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. A Systematic Approach to Discussing Active Surveillance with Patients with Low-risk Prostate Cancer

    Behfar Ehdaie, Melissa Assel, Nicole Benfante, Deepak Malhotra and Andrew Vickers

    A systematic approach to counseling—using appropriate framing techniques derived from principles studied by negotiation scholars—can be taught to physicians in a one-hour lecture. We found evidence that even this minimal intervention can decrease overtreatment of patients with low-risk prostate cancer. Our novel approach offers a framework to help address cancer screening–related overtreatment that occurs across medicine.

    Keywords: Health Care and Treatment; Health Disorders; Service Delivery; Negotiation; Health Industry;

    Citation:

    Ehdaie, Behfar, Melissa Assel, Nicole Benfante, Deepak Malhotra, and Andrew Vickers. "A Systematic Approach to Discussing Active Surveillance with Patients with Low-risk Prostate Cancer." European Urology 71, no. 6 (June 2017): 866–871. View Details
  2. Blunted Ambiguity Aversion During Cost-Benefit Decisions in Antisocial Individuals

    Joshua W. Buckholtz, Uma R. Karmarkar, Shengxuan Ye, Grace M. Brennan and Arielle Baskin-Sommers

    Antisocial behavior is often assumed to reflect aberrant risk processing. However, many of the most significant forms of antisocial behavior, including crime, reflect the outcomes of decisions made under conditions of ambiguity rather than risk. While risk and ambiguity are formally distinct and experimentally dissociable, little is known about ambiguity sensitivity in individuals who engage in chronic antisocial behavior. We used a financial decision-making task in a high-risk community-based sample to test for associations between sensitivity to ambiguity, antisocial behavior, and arrest history. Sensitivity to ambiguity was lower in individuals who met diagnostic criteria for Antisocial Personality Disorder. Lower ambiguity sensitivity was also associated with higher externalizing (but not psychopathy) scores and with higher levels of aggression (but not rule breaking). Finally, blunted sensitivity to ambiguity also predicted a greater frequency of arrests. Together, these data suggest that alterations in cost-benefit decision-making under conditions of ambiguity may promote antisocial behavior.

    Keywords: ambiguity; neuroscience; Neuroeconomics; choice; psychology; Decision choice and uncertainty; Behavior; Decision Choices and Conditions; Cost vs Benefits; Health Disorders;

    Citation:

    Buckholtz, Joshua W., Uma R. Karmarkar, Shengxuan Ye, Grace M. Brennan, and Arielle Baskin-Sommers. "Blunted Ambiguity Aversion During Cost-Benefit Decisions in Antisocial Individuals." Art. 2030. Scientific Reports 7 (2017). View Details
  3. Prevent Senior: A New Paradigm for Growth in the Health Care Sector?

    Regina E. Herzlinger, Ana Maria Malik and Priscilla Zogbi

    Keywords: health care; health care and treatment; health care delivery; Brazil; Health Care and Treatment; Brazil;

    Citation:

    Herzlinger, Regina E., Ana Maria Malik, and Priscilla Zogbi. "Prevent Senior: A New Paradigm for Growth in the Health Care Sector?" Harvard Business School Case 317-073, May 2017. View Details
  4. Assessing the Quality of Quality Assessment: The Role of Scheduling

    Maria Ibanez and Michael W. Toffel

    Many production processes are subject to inspection to ensure they meet quality, safety, and environmental standards imposed by companies and regulators. This paper explores how the scheduling of inspections risks introducing bias that erodes inspection quality by altering inspector stringency. We theorize that inspection results will be affected by (a) when the inspection occurs within an inspector’s daily schedule and (b) the inspection outcomes of the inspector’s prior inspected establishment. Analyzing thousands of food safety inspections, we find that inspectors cite fewer violations in successive inspections throughout their day and when inspections risk prolonging their typical workday. We also find that inspectors cite more violations after inspecting establishments that exhibited worse compliance or greater compliance deterioration. We discuss several implications for managers who schedule or rely on inspections.

    Keywords: Assessment; quality; bias; inspection; scheduling; Econometric Analysis; Empirical Research; regulation; Health; Food; Safety; Quality; Performance Consistency; Performance Evaluation; Food and Beverage Industry; Service Industry;

    Citation:

    Ibanez, Maria, and Michael W. Toffel. "Assessing the Quality of Quality Assessment: The Role of Scheduling." Harvard Business School Working Paper, No. 17-090, April 2017. View Details
  5. From mHealth Hackathon to Reality: Diabetes Care

    Kevin Schulman and Curry Cheek

    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.

    Keywords: innovation; mobile health technologies; health care; health care industry; Behavioral economics; Software; Health Care and Treatment; Mobile Technology; Innovation and Invention; Health Industry; Telecommunications Industry;

    Citation:

    Schulman, Kevin, and Curry Cheek. "From mHealth Hackathon to Reality: Diabetes Care." Harvard Business School Case 317-105, March 2017. View Details
  6. How Economics Can Shape Precision Medicines

    Ariel Dora Stern, Brian M. Alexander and Amitabh Chandra

    Many public and private efforts in coming years will focus on research in precision medicine, developing biomarkers to indicate which patients are likely to benefit from a certain treatment so that others can be spared the cost—financial and physical—of being treated with unproductive therapies while more easily uncovering therapeutic signals. However, such research initiatives alone will not deliver new medicines to patients in the absence of strong incentives to bring new products to market. We examine the unique economics of precision medicines and associated biomarkers, placing an emphasis on the factors affecting their development, pricing, and access.

