A Market for Human Cadavers in All but Name?

A shortage of cadavers has hampered medical education and training, a market that entrepreneurs are stepping forward to address. HBS professor Michel Anteby argues that scholars must learn more about the market dynamics of this uncomfortable subject in order to inform political debate.

Operational Failures and Problem Solving: An Empirical Study of Incident Reporting

Operational failures occur within organizations across all industries, with consequences ranging from minor inconveniences to major catastrophes. How can managers encourage frontline workers to solve problems in response to operational failures? In the health-care industry, the setting for this study, operational failures occur often, and some are reported to voluntary incident reporting systems that are meant to help organizations learn from experience. Using data on nearly 7,500 reported incidents from a single hospital, the researchers found that problem-solving in response to operational failures is influenced by both the risk posed by the incident and the extent to which management demonstrates a commitment to problem-solving. Findings can be used by organizations to increase the contribution of incident reporting systems to operational performance improvement.

Input Constraints and the Efficiency of Entry: Lessons from Cardiac Surgery

Many professions rely on highly and variably skilled individuals. If a new firm is looking to enter a specific market, in addition to setting up a physical facility the company needs to hire or contract with specialized labor. In the short term, the supply of these specialists is relatively inelastic. From the point of view of economics, there remains a well-known potential for free entry to be inefficient when firms make entry decisions without internalizing the costs associated with the business they "steal" from incumbent firms. In 1996 Pennsylvania eliminated its certificate-of-need (CON) policy that had restricted entry by hospitals into expensive clinical programs, such as coronary artery bypass graft (CABG) programs—leading to an increase from 43 to 63 in the number of hospitals providing this service. HBS professor Robert Huckman and coauthors examine the welfare implications of entry in the market for cardiac surgery.

Why Can't Americans Get Health Care Right?

Change is desperately needed, agreed readers of Professor Jim Heskett's online forum. But how to make that change remains in doubt. What can Americans learn from solutions implemented by other countries? (Forum now closed; next forum begins September 4.)

Diagnosing the Public Health Care Alternative

With deep experience in health insurance reform, HBS faculty describe how improved competition in insurance plans could improve value for patients. Professors Regina E. Herzlinger, Robert Huckman, and Michael E. Porter take the pulse of a debate.

Broadening Focus: Spillovers and the Benefits of Specialization in the Hospital Industry

What is the optimal scope of operations for firms? This question has particular relevance for the U.S. hospital industry, because understanding the effects of focus and spillovers might help hospitals determine how they should balance focusing in a single clinical area with building expertise in related areas. While some scholars argue that narrowing an organization's set of activities improves its operational efficiency, others have noted that seemingly unfocused operations perform at a high level and that a broader range of activities may in fact increase firm value. This study by HBS doctoral student Jonathan Clark and professor Robert Huckman highlights the potential role of spillovers—specifically complementary spillovers—in generating benefits from focus at the operating unit level.

Clay Christensen on Disrupting Health Care

In The Innovator's Prescription, professor Clayton Christensen and his coauthors target disruptive innovations that will make health care both more affordable and more effective in the future. Q&A with Christensen. From the HBS Alumni Bulletin.

Applying the Care Delivery Value Chain: HIV/AIDS Care in Resource Poor Settings

The prevention and treatment of a complex disease such as HIV/AIDS in resource‐poor settings presents enormous challenges. Many of the social and economic factors that make populations living in these settings vulnerable to HIV/AIDS such as poverty, malnutrition, and political instability conspire to create barriers to effective care delivery. Understanding how interventions are related to each other and how local socioeconomic factors influence them is critical to effective program design. The Care Delivery Value Chain (CDVC) looks at care as an overall system, not as a series of discrete interventions, and describes the activities required to deliver care, illustrating their sequence and organization. Government agencies, philanthropic organizations, and non‐governmental organizations can use the framework to improve HIV/AIDS care delivery.

How to Revive Health-Care Innovation

Simple solutions to complex problems lead to breakthroughs in industries from retailing to personal computers to printing. So let's try health care, too. According to HBS professor Clayton M. Christensen and coauthors of The Innovator's Prescription, such disruption to an industry might look like a threat, but it "always proves to be an extraordinary growth opportunity." Book excerpt.

Creating Leaders for Science-Based Businesses

The unique challenges of managing and leading science-based businesses—certain to be a driver of this century's new economy—demand new management paradigms. At Harvard Business School, the opportunities start just across the street. From HBS Alumni Bulletin.

What Should Employers Do about Health Care?

