Healthcare Management Initiative

The case examines how Guy’s and St Thomas’ NHS Foundation Trust partnered with analytics company Factor 50 to address lengthening hospital waiting lists and medical backlogs exacerbated by Covid-19. Together they developed a data-led prioritisation (DLP) system. The first pilot focused on diabetes patients, seeking to identify people most at risk of deterioration while awaiting care. Using clinical data and risk stratification, the system helped prioritise medical appointments for high-risk patients, while lower-risk patients were redirected to pathways such as patient-initiated follow-up (PIFU). The pilot also exposed a problem – hitherto hidden – of health inequality: a disproportionate number of patients at highest risk came from deprived communities and ethnic minorities, reaffirming the so-called inverse care law.The case highlights how digital health innovations can improve efficiency and help address inequality, as well as the challenges to be overcome – e.g., scaling up, integrating with existing electronic health records, getting doctors to adopt a data-driven approach. It thus serves to underline the complexity of embedding systemic change in the UK’s National Health Service (NHS).

Between 2002 and 2014, Sankara Eye Foundation India expanded rapidly, establishing nine community hospitals to provide free eye care across eight states in southern, western, and northern India. Its operating model ensured that 80% of its patients received free care, subsidized by the remaining 20% who paid for services. The foundation set an ambitious goal of operating 20 community hospitals by 2020 under the banner "Vision 20/20 by 2020."A decade later, the organization was present in ten states, having opened its 14th hospital in Varanasi. However, it decided to pause further expansion until 2030 to reassess its strategy. Its operating model had shifted to a 75/25 split between free and paid surgeries. Additionally, the foundation ventured into non-core areas, such as optical retail, and introduced new initiatives like vision centers, which triaged patients for surgeries, glasses, and other services.Recently, after a strategic review, Sankara decided to open another hospital following Varanasi, while adjusting its 2030 target for free surgeries from 425,000 to 400,000. It now faces the challenge of realigning its free and paid surgical services to maintain patient satisfaction and uphold quality standards. At the same time, the foundation must refine its system of activities to maximize synergies across both its free and paid care models.

The case follows two women entrepreneurs and their start-ups. It contrasts the different strategic choices made by the founders during the growth phase, including location, market segment, product and service design, and business model. The case highlights the importance of analysing the market context, including the cultural context, when making strategic decisions. It also reflects on the challenges faced by women entrepreneurs.

Every new mom goes through the “fourth trimester,” a period up to six weeks after childbirth to recover her body to a pre-pregnancy state. It is dealt with in various ways across cultures, from family members stepping in to help, and national healthcare programs providing support, to women individually dealing with it without support. In most Asian countries, and Korea specifically, postnatal care used to be considered an intra-familial affair in which new mothers were helped by their mothers or mothers-in-law. However, this long-held tradition has waned substantially, with social changes such as urbanization and a focus on nuclear families leaving new moms struggling to get the care they need. Who is going to fill the role of providing attentive care for new moms and newborns? The case titled, “A Club Med for New Moms and Newborns: The Postpartum Care Center in Korea,” illustrates how a new market opportunity can be captured that unearths the unmet needs of postpartum mothers. This case study examines the emergence and evolution of postpartum care centers in South Korea as a new market solution addressing the unlocked demand for postpartum care and creating an unprecedented experience of physical and psychological recovery for new moms while they learn essential baby care skills. The result is that over two-thirds of Korean mothers choose to stay at such retreats for more than a week before bringing their baby home, despite the hefty price tag. This business model has been rolling out to neighboring Asian countries like China and Taiwan, and now even to the United States.The case delves into how a half-billion-dollar market was created by unearthing taken-for-granted issues that had gone unnoticed in the existing healthcare industry. Postpartum care centers are a nondisruptive creation beyond existing healthcare industry boundaries that do not involve technological innovation but achieve value innovation across healthcare, hospitality, and education. The case probes opportunities and risks in rolling out the Korean business model in the United States, in which different traditions and market conditions exist.

Goodlife Pharmacy launched in 2014 with a vision to provide good-quality and affordable pharmaceuticals to all socio-economic groups in Kenya. With a strong strategy and operations focus, the leadership scaled up from 19 stores in 2016 to approximately 120 by 2022 in East Africa. They broadened the offering, introducing non-pharma products, a range of healthcare and wellbeing services, and different store formats depending on location. By 2022 Goodlife had grown from a pharmacy to a “health hub” with ambitions to open over 250 stores by 2025 and serve 8.5 million people (half of them living on less than £10 per day).The case explores the founding and early growth of Goodlife, which initially targeted middle-to-high-income earners in urban settings, having entered the market through the acquisition of an existing pharmacy chain. Two years later, a private investment firm saw the potential to realise its original mission and scale to other demographics and beyond Kenya.

Launched in 2013, Babylon Health is a UK-based digital-first health service provider that combines artificial intelligence (AI) and machine learning technology to provide customers with personalized health assessments, treatment advice, and face-to-face appointments with health professionals – through an app and a website. Despite its potential to improve access to quality healthcare, Babylon Health accentuated issues of inequality in the healthcare system, especially in England where it was first launched. The A case tracks Babylon Health’s growth, successes, failures, and the controversies surrounding its offering. At its core is the question of whether AI-based services could be a solution to the issue of inequality in healthcare or could penalise people who do not have access to the internet/IT skills or have learning challenges.The B case details Babylon Health’s path to bankruptcy.

Scaling Innovation in Genetics and Precision Medicine