Health Care

Health Care is a featured research topic and an initiative at Harvard Business School.
 
Over the past several decades, HBS has built a foundation in health care research, from Clayton Christensen's application of disruptive innovations and Regina Herzlinger's concept of consumer-driven health care to Michael Porter's use of competitive strategy principles. Today our research focuses on 
  • how management principles and best practices from other industries can be applied;
  • how the process of innovation can be improved;
  • how principles of strategy and consumer choice can be utilized;
  • how information technology can expand access, decrease costs, and improve quality;
  • how new approaches in developing nations can impact global health.
  1. Alnylam: Building a Biotechnology Powerhouse

    Kevin Schulman

    Alnylam is an early stage biomedical technology focused on commercial development of a novel technology platform, siRNA. This technology offered promise to treat rare genetic disorders that could not be treated with other technologies. Alnlyam's development entailed the aggressive assembly of an intellectual property portfolio around their core platform technology, the development of a licensure strategy with large-cap pharmaceutical firms (which included the co-development of a delivery platform for their technology), and finally a clinical development strategy. The case illustrates the challenges of drug development based on novel scientific frameworks, as well as the promise of "personalized" medicine.

    Keywords: Technological Innovation; Commercialization; Health Disorders; Intellectual Property; Biotechnology Industry;

    Citation:

    Schulman, Kevin. "Alnylam: Building a Biotechnology Powerhouse." Harvard Business School Case 316-113, June 2016. View Details
  2. Vaccination Rates Are Associated with Functional Proximity but Not Base Proximity of Vaccination Clinics

    John Beshears, James J. Choi, David Laibson, Brigitte C. Madrian and Gwendolyn I. Reynolds

    Background: Routine annual influenza vaccinations are recommended for persons 6 months of age and older, but less than half of U.S. adults get vaccinated. Many employers offer employees free influenza vaccinations at workplace clinics, but even then take-up is low.

    Objective: To determine whether employees are significantly more likely to get vaccinated if they have a higher probability of walking by the clinic for reasons other than vaccination.

    Method: We obtained data from an employer with a free workplace influenza vaccination clinic. Using each employee’s building entry/exit swipe card data, we test whether functional proximity—the likelihood that the employee walks by the clinic for reasons other than vaccination—predicts whether the employee gets vaccinated at the clinic. We also test whether base proximity—the inverse of walking distance from the employee’s desk to the clinic—predicts vaccination probability.

    Participants: A total of 1,801 employees of a health benefits administrator that held a free workplace influenza vaccination clinic.

    Results: A 2 SD increase in functional proximity is associated with a 6.4 percentage point increase in the probability of vaccination (total vaccination rate at company=40%), even though the average employee’s desk is only 166 meters from the clinic. Base proximity does not predict vaccination probability.

    Conclusions and Relevance: Minor changes in the environment can have substantial effects on the probability of vaccination. If these results generalize, health systems should emphasize functional proximity over base proximity when locating preventive health services.

    Keywords: Geographic Location; Employees; Health Care and Treatment;

    Citation:

    Beshears, John, James J. Choi, David Laibson, Brigitte C. Madrian, and Gwendolyn I. Reynolds. "Vaccination Rates Are Associated with Functional Proximity but Not Base Proximity of Vaccination Clinics." Medical Care 54, no. 6 (June 2016): 578–583. View Details
  3. Understanding Psychological Safety in Healthcare and Education Organizations: A Comparative Perspective

    Amy C. Edmondson, Monica Higgins, Sara J. Singer and Jennie Weiner

    Psychological safety plays a vital role in helping people overcome barriers to learning and change in interpersonally challenging work environments. This article focuses on two such contexts—health care and education. The authors theorize differences in psychological safety based on work type, hierarchical status, and leadership effectiveness. Consistent with prior research, the authors employ cross-industry comparison to highlight distinctive features of different professions. The goal is to illuminate similarities and differences with implications for future psychological safety research. To do this, the authors review relevant literature and present analyses of large data samples in each industry to stimulate further research on psychological safety in both sectors, separately and together.

