In 2012, eHealth Centers (eHCs) digitally delivered affordable medical care and diagnostic support for patients in villages and remote areas of India where none was otherwise available. The solution was initially conceived and developed as a mandate from Hewlett Packard India's corporate social responsibility team under the leadership of the chief technology officer. The eHCs design incorporated a self-contained diagnostic centre in a container, operated by a staff of paramedics. Doctors located in urban health hubs provided consulting care through video conferencing, and patients could experience the feeling of being in a doctor's office in real-time. These eHCs slowly turned out to be a business opportunity for Hewlett Packard India. By early 2016, there were 55 centres in operation. The challenge before the company was to scale up exponentially.

In November 2010, the senior director of Inpatient Services at Guelph General Hospital, which was situated in a small city in Southwestern Ontario, Canada, was facing questions about the implementation of the Process Improvement Program, part of a province-wide pilot project. Beginning in October 2009, the program had been tested at the hospital to deal with a deteriorating organizational culture and poor performance reviews. Guelph General Hospital was plagued with inefficiencies: patients leaving untreated, low staff morale, a defensive (blame) culture, and a lack of interdepartmental collaboration. The new program was based on the "lean" methodology developed by Japanese automotive manufacturers, but its use in the hospital had raised questions about whether it was suitable in a healthcare setting. Some employees did not support it and were threatening to leave. Should the hospital continue to implement the lean strategy? How should it move forward?

The president and chief executive officer (CEO) of a provincial auto club is assessing opportunities to grow his organization in light of industry consolidation and punitive changes in allocating of national operating costs. The auto club has diversified from automobile towing and travel services into insurance, package travel, automobile sales and service. However, his vision to the upcoming board of directors' meeting calls for a 300 per cent increase in operating revenues over next 10 years. Without a larger critical mass, the auto club cannot support its allocated costs of branded national and international products. The CEO's challenge is where are the growth opportunities.

In July 2008, the vice chairman, General Electric (GE), and president and chief executive officer (CEO), GE Energy Infrastructure, was mulling over whether GE should re-enter the windpower market in India. Financial incentives had been announced by the Government of India for wind farm operators who generated power through wind energy. These incentives might encourage market development so that GE could leverage the technological strength of its wind-powered turbines. However, as recently as 2005, GE Energy had pulled out of the Indian market after a frustrating stint in the country. The vice chairman needed to weigh the pros and cons of re-entering India and make a decision. There was reason for caution, however, from GE's point of view. India was a complex market in which to operate, and the wind energy market was still developing. To be successful, GE would need to build a local supply chain and compete with Suzlon's (the major domestic competitor) speed of delivery. Suzlon's was a formidable player. Should GE re-enter India?

In January 2010, Andrew Witty realized that the Pharmaceutical Patent Pool in and of itself was insufficient to generate action on neglected tropical diseases. He announced, therefore the "Open Labs, Open Minds" strategy. Was this enough to encourage action for neglected diseases affecting the world's poorest? How would GSK's shareholders react?

In February 2009, Andrew Witty reflected on his vision for big pharma as a catalyst for change which focused on two key issues: 1) promoting innovation for the products that treat or prevent neglected tropical diseases and 2) improving access to medicines in the world's poorest countries. He had announced the creation of the "Pharmaceutical Patent Pool" and wondered if it was the right strategy to deliver on the two key issues.

In January 2009, Pfizer announced its acquisition of Wyeth in a cash and stock deal valued at $68 billion. This deal represented the first mega-acquisition since the world economic crisis, which began in September 2008. Jeff Kindler knew that the last acquisition (Pharmacia in 2003) had not gone as planned. Was Pfizer prepared for the Wyeth acquisition? Would it solve some of Pfizer's pressing problems or create new ones?

The integration of Wyeth began soon after the acquisition was announced in April 2009. Linked to the integration were a series of organizational structural changes. Jeff Kindler wondered whether the acquisition and all the organizational changes linked to it would be enough to generate real long-term success.

Pfizer Inc., the largest research based drug company in the world, is faced with multiple challenges. The key challenges include fierce court battles with generic companies over the patents of Lipitor, reduced productivity from research and development, and a changing external healthcare environment globally with growing importance of emerging markets. These challenges are set within a business environment itself characterized by multi-level change and uncertainty. The case dwells on the newly appointed chief executive officer's strategy in transforming a giant pharmaceutical organization by changing the business model, the strategy and structure to foster organic growth, as well as to explore external opportunities. Does Pfizer need more change or is it merely a matter of time before the new strategy generates results?

As of late 2004, the chief executive officer (CEO) of New York-based wine distributor Monarchia Matt International (MMI) is looking at his portfolio of wines and wondering what advantage Hungarian wine could provide in becoming a powerful niche player in the highly fragmented and complicated U.S. wine industry. The CEO is cognizant of Hungarian wine's reputation in the United States as an inexpensive, mass-produced, and low quality drink. At the same time, the CEO is aware of Hungary's rich wine making tradition and is confident that the country's wine varieties could prove to be a key differentiator and help him grow revenues, from $6 million in 2004 to $50 million by 2010.

In September 2004, four months after Hungary joined the European Union, the strategy group of Matav, Hungary's largest communications company, is working on its mid-term strategic plan. Since being privatized from the state in 1993, the company has seen several changes in its strategy, structure, and culture. Nearly 15 years later, the company is a fully integrated telecommunications company involved in a broad range of services, including fixed line telephony, mobile communications, Internet services, data transmission, and outsourcing. The company's latest acquisition of a state-run telecommunications company is considered a success, and management believes that international expansion is necessary to realize dynamic growth as its domestic fixed line business is declining. In addition, Hungary's mobile market is highly competitive and saturated with 80% of the country having mobile phones. The management team feels that Matav is at a crossroads with three main options: expansion in Hungary, regional expansion, or organic growth in existing product lines. The team has to consider all of the lines of business in forming a strategy and whether Matav's resources and organization are suitable for a healthy future.

The technical director of Shimla Dairy Products, a government-licensed food manufacturer, has spent time working in the cheese industry in Australia. He has returned to India with new skills and ideas to share with the company. Cheese is a fairly new product in India and he must decide how best to take advantage of the growth potential in the Indian cheese market. He must consider issues of marketing, branding, production processes, operations, and customer focus.