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- October 2022
- Article
A Structural Model of Organizational Buying for Business-to-Business Markets: Innovation Adoption with Share-of-Wallet Contracts
By: Navid Mojir and K. Sudhir
The paper develops the first structural model of organizational buying to study innovation diffusion in a B2B market. Our model is particularly applicable for routinized exchange relationships, whereby centralized buyers periodically evaluate and choose contracts,...
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- 2022
- Article
Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing
By: Nikhil G. Thaker, Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley and Steven J. Frank
Integrated quality improvement (QI) and cost reduction strategies can help increase value in cancer care. We applied standard QI and TDABC methods to improve workflow efficiency and reduce costs for MRI-guided prostate brachytherapy. We constructed process maps,...
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- Article
A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal
By: Jiayin Xue, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg and Kevin Schulman
U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: a U.S.-based academic hospital...
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- Article
The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit
By: Junaid Nabi and Robert S. Kaplan
The Centers of Medicare and Medicaid Services (CMS) recently announced that it will be removing more...
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- 2021
- Working Paper
Diagnosing Quality: Learning, Amenities, and the Demand for Health Care
By: Achyuta Adhvaryu, Emilio Gutierrez, Anant Nyshadham and Jorge Tamayo
We study the role of amenities in increasing demand for underutilized healthcare services. We evaluate the offer of a high-amenity diagnostic consultation for cataracts with a randomized price and find that a lower price for the high-amenity consultation increases...
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- February 2021 (Revised June 2021)
- Case
Brainlab: Imaging a MedTech Future
By: Regina E. Herzlinger, Gregory P. Licholai and Federica Gabrieli
Can Brainlab, a privately held firm, compete with giants like Medtronic and Amazon in delivering the Digital Operating Room of the future? The CEO is pondering solutions for secure exchange of medical information, pricing a new robotic imaging device, and reorganizing...
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Keywords:
Surgery;
Robotics;
Health Care;
Private Healthcare;
Pricing;
Technology Platform;
Acquisition;
Business Growth and Maturation;
Growth and Development Strategy;
Business Strategy;
Corporate Strategy;
Corporate Entrepreneurship;
Health Care and Treatment;
Health;
Innovation and Invention;
Innovation and Management;
Innovation Strategy;
Technological Innovation;
Applications and Software;
Information Infrastructure;
Information Technology;
Digital Platforms;
Health Industry;
Europe;
Germany;
Munich
- February 2021
- Case
New England Baptist Hospital: Getting Paid for Value
By: Robert S. Kaplan, Mary Witkowski, Toby E. Emanuel and Syed S. Shehab
New England Baptist Hospital (NEBH), a national leader in adult orthopedic care, has the lowest rate of complications and 30-day readmissions in New England, but gets paid 30% less for its surgeries than nearby institutions. NEBH introduces, with several large...
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- December 2020 (Revised May 2021)
- Supplement
Tales of Life-changing Innovations: Minimally Invasive | Note on the Development of Laparoscopic Surgery (B) (2000-2005)
By: Amar Bhidé, Srikant M. Datar and Caitlin Bowler
- December 2020 (Revised May 2021)
- Technical Note
Tales of Life-changing Innovations: Minimally Invasive | Note on the Development of Laparoscopic Surgery (through the 1990s)
By: Amar Bhidé, Srikant M. Datar and Caitlin Bowler
- Article
Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?
By: R. S. Kaplan, F. Erhun, V.G. Narayanan, B. Mistry and K. Brayton, et al
We use time-driven activity-based costing to estimate the cost of personnel and space for an elective coronary artery bypass graft (CABG) surgery at two U.S. hospitals, Intermountain and Baylor Heart, and Narayana Health (NH), in India. All three hospitals use modern...