    Keywords: healthcare organizations; Organizations; Health Care and Treatment; Health Industry;

    Citation:

    Edmondson, Amy C., Monica Higgins, Sara J. Singer, and Jennie Weiner. "Understanding Psychological Safety in Healthcare and Education Organizations: A Comparative Perspective." Special Issue on the Role of Psychological Safety in Human Development. Research in Human Development 13, no. 1 (2016): 65–83. View Details
  4. AbbVie

    Kevin Schulman, Laura Little, Samyukta Mullangi and Stephen Schleicher

    This case focuses on the impact of a novel regulatory pathway, the biosimilars pathway, on the strategy of a major pharmaceutical firm that finds its largest product (60% of revenue) at risk. The case reviews the rationale for the pathway, the emerging biosimilars market entrants, and a series of adverse financial forecasts for AbbVie. Given all of these risks, did the acquisition add value to shareholders?

    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 its 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.

    Keywords: Pharmaceutical Company; M&A Valuation; AbbVie; health care; Health Care and Treatment; Pharmaceutical Industry; Health Industry; United States;

    Citation:

    Schulman, Kevin, Laura Little, Samyukta Mullangi, and Stephen Schleicher. "AbbVie." Harvard Business School Case 316-095, May 2016. View Details
  5. Hôpital Universitaire de Mirebalais, Partners In Health in Haiti

    Robert S. Kaplan, Bipin Mistry and Karla Bertrand

    The case describes the application of Time-Driven Activity-Based Costing (TDABC) at a new tertiary hospital, operated by Partners in Health in Mirebelais, Haiti. A project team mapped the clinical processes for use in estimating the direct costs of personnel, equipment, and facilities for obstetric and breast cancer care. The accurate cost information revealed opportunities to optimize resource utilization and reduce costs by establishing more efficient sterilization procedures and task-shifting administrative responsibilities away from high-cost physicians. It would also potentially be used for budgeting and to propose new payment models with Haiti's Ministries of Health and Finance.

    Keywords: Time-Driven Activity-Based Costing; Activity Based Costing and Management; Cost Accounting; Developing Countries and Economies; Health Care and Treatment; Health Industry; Haiti;

    Citation:

    Kaplan, Robert S., Bipin Mistry, and Karla Bertrand. "Hôpital Universitaire de Mirebalais, Partners In Health in Haiti." Harvard Business School Case 116-041, April 2016. (Revised May 2016.) View Details
  6. Advanced Leadership Pathways: Harvey Freishtat and Conversations about End-of-Life Care

    Rosabeth Moss Kanter, Ai-Ling Jamila Malone and Oludamilola Aladesanmi

    Former law firm chairman/CEO Harvey Freishtat was actively involved in the formation of The Conversation Project, a national public engagement campaign to promote earlier end-of-life care discussions among loved ones and then with providers to ensure that end-of-life care wishes were both expressed and respected. The Conversation Project’s media campaign and three-pronged strategy of targeting people where they live, work, and pray, was beginning to yield results. However, questions still remained. Would the health care industry create the mechanisms needed to follow people’s end-of-life wishes? Was The Conversation Project taking the right steps to fulfill its mission of culture change?

    Keywords: leadership; social enterprise; Health; Health Care and Treatment;

    Citation:

    Kanter, Rosabeth Moss, Ai-Ling Jamila Malone, and Oludamilola Aladesanmi. "Advanced Leadership Pathways: Harvey Freishtat and Conversations about End-of-Life Care." Harvard Business School Case 316-050, March 2016. View Details
  7. Evive Health and Workplace Influenza Vaccinations

    John Beshears

    Evive Health is a company that manages communication campaigns on behalf of health insurance plans and large employers. Using big data techniques and insights from behavioral economics, Evive deploys targeted and effective messages that improve individuals' health behaviors. This case follows Prashant Srivastava, Evive's Chief Operating Officer, and Jennifer Lindner, Evive's Creative Director, as they design a messaging strategy for promoting influenza vaccination at the free workplace clinics of a large utility company.

    Keywords: vaccination; influenza; flu shot; preventive care; health care; Behavioral economics; choice architecture; nudge; experimental design; randomized controlled trial; RCT; causal inference; Consumer Behavior; Health Care and Treatment; Health Testing and Trials; Communication Strategy; Health Industry;

    Citation:

    Beshears, John. "Evive Health and Workplace Influenza Vaccinations." Harvard Business School Case 916-044, March 2016. View Details
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