Course Syllabus

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Innovation and Entrepreneurship in Health Care

HPM 557

2016 Syllabus

 

Faculty:

Rick Siegrist, co-instructor, email rsiegris@hsph.harvard.edu, phone: 508-395-1884

Teresa Chahine, co-instructor, email tchahine@hsph.harvard.edu, phone: 617-384-8855

Tayeisha Jackson, teaching assistant, email taj915@mail.harvard.edu

 

Objectives and Approach:

            The Innovation and Entrepreneurship in Health Care course is designed to expose you to the theory and practice of innovation and entrepreneurship in health care settings, both domestically and globally. The first half of the sessions focus on various aspects of starting and growing a new health care business, whether a for-profit or non-profit venture.  The second half of the sessions focus on fostering innovation and intrapreneurship in established organizations such as non-profit, for-profit or governmental organizations engaged in health care related activities.

            The course places particular emphasis on the development and practical application of innovation and entrepreneurial skills in the health care sector. By the end of the course, you should be able to:

(a) Analyze the idea, value proposition, team, business model, financing and execution of any early stage health care company and make recommendations for improvement.

(b) Assess the innovation environment, challenges and barriers for any established health care company and make recommendations for improvement.

            As healthcare organizations strive to deliver on the triple aim of better health and better care at lower cost, they need to identify new ways to understand healthcare information and introduce new methods of healthcare management and care delivery.  Fortunately, many health care organizations now recognize the importance of being innovative in order to survive in such a rapidly changing environment.  However, most people in those organizations do not truly understand how to foster such innovation, either internally or externally.  Though this course, we hope to prepare you to encourage effective innovation and intrapreneurship within an existing organization and/or contribute to the success of or start an innovative, entrepreneurial venture in health care.

 

Class Preparation and Participation:

            We expect you to make an effort to prepare every case.  This preparation is particularly important since the cases build upon one another and techniques introduced in one case are frequently applied in future cases.  We suggest between two and three hours of preparation for each class and encourage case discussion in small study groups where feasible.

            The assigned readings are not simply background readings.  They introduce key concepts regarding innovation and entrepreneurship that are essential to properly analyze the cases and participate in class discussion.

            Since the course will be primarily case oriented, class participation is very important.  We value the quality of classroom participation over quantity.  We will complement the case study approach with practical lectures on key concepts in innovation and entrepreneurship.  We will also have guest speakers with particular knowledge about the case or topics being discussed.

 

Grading: 

We will determine your grade for the course as follows:

Mid Term Paper due on November 21, 2016 40%
Final Paper due on December 14, 2016   40%
Class preparation and participation 20%
Total 100%

            A three-page mid term paper will be due on November 21, 2016.  We will distribute the case and related questions for the paper at the end of class on November 16, 2016.

            The final paper will be due on December 14, 2016. We will distribute the case and related questions for the paper on December 5, 2016.

 

Office Hours:

            Rick Siegrist’s office hours will be by appointment, either in person or via the phone.  His telephone number is 508-395-1884, and he can be reached at rsiegris@hsph.harvard.edu or at ricksiegrist@gmail.com.  His office is Kresge 301.

            Teresa Chahine’s office hours will be by appointment, either in person or via the phone.  Her telephone number is 617-384-8855, and she can be reached at tchahine@hsph.harvard.edu. Her office is Landmark Center 4th Floor West, 401 Park Drive.

 

Suggested Book:

Kawasaki G.  The Art of the Start 2.0:  The Time-Tested, Battle-Hardened Guide for Anyone Starting Anything.  Penguin Group, 2015.

 

Course Session Details:

Session 1         10/24/16, 3:30-5:20                            Introduction – Lenny’s Lemonade

Case:               None

Reading:         Siegrist RB. 2013.  Entrepreneurship in Health Care, pp. 1 to 21.

Assignment:  

None.  Session will be an interactive class discussion, applying course concepts to a simple organization as an introduction to the course content and approach.

                       

Session 2         10/26/16, 3:30-5:20                            Idea/Value Proposition/Team Formation

Case:             Walker BL. 2014.  North End HealthCare:  Pediatric Ambulatory Surgery Center Expansion Strategy, HSPH

Reading:       Siegrist RB. 2013.  Entrepreneurship in Health Care, pp. 1 to 5.

Blank S.  May 2013.  Why the Lean Startup Changes Everything.  Harvard Business Review, pp. 65-72.

Assignment:  

  1. What kind of innovation is involved in NEHC’s approach?
  2. What is their value proposition?
  3. Evaluate the strengths and weaknesses of their management team.
  4. What expansion strategy should NEHC follow?  Why?

 

Session 3         10/31/16, 3:30-5:20                            Business Model/Competition

Case:             Huckman RS, Stern AD, Preble MG.  March 2015.  Twine Health.  HBS 9-615-068

Reading:       Siegrist RB. 2013.  Entrepreneurship in Health Care, pp. 5 to 9.

