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.

Featured Works

 

  1. Article | Biostatistics | April 2020

    Regulatory Oversight, Causal Inference, and Safe and Effective Health Care Machine Learning

    Ariel Dora Stern and W Nicholson Price, II

    In recent years, the applications of Machine Learning (ML) in the health care delivery setting have grown to become both abundant and compelling. Regulators have taken notice of these developments and the U.S. Food and Drug Administration (FDA) has been engaging actively in thinking about how best to facilitate safe and effective use. Although the scope of its oversight for software-driven products is limited, if FDA takes the lead in promoting and facilitating appropriate applications of causal inference as a part of ML development, that leadership is likely to have implications well beyond regulated products.

    Keywords: Machine learning; causal inference; Health Care and Treatment; Safety; Governing Rules, Regulations, and Reforms;

    Citation:

    Stern, Ariel Dora, and W Nicholson Price, II. "Regulatory Oversight, Causal Inference, and Safe and Effective Health Care Machine Learning." Biostatistics 21, no. 2 (April 2020): 363–367.  View Details
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  2. Article | npj Digital Medicine

    Quantifying the Use of Connected Digital Products in Clinical Research

    Caroline Marra, Jacqueline L. Chen, Andrea Coravos and Ariel D. Stern

    Over recent years, the adoption of connected technologies has grown dramatically, with potential for improving health care delivery, research, and patient experience. Yet, little has been documented about the prevalence and use of connected digital products (e.g., products that capture physiological and behavioral metrics) in formal clinical research. Using 18 years of data from ClinicalTrials.gov, we document substantial growth in the use of connected digital products in clinical trials (~34% CAGR) and show that these products have been used across all phases of research and by a diverse group of trial sponsors. We identify four distinct use cases for how such connected products have been integrated within clinical trial design and suggest implications for various stakeholders engaging in clinical research.

    Keywords: connected digital products; clinical trials; Health Testing and Trials; Technology; Research;

    Citation:

    Marra, Caroline, Jacqueline L. Chen, Andrea Coravos, and Ariel D. Stern. "Quantifying the Use of Connected Digital Products in Clinical Research." Art. 50. npj Digital Medicine 3 (2020).  View Details
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  3. Case | HBS Case Collection | March 2020

    A Tower for the People: 425 Park Avenue

    John Macomber, Joseph Allen and Emily Jones

    Healthy buildings and superior air quality are increasingly important since people now spend so much time indoors. Indoor spaces drive performance and productivity. Commercial real estate landords and investors are responding to the demands of sophisticated tenants and end users by making investment choices around indoor air quality and certification, and related expectations for increased rent or increased occupancy. It's anticipated that these learnings will extend to other situations including offices, schools, hospitals, factories, and homes. This case investigates the tradeoffs in several engineering, marketing, and finance decisions. The setting is a billion dollar premier new office building on Park Avenue in New York City, designed by the eminent architecture firm Foster + Partners. The decision factors in the case include health information from CogFX and 9 Foundations of Healthy Buildings research from the TH Chan Harvard School of Public Health.

    Keywords: health and wellness; real estate; sustainability; Health; Pollution; Buildings and Facilities; Performance Productivity; Finance; Real Estate Industry; New York (city, NY);

    Citation:

    Macomber, John, Joseph Allen, and Emily Jones. "A Tower for the People: 425 Park Avenue." Harvard Business School Case 220-065, March 2020.  View Details
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  4. Case | HBS Case Collection | March 2020

    Maven Clinic: Women’s Health in the Digital Age

    Ariel Dora Stern and Sarah Mehta

    In late 2017, Kate Ryder, the founder and CEO of digital women’s health telemedicine company Maven Clinic, faced an important decision. Maven offered both a direct to consumer (D2C) product that anyone could use to book virtual appointments with health practitioners across a range of services and specialties for a fee, and an enterprise product—the Maven Family Benefits platform—which it sold to large employers as an employee benefit. Since founding Maven in 2014, Ryder had believed that the way to achieve true impact and scale is to work within that system, but the most effective strategy for pursuing enterprise customers was an open question. She considered her options.