    Keywords: Health Care and Treatment; Research; Economics; Motivation and Incentives;

    Citation:

    Stern, Ariel Dora, Brian M. Alexander, and Amitabh Chandra. "How Economics Can Shape Precision Medicines." Science 355, no. 6330 (March 17, 2017): 1131–1133. View Details
  7. OpenNotes

    Jeffrey Rayport and Annelena Lobb

    In 2017, executives at OpenNotes, a national movement to improve the relationship between doctors and patients by sharing doctors’ visit notes about patients with patients, were considering options in efforts to achieve scale. The movement hoped to reach 50 million patients by 2020. One opportunity was building an OpenNotes app for smartphones, in which patients could access their visit notes on their phones through an app compatible with Apple CareKit. But OpenNotes had other options, including partnerships with consumer groups and insurers. In addition, they would always have a role in encouraging doctors and institutions to share notes more readily. What was the best way to scale OpenNotes? Was it the app route, or some other way to pursue the group’s ambitions?

    Keywords: health care and treatment; Health Care and Treatment; Technology Adoption; Growth and Development Strategy; Technology Industry; Health Industry; United States;

    Citation:

    Rayport, Jeffrey, and Annelena Lobb. "OpenNotes." Harvard Business School Case 817-080, March 2017. (Revised March 2017.) View Details
  8. Cantel Medical

    John R. Wells and Gabriel Ellsworth

    Cantel Medical Corporation provided infection prevention and control products and services for patients, caregivers, and other healthcare providers. In 2016, Cantel generated sales of $665 million and net profits of $60 million, double the levels of five years earlier. Chief Executive Officer Jørgen B. Hansen, appointed on August 1, 2016, was aiming to double the size of the business again. Cantel operated in three major vertical market segments: endoscopy, water purification and filtration, and healthcare disposables, which together accounted for more than 95% of Cantel’s sales. Over 90% of revenues were generated in North America. Hansen was looking to add new verticals to the portfolio, but he also saw opportunities to drive growth in Cantel’s core businesses, both at home and internationally. Over two decades, the company had delivered consistent organic growth and integrated over 30 acquisitions, providing total annual returns of 22% to its shareholders, with relatively limited leverage. Hansen was determined to maintain that track record, but the key question was how to achieve this goal. Was there enough growth in Cantel’s three key verticals in North America, or would more be needed? If so, which other verticals should Cantel consider? Should the company stick to infection control or add other products to its offering to leverage its customer relationships? How much would a drive into international markets help? And what organization was best suited to Cantel’s strategy? It had been run as a holding company in the past. Did that structure still make sense as the company ventured overseas?

    Keywords: Cantel; Charles Diker; furniture industry; Matrix organization; Acquisition; Mergers and Acquisitions; Business Conglomerates; Business Units; Business Growth and Maturation; Business Organization; For-Profit Firms; Chemicals; Profit; Revenue; Geographic Scope; Multinational Firms and Management; Health; Health Care and Treatment; Business History; Business or Company Management; Goals and Objectives; Growth and Development Strategy; Organizational Structure; Problems and Challenges; Research and Development; Opportunities; Strategy; Adaptation; Business Strategy; Competitive Strategy; Corporate Strategy; Diversification; Expansion; Technology; Biotechnology Industry; Chemical Industry; Health Industry; Manufacturing Industry; Medical Devices and Supplies Industry; Pharmaceutical Industry; United States; New Jersey;

    Citation:

    Wells, John R., and Gabriel Ellsworth. "Cantel Medical." Harvard Business School Case 717-482, March 2017. View Details
  9. My Favorite Slide: The Entrepreneurial Gap Applied to Health Care

    Robert S. Kaplan and Robert Simons

    Value-based health care increases physicians’ accountability for patient outcomes. Many have resisted, claiming that patient outcomes are influenced by many forces outside their control, such as patient’s compliance with post-acute and rehab care. The difference between accountability and control is an “entrepreneurial gap,” evoking the HBS definition of entrepreneurs as those who pursue opportunities—internally and externally—without regard to the resources they currently control. The creative tension generated by the entrepreneurial gap of holding physicians responsible for patient outcomes, motivates more integrated patient care that delivers superior patient outcomes at a lower total cost.

    Keywords: Health Care and Treatment; Outcome or Result; Motivation and Incentives;

    Citation:

    Kaplan, Robert S., and Robert Simons. "My Favorite Slide: The Entrepreneurial Gap Applied to Health Care." NEJM Catalyst (March 8, 2017). (Blog Post.) View Details
  10. PharmAccess and the M-TIBA Platform: Leveraging Digital Technology in the Developing World

    Kevin Schulman, Sashidaran Moodley and Anant Vasudevan

    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.

    Keywords: Finance; Entrepreneurship; Health Care and Treatment; Online Technology; Health Industry; Africa; Kenya;

    Citation:

    Schulman, Kevin, Sashidaran Moodley, and Anant Vasudevan. "PharmAccess and the M-TIBA Platform: Leveraging Digital Technology in the Developing World." Harvard Business School Case 317-103, March 2017. View Details
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