biologics, or biosimilars.

Dan Burton, Health Catalyst CEO (HBS Baker Scholar), and Tom Burton, Health Catalyst Senior Vice President of Product Development and co-founder closed on a $41 million investment round. Their firm was one of the hottest companies in the health information technology field. They provided core data warehouse technology to enable analytics from electronic health record systems. Still, they faced significant competition in this space. Could they execute against their vision?

John Muthee and Justus Paul are recent graduates of medical school and a unique program in clinical inforamtics. They return to Nairobi, Kenya with a passion to make a difference in their community. They have a team they know well, but need to find a project concept for a new company. Eventually, they focus on what they believe to be a significant opportunity-supporting health insurance with an electronic eligibility verification and claim submission. They develop a business concept, but have challenges breaking into the market and attracting investment. They finally land a grant (non-dilutive financing) from the US Agency for International Development (USAID) and build their product. Having proven that the technology works, can they scale their solution?

MedCath is a horizontally integrated chain of heart hospitals that partners with local cardiologists. It claims that its focus leads to better and cheaper results than those of an everything-for-everybody general hospital. Community hospitals generally vehemently oppose their entry into a new area. What options does MedCath have?