Johnson MW, Christensen CM, Kagermann H.  Dec 2008.  Reinventing Your Business Model.  Harvard Business Review, pp. 50-59.

Detsky AS, Garber AM.  Uber’s Message for Health Care.  Mar 2016.  n engl j med 374;9, pp. 806-9.

Burke A, Hussels S.  Mar 2013.  How Competition Strengthens Startups.  Harvard Business Review, pp. 24.

Assignment:   

  1. Evaluate the value proposition for Twine Health.
  2. Assess the team and advisory board that John Moore has assembled by going to https://www.twinehealth.com/about. What capabilities may be missing?
  3. How worried are you about the competition? Why? How would you suggest Twine Health distinguish itself?
  4. What pricing strategy would you advocate for Twine Health? How might that strategy be impacted by new payment models?

 

Session 4         11/2/16, 3:30-5:20                              Financing/Valuation/Pitch                                                           

Case:              Herzlinger RE. 2014.  MedVal Ventures, HBS 9-308-087

Reading:        Siegrist RB. 2013.  Entrepreneurship in Health Care, pp. 9 to 15.

                        Mulcahy D. May 2013.  Six Myths About Venture Capitalists.  Harvard Business Review, pp. 80-83.

                        Deepak M.  May 2013.  How to Negotiate with VCs.  Harvard Business Review, pp. 84-90.

Assignment: 

  1. Evaluate MedVal Ventures in terms of the entrepreneurial framework we have covered in class - idea/value proposition, team formation/roles, business model/competition, financing and execution.
  2. What would you suggest that the MedVal Ventures team do?  Why?

 

Session 5         11/7/16, 3:30-5:20                              Structure/Equity/Intellectual Property

Case:              Marguis C, Margolis J.  Dec 2012.  How Much is Sweat Equity Worth?  Harvard Business Review, pp. 121-123.

Reading:       Siegrist RB. 2013.  Entrepreneurship in Health Care, pp. 15 to 18.

Kotha R, Kim P, Alexy O.  Nov 2014. Turn Your Science into a Business. Harvard Business Review, pp. 106-114.

Assignment:  

  1. What arguments are Brooks and Tyler making about their respective contributions to the company?
  2. Which arguments do you find the most convincing?
  3. How much equity should Brooks give Tyler in the company?
  4. What do you think the short term and long term ramifications of your recommended equity split might be?

 

Session 6         11/9/16, 3:30-5:20                              International Entrepreneurship

Case:             Lundberg K. 2015.  The Trials of a Social Entrepreneur:

                      ZiDi™, MicroClinic Technologies and Kenyan Healthcare, HSPH

Reading:        

Crean, KW. Feb 2010.  Accelerating Innovation in Information and Communication Technology For Health.  Health Affairs, pp. 278-283.

Sabeti H.  Nov 2011.  The For-Benefit Enterprise.  Harvard Business Review, pp. 98-104.      

Assignment: 

  1. What is the societal challenge that ZiDi aims to tackle?  What do we know about its causes, distribution and stakeholders?
  2. What solution does ZiDi offer? What is the innovation and value proposition?
  3. What business model would you build around this solution? Who is the customer, who is paying, what are key costs, revenue streams, performance metrics and impact metrics?
  4. Would you continue to pursue the public sector route, or go for private? Why or why not?

                                                                                                                                   

Session 7         11/14/16, 3:30-5:20                            International Entrepreneurship

Case:             Sahlman, William A., and Vineeta Vijayaraghavan. "Iora Health." Harvard Business School Case 814-030, February 2014.

Reading:       Thompson JD, MacMillian JC.  Sep 2010.  Making Social Ventures Work.  Harvard Business Review, pp. 66-73.

Bugg-Levine A., Kogut B, Kulatilaka N.  Jan/Feb 2012.  A New Approach to Funding Social Enterprises.  Harvard Business Review, pp. 119 – 123.

Assignment:  

  1. What do you consider the most important differences between the Iora model and a traditional primary care model? Why?
  2. Assess the executive team, board and investors that Rushika Fernandopulle has assembled by going to http://www.iorahealth.com/about-us/meet-team/. How does it compare to Twine Health (https://www.twinehealth.com/about)?
  3. Evaluate the following strategic and operational choices of Iora Health:
    • Iora branded vs. Intel Inside approach for clinic sites
    • Build own EHR (ICIS) vs. buy existing system
    • Geico vs. Staples approach for expansion
    • Employer sponsors vs. Medicare/Medicaid/Individual markets
  4. How successful do you think Iora Health will be in raising their series B financing round?  Will they find that “unicorn” investor?                                                                                                                                      

Session 8         11/16/16, 3:30-5:20                            Execution and Exit Strategy

Case:             Siegrist RB. 2015.  Cambria Health:  Failure in Vision, Strategy or Execution?

Reading:       Siegrist RB. 2013.  Entrepreneurship in Health Care, pp. 19 to 21.