    Keywords: Business Growth and Maturation; Business Model; Business Startups; Entrepreneurship; Health; Health Care and Treatment; Strategy; Technology; Software; Health Industry; Technology Industry; United States;

    Citation:

    Stern, Ariel Dora, and Sarah Mehta. "Maven Clinic: Women’s Health in the Digital Age." Harvard Business School Case 620-035, March 2020.  View Details
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  5. Case | HBS Case Collection | March 2020

    Behavior Change for Good

    Max Bazerman, Michael Luca and Marie Lawrence

    In 2017, Katy Milkman and Angela Duckworth created Behavior Change for Good (BCFG)—a behavioral science initiative founded with the goal of helping people achieve long-term behavior change in the areas of personal health, financial decisions (savings), and education. The initiative centered around a simple idea—by partnering with large customer-facing organizations such as gyms and banks, BCFG could design interventions aimed at changing habits of these organizations’ customers. The earliest BCFG experiments focused on increasing exercise, partnering with two major gym chains—24 Hour Fitness and Blink Fitness. The gyms were on board with the idea of nudging members to exercise more and continue their memberships. But what interventions might lead their gym members to have better exercise habits? And how will they decide if an intervention is successful?

    Keywords: behavioral science; interventions; Behavior; Change; Health;

    Citation:

    Bazerman, Max, Michael Luca, and Marie Lawrence. "Behavior Change for Good." Harvard Business School Case 920-049, March 2020.  View Details
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  6. Article | JAMA Network Open

    Association of the Meaningful Use Electronic Health Record Incentive Program with Health Information Technology Venture Capital Funding

    Samuel Lite, William J. Gordon and Ariel Dora Stern

    IMPORTANCE
    Although the Health Information Technology for Economic and Clinical Health (HITECH) Act has accelerated electronic health record (EHR) adoption since its passage, clinician satisfaction with EHRs remains low, and the association of HITECH with health care information technology (IT) entrepreneurship has remained largely unstudied.

    OBJECTIVE
    To determine whether the passage of the HITECH Act was associated with an increase in key measures of health care IT entrepreneurship.

    DESIGN, SETTING, AND PARTICIPANTS
    This economic evaluation of venture capital (VC) activity in the US from 2000 to 2019 examined funding trends in health care IT, EHR-related companies, and all VC investments before and after the passage of HITECH. A difference-in-differences analysis compared investments in health care IT companies with those of companies in 3 categories: general health care (non-IT), IT (non–health care), and all US VC transactions. Data were analyzed from September 2018 to August 2019.

    EXPOSURES
    Venture capital funding received by US companies before and after the HITECH Act.

    MAIN OUTCOMES AND MEASURES
    Venture capital investment in health care IT companies and the proportion of those investments going to seed-stage companies, a proxy for very early-stage entrepreneurship and innovation.

    RESULTS
    The data included 70 982 investments, of which 9425 (13.3%) were seed stage, 10 706 (15.1%) were early stage, and 50 851 (71.6%) were growth stage. After passage of the HITECH Act, investment in both health care IT companies and EHR-related companies increased at a rate much faster (13.0% and 11.4%, respectively) than VC as a whole (6.9%). In addition, the proportion of investments going to seed-stage health care IT companies increased compared with both overall VC investments and non-IT health care investments. Health care IT companies saw increased probabilities of transactions being seed-stage of 5.1% (SE, 2.2%; 95% CI, 0.8% to 9.3%; P = .02) compared with the entire sample of VC transactions and 13.6% (SE, 1.9%; 95% CI, 9.9% to 17.2%; P < .001) compared with non-IT health care VC transactions. Health care IT had essentially 0 increased probability of a transaction being seed stage compared with IT companies outside health care (−0.8% probability; SE, 2.4%; 95% CI, −5.4% to 3.9%; P = .75).

