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In January 2006, eClinicalWorks (eCW) had an acquisition opportunity that could fundamentally change the way they had done business since the inception of the company in 1999. eClinicalWorks was a privately run business in the healthcare information technology field that took in $25 million in revenue in 2005. Revenues for 2006 were projected to reach $40 million. This successful electronic medical record (EMR) company had grown thanks to their reliable software and responsive customer service. The company had achieved this growth without the help of any outside financing. The five co-founders of eCW, who treated each other like an extended family, invested years of sweat equity and hard work to shape eCW as they wanted. They were also proud of their company culture, which de-emphasized traditional company hierarchies and encouraged independent thinking and cooperative working arrangements across departments. Keeping the company private, in their view, had helped them to maintain this culture. The opportunity to acquire another EMR company offered eCW the chance to grow quickly in an industry that is estimated to take in more than $40 billion in overall revenues in 2007. But this acquisition would require outside financing of some sort. Was this the moment to accelerate the rate of growth to which eCW had become accustomed-catching up with, rather than anticipating, how their customer base would expand? Or should they maintain the same approach that had worked so well since 1999?

In May 2005, Steve Bollinger was about to become president and chief operating officer of Pervasis Therapeutics, a small cell therapy start-up in Cambridge, MA. If proven successful, Pervasis' product, Vascugel, could change the way vascular disease is treated and have a major impact in a large and underserved population. However, Vascugel had not yet gone into human clinical trials, and getting it to market would mean navigating the FDA approval process, as well as raising the capital necessary to finance the endeavor. It was up to Bollinger to decide on a strategy for Vascugel's clinical trials. In addition, he would have to decide how much money the company needed to raise, taking into account the interests of the company's founders and existing venture investors. Finally, while Bollinger was expected to lead the company for the next two to three years, Pervasis' board was planning to launch a search for a permanent CEO in the future.

Grove International Partners, one of the world's largest international real estate private equity funds, is actively seeking new investment opportunities in the seniors housing industry. The firm has identified two potential opportunities--one located in Japan and one in the United Kingdom--that would place it at the leading edge of one of the most lucrative and socially meaningful health care services markets in the world. Grove evaluates these two opportunities and decides which one, if either, to pursue.

Describes the start up of Viacord, a Boston-based medical services firm founded by Cynthia Fisher (HBS MBA) in 1993. Told from Fisher's perspective, the entrepreneur details the conceptualization and launch of the business and the many obstacles and expenses faced in the company's first seven years. Fisher describes the venture capital negotiations and a merger with a biotech company that led to the creation of ViaCell in 2000. Fisher explains how her role changed from founder and CEO of Viacord to president and then board member of ViaCell, and carries the firm's story to the successful 2005 IPO.

Provides an overview of the second-year MBA elective course Entrepreneurship and Venture Capital in Healthcare.

The vice-president of a U.S.-based multinational company must reach a decision regarding a $13 million capital expenditure proposal from the firm's Brazilian division. The proposal is of particular interest because it is considered to be a test case in the development of a process to evaluate foreign currency-based investment proposals companywide. The vice-president's objective is to establish a process to measure the relative economic attractiveness of investment proposals worldwide, regardless of the currencies in which these proposals are initially assessed.

Describes the career path and insights of Stanley Lapidus, a successful serial entrepreneur in the medical and life sciences industry. Lapidus is the founder of Cytyc Corp. (NASDAQ: CYTC) and EXACT Sciences (NASDAQ: EXAS) and is currently the CEO of his third start-up, Helicos BioSciences. Gives students insight into the skills and experiences that are helpful in building successful medical technology companies.

Conor Medsystems had developed a drug-eluting stent that could capture significant share of the $5 billion global market. Chief executive officer, Frank Litvack, is considering alternative sources of financing to test the device.

Describes the evolution of a start-up venture in the pathology lab segment of the clinical lab business. U.S. Labs tries a series of business models before running out of cash. The company is in dire need of financing, as its venture capital backers are refusing to put up more capital and its bank is calling its loan. Discusses how the CEO is willing to put up his own funding and still believes in the company's future.