Halvorson H.  May 2014.  Get Your Team to Do What It Says It’s Going to Do.  Harvard Business Review, pp. 82-87.

Onyemah V, Pesquera MR, Ali A. May 2013.  What Entrepreneurs Get Wrong.  Harvard Business Review, pp. 74-79.

Assignment:  

  1. Evaluate Cambria Health in terms of:
    • Idea and value proposition
    • Team formation
    • Business model and competition
    • Execution
  2. What do you think contributed most to the lack of success of Cambria Health?
  3. What would you do differently?

 

Session 9         11/21/16 (no class – paper due)       Mid Term Paper

Case:               To be distributed

Reading:         None

Assignment:   A paper on the case distributed on November 16th will be due on, Monday November 21st by 5:00 p.m.  Please put it in Rick's mailbox on the 3rd floor of Kresge.  This paper should be a maximum of three double-spaced pages, plus exhibits. The paper should address the set of questions distributed with the case.

 

Session 10       11/28/16, 3:30-5:20                            Innovation – Payer

Case:             Herzlinger RE. 2014.  Vitality Group:  Paying for Self-Care, HBS 9-310-071

Reading:       Stewart JB. Jan 29, 2015.  “How, and Why, Apple Overtook Microsoft”, New York Times.

Webb J.  Jan 23, 2013. How Dreamworks, LinkedIn and Google Build Intrapreneurial Cultures. www.innovationexcellence.com.

Pfitzer M, Bockstette V, Stamp M.  Sep 2013.  Innovating for Shared Value.  Harvard Business Review, pp. 100-107.

                      Anthony S.  Sep 2012.  The New Corporate Garage.  Harvard Business Review, pp. 44-53.

Assignment:  

  1. What kind of innovation is the Vitality program?
  2. What is their value proposition?
  3. Who is Vitality’s competition?  How do they differentiate themselves?
  4. What business model should Vitality pursue and why?
  5. How have the Discovery Group and Vitality fostered internal innovation?                      

 

Session 11       11/30/2016, 3:30-5:20                        Innovation – Government Agency

Case:            Lapedis JB, Madden SL. 2015.  Health Policy Commission – The CHART Program.

Reading:      Isenberg DJ.  Jun 2010.  How to Start an Entrepreneurship Revolution.  Harvard Business Review, pp. 41-50.

Arnold E, Magia S.  2013.  Intrapreneurship in Government – Making it work.  Deloitte University Press.

Assignment:  

  1. What is the HPC trying to accomplish through the CHART program?
  2. What mechanisms are they using?
  3. What is exciting/different/innovative about their approach?
  4. Do you think they will be successful?  Why or why not?

               

Session 12       12/5/16, 3:30-5:20                              Innovation – Software Company

Case:             Chakravorti B, Winig L, Arastu N. 2010. athenahealth: Innovating in Response to a Crisis in Healthcare, HBS 810079

Reading:      

Altringer B. Nov 19, 2013.  A New Model for Innovation in Big Companies.  Harvard Business Review post on Innovation                         

Assignment:  

  1. Evaluate Athena Collector using the framework we have applied in class -- idea/value proposition, team and culture, competition and differentiation, marketing and distribution, profit and cost, and execution. For your evaluation, use the information you have about the current market as of February 2010.
  2. What would you suggest that the founder do? Why?

 

 

Session 13       12/7/16, 3:30-5:20                              Innovation – iLab

Case:               We will be discussing the CVI midterm case in class.

Readings:       None.

Assignment:  

  1. If you’ve entered one of the iLab challenges, email Teresa with the submission or idea/title. Let Teresa know if you’d like to discuss your idea with the class.

 

Session 14       12/12/16, 3:30-5:20                            Innovation – International

Case:               Khanna T, Gupta B. 2014.  Health City Caymen Islands.  Harvard Business School 9-714-510.

Reading:         None

Assignment:  

  1. What kind of innovation is Health City Caymen Islands?
  2. What are the challenges and barriers to success for Health City Caymen Islands?
  3. Why and how did Narayana Health foster the innovation that lead to Health City Caymen Islands?
  4. What role is Ascension Health playing?  How innovative an organization is Ascension Health?

 

Session 15       12/14/16, 3:30-5:20                            Becoming Intra/Entrepreneurs

                                                                                     In-Class Exercise

Case:               None

Reading:        

Schlesinger L, Kiefer C.  Jul 14, 2014.  Act Like an Entrepreneur Inside Your Organization.  Harvard Business Review post on Leadership.

Wasserman N.  Feb 2008.  The Founder’s Dilemma.  Harvard Business Review, pp. 103-109.

Assignment:  

  1. Break into groups of approximately six people. 
  2. Discuss how you might pursue intrapreneurship or entrepreneurship in your future career.
  3. What challenges or barriers do you foresee and how might you address them?
  4. Choose a spokesperson to summarize and briefly present your group’s thoughts to the class.

Course Summary:

Course Summary
Date Details Due