    CONCLUSIONS AND RELEVANCE
    Although widespread clinician dissatisfaction with EHR systems remains a challenge, the HITECH Act’s incentive program may have catalyzed early-stage entrepreneurship in health care IT, suggesting an important role for incentives in promoting innovation.

    Keywords: Health Care and Treatment; Information Technology; Laws and Statutes; Innovation and Invention; Entrepreneurship; Venture Capital;

    Citation:

    Lite, Samuel, William J. Gordon, and Ariel Dora Stern. "Association of the Meaningful Use Electronic Health Record Incentive Program with Health Information Technology Venture Capital Funding." JAMA Network Open 3, no. 3 (March 2020).  View Details
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  7. Chapter | The Trillion Dollar Revolution | 2020

    Health Care Markets a Decade After the ACA: Bigger, but Probably Not Better

    Leemore S. Dafny

    Love it or hate it, the Affordable Care Act (ACA) embraced and extended the role of private markets in financing and delivering health care in the United States. Ten years after the ACA’s passage, it is unclear whether health care markets are better (along a range of dimensions, including delivering health per dollar spent), but there is no doubt that they are bigger. While growth in the share of U.S. GDP devoted to health care has slowed since the ACA, the absolute level has risen from 16.3 percent in 2008 (before the ACA had taken shape) to 17.9 percent in 2017, the most recent year for which data are currently available. Between 2008 and 2015 (five years following the ACA), the S&P 500 Health Care Index more than doubled. By comparison, the S&P 500 Index (spanning all sectors) increased only 45 percent during the same period, notwithstanding its greater sensitivity to the economic recovery following the 2009 recession. To put it colloquially, the ACA “has not been bad for business,” notwithstanding the trepidation of various industry stakeholders—or perhaps owing to concessions negotiated as a result of that trepidation on the eve of its passage. But this growth has not been accompanied by more robust competition to serve patients’ needs, the much-vaunted benefit of market-based systems.

    Keywords: Health Care and Treatment; Markets; Laws and Statutes; Outcome or Result; Health Industry; United States;

    Citation:

    Dafny, Leemore S. "Health Care Markets a Decade After the ACA: Bigger, but Probably Not Better." Chap. 15 in The Trillion Dollar Revolution: How the Affordable Care Act Transformed Politics, Law, and Health Care in America, edited by Ezekiel J. Emanuel and Abbe R. Gluck. New York: PublicAffairs, 2020.  View Details
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  9. Case | HBS Case Collection | February 2020

    Theranos: Who Has Blood on Their Hands? (B)

    Nien-he Hsieh, Christina R. Wing and John Masko

    This supplemental case tracks the results of the Colman and Taubman-Dye class action suit against Theranos as well as Theranos’ other legal challenges and chronicles the final demise of the company in 2019.

    Keywords: Health Testing and Trials; Corporate Accountability; Organizational Culture; Misleading and Fraudulent Advertising; Crime and Corruption; Entrepreneurship; Lawsuits and Litigation; Business Exit or Shutdown; Medical Devices and Supplies Industry; California; United States;

    Citation:

    Hsieh, Nien-he, Christina R. Wing, and John Masko. "Theranos: Who Has Blood on Their Hands? (B)." Harvard Business School Case 320-091, February 2020.  View Details
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    11.  
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Initiatives & Projects

  • Health Care

    The Health Care Initiative serves as a gateway for health care research, educational programs, and collaboration across all sectors of the health care industry.

  • Social Enterprise

    The Social Enterprise Initiative at HBS applies innovative business practices and managerial disciplines to drive sustained, high-impact social change.

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Faculty

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Harvard Business Publishing

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by Nitin Nohria
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by Max Bazerman, Michael Luca and Marie Lawrence

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