Case Studies

The institute works closely with ISB’s Centre for Learning and Management Practice (CLMP) in developing case studies from the healthcare sector that document real business scenario. This allows our faculty in delivering management lessons in tune with the latest in the industry. These case studies are also disseminated to global classrooms through the HBS network. 

Listed below are select published healthcare cases which include those supported by MIHM as well independent work by ISB faculty members.

Scaling Niramai: Disrupting Breast Cancer Detection Using Artificial Intelligence

Authors: Sukanya Roy, Raj Krishnan Shankar, D.V.R. Seshadri, Venkat Ramana Sudigali, Rajesh Pandit

The case describes the relentless efforts of Dr. Geetha Manjunath, the founder of Niramai, to improve early-stage breast cancer detection in women. India was plagued by a lack of medical facilities, poor access to early-stage cancer screening programs, and a lack of awareness of breast cancer in rural areas. These were the primary causes of the high rate of death due to cancer among women, of which breast cancer was a major contributor. The case study explores the different stages of Niramai's journey and poses the key question of what Niramai should do to scale its innovative and crucial offering for marketplace success. Manjunath, a healthcare research scientist, developed an innovative thermal-analytics-based solution to detect early-stage breast cancer. Niramai's innovative product received global recognition; it was the only Indian start-up to be listed on the global business data intelligence platform CB Insights. She had the noble vision of providing an affordable early-stage breast cancer solution to women, especially the underprivileged in the hinterland of the country. Manjunath considered her start-up to be much more than merely a business. The company raised US$7 million from investors for business expansion and growth. Given the potential upside, the opportunities to raise funds and scale globally created a plethora of dilemmas and challenges for Niramai's senior management team.

Hopes Critical Care: Scale-up of a Tele-Intensive Care Solution

Authors: Vijaya Sunder M, Meghna Raman, D.V.R. Seshadri

The case is set in 2021 and follows the journey of Dr. Shailesh Jhawar, an intensivist trained in the United Kingdom, who returned to India to join his father, Dr. Shiv Bhagwan Jhawar, at Apex Hospitals in Jaipur, Rajasthan, which his father had founded in 1994. The case describes Jhawar's efforts to improve patient outcomes in critical care with the tele-intensive care unit (tele-ICU) model. It takes the reader through Jhawar's journey from the time he discovered the need for tele-ICU and understood the various facets of its implementation to the establishment of Hopes Critical Care (HCC) as a tele-ICU provider and the induction of the first few "spoke" hospitals into the tele-ICU network.

Project Ashray: Planning a Time-Constrained Project

Authors: Vijaya Sunder M, Sarang Deo, Siddhartha Modukuri

In response to the uncontrollable second wave of Covid-19 in the south Indian state of Telangana in April 2021, a few like-minded social activists in the capital city of Hyderabad came together to establish a 100-bed medical care center to treat Covid-19 patients. The project was named Ashray. Dr. Chinnababu Sunkavalli (popularly known as Chinna) was the project manager of Project Ashray. In addition to the inherent inadequacy of hospital beds to accommodate the growing number of Covid- 19 patients till March 2021, the city faced a sudden spike of infections in April that worsened the situation. Consequently, the occupancy in government and private hospitals in Hyderabad increased by 485% and 311%, respectively, from March to April. According to a prediction model, Chinna knew that hospital beds would be exhausted in several parts of the city in the next few days. The Project Ashray team was concerned about the situation. The team met on April 26, 2021, to schedule the project to establish the medical care center within the next 10 days.

Health-Tech Strategy at KG Hospital Part B: Tech Strategy Design and Implementation

Authors: Vijaya Sunder M, Meghna Raman

The objective of this case study (in two parts, A and B) is to provide a systematic methodology for capturing metrics crucial for patient experience and hospital performance, defining a framework to design an enterprise technology strategy map, and examining the readiness, deployment, and sustainability of technology solutions to help achieve superior patient satisfaction. Part B (Tech Strategy Design and Implementation ) of this two-part case study is a follow-up to Part A, and it takes the reader through Avantika Raghu's journey of solving the problems identified in Part A. Part B of the case study describes her efforts to address prioritized metrics by identifying technology solutions (both in-house and external vendors).

Health-Tech Strategy at KG Hospital Part A: Identification and prioritization of key focus areas

Authors: Vijaya Sunder M, Meghna Raman

The objective of this case study (in two parts, A and B) is to provide a systematic methodology for capturing metrics crucial for patient experience and hospital performance, defining a framework to design an enterprise technology strategy map, and examining the readiness, deployment, and sustainability of technology solutions to help achieve superior patient satisfaction. Part A (Identification and Prioritization of Key Focus Areas) of this two-part case study takes the reader through the exploration of Avantika Raghu, Chief Experience and Technology Officer at the KG hospital, where she uncovers various pain points. It describes Raghu's observations during her Gemba walks covering key departments at the hospital, learnings from her focus group meetings with stakeholders, and insights from examining the hospital's quality and performance parameters. The case concludes with Raghu identifying patient satisfaction as a core challenge in the current setup and considering technological solutions that can help improve patient satisfaction while enabling hospital expansion to meet the goals of Vision 2025.