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- 2021
- Working Paper
Gastrointestinal Endoscopy: Case Histories of Significant Medical Advances
By: Amar Bhidé, Srikant M. Datar and Katherine Stebbins
We describe how endoscopy transformed the diagnosis of ulcers, cancerous polyps and other diseases of the alimentary canal and enabled “minimally invasive” surgeries to treat such diseases. Specifically, we chronicle how: 1) flexible glass fiber instruments in the...
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- 2021
- Working Paper
Laparoscopy: Case Histories of Significant Medical Advances
By: Amar Bhidé, Caitlin N. Bowler and Srikant M. Datar
We describe how operations through laparoscopes—tubular instruments inserted into abdominal cavities—revolutionized gynecological and other surgeries inside the abdomen such as gall bladder removal. Specifically, we chronicle the: 1) foundational technologies and...
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- Article
Burnout in Surgery Viewed Through the Lens of Psychological Safety
By: Robert A. Swendiman, Amy C. Edmondson and Najjia N. Mahmoud
- April 2017
- Supplement
Imprimis (B)
By: Ramon Casadesus-Masanell, Karen Elterman and Marc Appel
This case is a supplement to Imprimis (A). It describes the company’s decision to enter into the pharmaceutical compounding business in 2013–2014. Imprimis purchased a compounded ophthalmological medication called Dropless Therapy, which was injected into patients’...
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- Article
Time-Driven Activity-Based Costing for Surgical Episodes
By: Peter Najjar, Matt Strickland and Robert S. Kaplan
Health care costs related to surgical care account for 40% of all hospital and physician spending. Payers attempting to contain costs are replacing fee-for-service with value-based payment schemes that can encompass entire episodes of care, including physician services...
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- June 2016
- Article
When Doctors Go to Business School: Career Choices of Physician-MBAs
By: Damir Ljuboja, Brian W. Powers, Benjamin Robbins, Robert S. Huckman, Krishna Yeshwant and Sachin Jain
There has been substantial growth in the number of physicians pursuing Master of Business Administration (MBA) degrees over the past decade, but there is continuing debate over the utility of these programs and the career outcomes of their graduates. The authors...
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- December 2015
- Article
Task Shifting in Surgery: Lessons from an Indian Heart Hospital
By: Budhaditya Gupta, Robert S. Huckman and Tarun Khanna
We present a case study that illustrates task shifting, the transfer of activities from senior to junior colleagues, in the context of cardiac surgery at the Narayana Health City Cardiac Hospital (NH) in India. The case discusses the factors driving the adoption of...
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- November 2015
- Article
Influence of Experience and the Surgical Learning Curve on Long-term Patient Outcomes in Cardiac Surgery
By: Bryan M. Burt, Andrew W. ElBardissi, Robert S. Huckman, Lawrence H. Cohn, Marisa W. Cevasco, James D. Rawn, Sary F. Aranki and John G. Byrne
OBJECTIVE: We hypothesized that increased post-graduate surgical experience correlates with improved operative efficiency and long-term survival in standard cardiac surgery procedures.
METHODS: Utilizing a prospectively collected retrospective database,... View Details
METHODS: Utilizing a prospectively collected retrospective database,... View Details
- Article
Time-driven Activity-based Costing of Multivessel Coronary Artery Bypass Grafting across National Boundaries to Identify Improvement Opportunities: Study Protocol
By: F. Erhun, B. Mistry, T. Platcheck, A. Milstein, V.G. Narayanan and R. S. Kaplan
Coronary artery bypass graft (CABG) surgery is a common treatment for coronary artery disease—a disease that affects over 10% of US adults and is a major cause of morbidity and mortality. In 2005, the mean cost for a CABG procedure among Medicare beneficiaries in the...
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- August 2014 (Revised February 2021)
- Case
Hospital for Special Surgery (A)
By: Regina E. Herzlinger and Stacy Schwartz
Hospital for Special Surgery, a focused factory for orthopedics and joint disease, is contemplating various growth options: further growth in the United Kingdom's National Health Services, management of hospitals in the United States, and/or hospital consulting....
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