Companies that cut health care costs without improving the overall value of care eventually pay a price in terms of employee absenteeism and chronic ailments. According to Harvard University professor and strategy expert Michael E. Porter and coauthors, the best way to truly reduce health care costs is to improve quality.

Pursuing a Deadly Opportunity

Cadavers are a necessity for medical students and researchers, but the business of supplying this market is a touchy moral and ethical issue. Harvard Business School professor Michel Anteby and research associate Mikell Hyman explore strategies used by both academic and entrepreneurial organizations that deal in the dead.

The Rise of Medical Tourism

Medical tourism—traveling far and wide for health care that is often better and certainly cheaper than at home—appeals to patients with complaints ranging from heart ailments to knee pain. Why is India leading in the globalization of medical services? Q&A with Harvard Business School's Tarun Khanna.

The FDA: What Will the Next 100 Years Bring?

With the possible exception of the Internal Revenue Service, no other governmental agency touches the lives of more Americans than the U.S. Food and Drug Administration, which ensures the safety of $1.5 trillion worth of consumer goods and medicines. Harvard Business School professor Arthur A. Daemmrich discusses the impact and challenges of the agency and his new book, Perspectives on Risk and Regulation: The FDA at 100.

Improving Patient Outcomes: The Effects of Staff Participation and Collaboration in Healthcare Delivery

Health-care organizations have a well-documented, industry-wide need to improve their processes. To that aim, the Institute of Medicine has made at least 2 recommendations that focus on front-line staff—physicians, nurses, and respiratory therapists. The first recommendation states that front-line staff should be involved in unit decision-making and the design of work processes and workflow (participation). The second emphasizes respectful interactions among front-line staff, including information-sharing and coordinating activities to achieve organizational goals (collaboration). This study provides preliminary supporting evidence for the Institute of Medicine's recommendations to use a dual, front-line strategy of participation and collaboration to improve patient outcomes.

Is Health Care Making You Better—or Dead?

Professor Regina Herzlinger has been studying the U.S. health care system for decades, advocating for consumer-driven reform as the best remedy. But the slow pace of change, which she attributes to a fat-cat network of insurers, policymakers, hospitals, and even employers, has her fed up. Her new book, Who Killed Health Care? adopts the emotional language of a manifesto in demanding change to make health care more responsive to customers, affordable to those in need, and a hotbed of innovation and entrepreneurship.

Health Care Under a Research Microscope

Perhaps no industry has caught the research attention of Harvard Business School faculty as much as health care. Researchers are investigating business-focused solutions on everything from improving team work among surgical teams to developing market motivations that increase the use of water purification in poor villages.

What Is the Government's Role in U.S. Healthcare?

Healthcare will grab ever more headlines in the U.S. in the coming months, says Jim Heskett. Any service that is on track to consume 40 percent of the gross national product of the world's largest economy by the year 2050 will be hard to ignore. But are we addressing healthcare cost issues with the creativity they deserve? What do you think?

Improving Public Health for the Poor

Microfinance may offer a window on new methods for widening access to healthcare for the poor, says Harvard Business School's Michael Chu. He and colleagues at the Harvard School of Public Health have embarked on a new project to serve this critical sector. Bringing together public healthcare and market forces "could have huge impact," he says.

Competition the Cure for Healthcare

Michael Porter is considered by many the world's foremost authority on competition and strategy. He discusses the need for fundamental reform in the way the United States delivers healthcare. Q&A.

Using Competition to Reform Healthcare

In their new book, HBS Professor Michael Porter and Elizabeth Olmsted Teisberg argue that the very structure of U.S. healthcare must be redesigned to create value and effective competition throughout the system. An excerpt from Redefining Health Care: Creating Value-Based Competition on Results.

Implementing New Practices: An Empirical Study of Organizational Learning in Hospital Intensive Care Units

How do hospital units, as complex service organizations, successfully implement best practices? Practices involve people and knowledge; people must apply knowledge to particular situations, so changing practices requires changing behavior. This study is a starting point for healthcare organizations to improve work practices.

The researchers drew from literature on best practice transfer, team learning, and process change and developed four hypotheses to test at highly specialized hospital units that care for premature infants and critically ill newborns.

The Hidden Market for Babies

Surrogates. Fertility clinics. Egg donors. Adoption. It's time to recognize (and perhaps regulate) the huge market being created by reproductive technologies, says HBS professor Debora L. Spar. She discusses her new book, The Baby Business.