Transforming maternal and newborn healthcare in India through midwifery: The Fernandez Foundation Initiative

Authors: Swati Sisodia, D V R Seshadri

The case explores the promises and challenges of Public-Private Partnerships (PPPs) in the Indian Healthcare system. India has a high maternal mortality rate, poor doctor-to-patient ratio, rising C-section rates, absence of last-mile access to quality maternal healthcare. In this context, Dr. Fernandez, a veteran in maternal healthcare, believes that midwifery is a workable solution to these widespread problems. However, to have an impact both in terms of and financial sustainability, government support is essential. Dr. Fernandez thinks that a PPP may be the best way to create many well-trained and professional midwives in the country. However, given India's complex healthcare structure, it is not easy to get acceptance and commitment from all the states for government schemes. Problems such as frequent changes in the bureaucratic leadership often disrupt the implementation of schemes. Another challenge is the mindset of birthing mothers, the obstetric community, and family members who view the medicalization of birthing as acceptable. Dr. Fernandez has to overcome multiple challenges. She has to address obstetricians' pushback while changing birthing mothers' mindsets and continually motivate the midwives her team had trained. Regarding the PPP, she has to evolve a plan to fast-track the rollout of the PPP model, ensure that the complex PPP involving multiple stakeholders works effectively, she has to address the roadblocks to the implementation of the PPP initiative, and design mechanisms to monitor progress.

Technology decision-making in a semi-urban ICU: An intensivist's dilemma

Authors: Vijaya Sunder M, Sarang Deo

Set in April 2017, this case centers around the digital technology dilemma facing the protagonist Dr. Vimohan, the chief intensivist of Prashant Hospital. The case describes the critical challenges afflicting the intensive care unit (ICU) of the hospital. It then follows Dr. Vimohan as he visits the Bengaluru headquarters of Cloudphysician Healthcare, a Tele-ICU provider. The visit leaves Dr. Vimohan wondering whether he can leverage the Tele-ICU solution to overcome the challenges at Prashant Hospital. He instinctively knew that he would need to use a combination of qualitative and quantitative analysis to resolve this dilemma.

L. V. Prasad Eye Institute: Innovating the business of eye care

Authors: Shlomo Maital, D V R Seshadri, Swati Sisodia

The case delineates the journey of L.V. Prasad Eye Institute (LVPEI), which evolved to become the biggest rural eyecare network, and it is amongst the most well-known eyecare providers in the world. Established in the year 1987 in the city of Hyderabad, India, LVPEI had been known internationally for its quality of eye care. As part of its vision, it treats half of its patients free of cost by adopting the cross-subsidization model. It developed the unique 'Pyramid Model' to serve the last mile population. The subject of Strategy and Innovation is riddled with paradoxes. A paradox is typically a pair of opposites, that have to be creatively reconciled, ensuring that both the opposites are simultaneously true. The case is set in the year 2018, and the key highlight of the case is to showcase how LVPEI has reconciled the hierarchy of paradoxes, i.e., strategy paradoxes, and innovation paradoxes during its 30 years journey and achieved excellence in eye care. The vital question of how LVPEI can sustain continued innovative excellence has emerged now. The senior management of LVPEI has to chart their way forward for the coming 30 years, reconciling the hierarchy of paradoxes. These paradoxes are elusively described in the case. Students would need to identify the paradoxes and think through LVPEI's journey ahead by reconciling them.

Cloudphysician: A collaboration between man and machine to save lives

Authors: Rajesh Pandit, D V R Seshadri

Set in 2019, the case traces the journey of Cloudphysician, a four-year old healthcare start-up offering comprehensive remote monitoring and advisory solutions to intensive care units (ICUs) of hospitals in India. The primary beneficiaries of the start-up's services were hospitals in tier-2 and tier-3 cities and towns across India, particularly smaller hospitals, which did not have emergency care in their ICUs, which resulted in high mortality rates. Cloudphysician team built a solution that significantly increased the capacity and capabilities of doctors in charge of ICUs at these hospitals. Cloudphysician developed a sophisticated technology using a combination of new age technologies such as computer vision, artificial intelligence (AI), machine learning (ML) and analytics. More than a dozen paying hospitals were reaping the benefits of Cloudphysician as its customers. Having demonstrated the proof of concept, its founders hoped to rapidly scale up the number of hospitals adopting its solution. The case tells the story of the start-up and its founders, starting from the origin of the idea. The founders were facing several dilemmas about scaling the business, expanding the scope and scale of technology-enabled solutions, potential scaling issues, an uncertain regulatory landscape, and probable competitors. This case could be used in courses on strategy, entrepreneurship or technology disruption in the healthcare industry in both MBA and executive education programs. While the case has relevance in both developed and developing world contexts, what is unique about it is that the business concept of the firm arose out of a resource-constrained environment characteristic of emerging markets. The Teaching Note provides a framework for the instructor to navigate the case discussion in an effective manner in a typical 90-minute session.

Basic Healthcare Services: An innovative model for primary healthcare delivery in rural India

Authors: Devendra Tayade, D V R Seshadri

Set in the year 2019, this case looks at the development of Basic Healthcare Services (BHS), a primary healthcare organization in India based out of Udaipur, Rajasthan, and its efforts to achieve sustainability. This case sheds light on the state of primary healthcare in India and, in doing so, unravels the underlying challenges of setting up and running a privately-led primary healthcare delivery organization in rural India catering to people at the bottom of the pyramid. It shows how building physical infrastructure alone is not enough to provide last-mile primary healthcare coverage to people living in the rural hinterlands. BHS, under the leadership of its Founder-Director Dr. Pavitra Mohan, engaged with rural communities to build their trust in allopathic healthcare and wean them away from pseudo-practitioners, and created systems that would address their health needs. This case gives readers a glimpse of Mohan's formative years and the many challenges he had to overcome to realize his vision of providing affordable and accessible last-mile healthcare. One of BHS's successful strategies was to engage with the communities it served and forge meaningful collaborations. A small but dedicated team of healthcare professionals and community workers delivered compassionate care and conducted outreach in poor rural communities. It relied on grant aid to finance its operations. The primary issue confronting BHS in 2019 was how to achieve financial viability and catalyze the growth of the organization.