From Turf Wars to Learning Curves: How Hospitals Adopt New Technology

Turf wars and learning curves influence how new technology is adopted in hospitals. HBS professors Gary Pisano and Robert Huckman discuss the implications of their research for your organization.

New Learning at American Home Products

In Alfred D. Chandler Jr's new history of the modern chemical and pharma industries, American Home Products follows a singular path to success. An excerpt from Shaping the Industrial Century.

Entrepreneurial Hospital Pioneers New Model

A "Robin Hood" cardiac hospital in India—which charges wealthy patients, yet equally welcomes the destitute—is an exciting example of entrepreneurship in the subcontinent, says HBS professor Tarun Khanna.

Learning Tradeoffs in Organizations: Measuring Multiple Dimensions of Improvement to Investigate Learning-Curve Heterogeneity

How and why experience leads to performance improvement has made the learning curve an important management topic for sites ranging from nuclear power plants to cardiac surgical units. This new research looks deeper at learning curves by focusing on learning rates in technology adoption in similar organizations along multiple, potentially competing dimensions. Using longitudinal data from sixteen hospitals that are adopting a new technology for cardiac surgery, it specifically studies two dimensions: efficiency and application innovation and the potential tradeoff between efficiency and application innovation. It also asks how such tradeoffs are influenced.

Side Effects: The Case of Propecia

Selling Propecia was a difficult marketing task for Merck & Co., and was recently the subject of a case study debated by Harvard Business School alumni.

Solving the Health Care Conundrum

Executive summary of a presentation on reforming health care made by Professor Michael Porter at a Harvard Business School Publishing Virtual Seminar.

Health Care Research and Prospects

A groundbreaking project at Harvard Business School is bringing together faculty, researchers, and students to probe issues in health care management. An interview with Professor Gary P. Pisano.

Why Europe Lags in Pharmaceuticals and Biotech

Governmental, cultural and academic differences are hurting Europe’s chances of gaining on the U.S. Can anything be done?

Sometimes Success Begins at Failure

Projects that appear to be duds may have unintended upsides—Viagra started life and failed as a drug for hypertension. Here are tips for turning negative test results into gold.

The Business Case for Diabetes Disease Management

Diabetes is a tough disease to tackle. A case-study discussion led by HBS professor Nancy Beaulieu asked why it is so complex for business and society, and what might be done to curb its incidence.

The Business of Babies

The demand for babies by infertile couples and other would-be parents is huge—and little discussed. HBS professor Debora L. Spar looks at the market realities.

Making Biotech Work as a Business

What will it take for biotechnology to fulfill its economic potential? Participants need to think twice about the strategies and assumptions that are driving the industry, says HBS professor Gary P. Pisano.

Healthcare Conference Looks At Ailing Industry

What's plaguing healthcare? Experts including HBS professor Clayton Christensen make the diagnosis on future trends for biology and medicine—and the business opportunities within—at the 2^nd HBS Alumni Healthcare Conference.

How Technological Disruption Changes Everything

From countries to companies, HBS Professor Clayton Christensen sees disruptive technologies upsetting applecarts all over the globe. In his talk at the HBS Global Alumni Conference 2001, Christensen discussed how disruptive technologies could change forever the health field, Microsoft, and even the Harvard Business School.

The Business of Biotech

On the cusp of what most analysts agree will be the age of biotechology, Professor Gary P. Pisano and four HBS alums on the front lines of the biotech revolution offer their views of the challenges, issues and opportunities facing the industry in the laboratory, the boardroom and the marketplace.

What's an Internet Business Model? Ask a Health Care Professional

Health care and the Internet are well-matched for each other, quipped one panelist at the IS2K conference, "because no one wants to pay for either." Quips aside, the health care field is emerging as one of the busiest laboratories for exciting new business models—and the stakes are high indeed. In a discussion moderated by HBS Professor Lynda Applegate, experts in this burgeoning realm of Internet activity talked about what their businesses are doing to change the rules, all while trying to fulfill their primary goal of earning patients' trust.

Putting Health Care Consumers in the Driver's Seat

Amid rising costs, changing attitudes and increasing dissatisfaction with the existing health care system, the development of consumer-driven health care is a given: the question, according to participants in an HBS conference chaired by Professor Regina A. Herzlinger, is not If, but When.

Growing Pains: Prescriptions for U.S. Health Care

The health care industry may look seriously ill, says HBS Professor Clayton M. Christensen, but it's merely suffering the growing pains of a natural evolution as technology forces change at both the high and low ends of the market.