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Harvard Case - Intermountain Healthcare: Pursuing Precision Medicine

"Intermountain Healthcare: Pursuing Precision Medicine" Harvard business case study is written by Richard G. Hamermesh, Kathy Giusti, Robert S. Huckman, Julia Kelley. It deals with the challenges in the field of Entrepreneurship. The case study is 22 page(s) long and it was first published on : Sep 28, 2017

At Fern Fort University, we recommend that Intermountain Healthcare (IHC) continue its pursuit of precision medicine through a multi-pronged approach that leverages its existing strengths and addresses emerging opportunities. This strategy should focus on building a robust data infrastructure, investing in AI and machine learning, fostering strategic partnerships, and engaging in proactive communication and education to drive adoption and value creation.

2. Background

Intermountain Healthcare, a non-profit integrated delivery system in Utah and Idaho, is a leader in healthcare innovation. Driven by a mission to improve the health of its communities, IHC has been at the forefront of adopting technology and data-driven approaches to enhance patient care. The case study highlights IHC?s journey into precision medicine, a personalized approach to healthcare that leverages genetic and other patient data to tailor treatments and improve outcomes.

The main protagonists of the case study are:

  • Dr. Marc Harrison, CEO of IHC, who champions the vision of precision medicine and its potential to transform healthcare.
  • Dr. Lincoln Nadauld, Chief Scientific Officer of IHC, who leads the development of the precision medicine program and its research initiatives.
  • The IHC team, including clinicians, researchers, and IT professionals, who are actively involved in implementing and advancing precision medicine within the organization.

3. Analysis of the Case Study

Strategic Framework:

To analyze IHC?s situation, we employ a combination of frameworks:

  • Porter?s Five Forces: Analyzing the competitive landscape reveals a highly competitive healthcare industry with increasing pressure from rising costs, regulatory changes, and evolving patient expectations. However, IHC?s integrated delivery system model provides a competitive advantage.
  • SWOT Analysis:
    • Strengths: Strong brand reputation, established IT infrastructure, extensive data repository, commitment to innovation, and a culture of collaboration.
    • Weaknesses: Limited access to venture capital, potential for data security breaches, and challenges in scaling precision medicine initiatives.
    • Opportunities: Growing demand for personalized healthcare, advancements in AI and machine learning, and potential for new revenue streams through precision medicine services.
    • Threats: Regulatory uncertainty, potential for data privacy concerns, and competition from other healthcare providers adopting precision medicine.
  • Value Chain Analysis: IHC?s value chain is strengthened by its focus on data collection, analysis, and utilization to enhance patient care. Precision medicine initiatives further enhance this value chain by enabling more targeted and effective interventions.
  • Resource-Based View: IHC possesses valuable resources such as its data infrastructure, clinical expertise, and strong brand reputation. These resources, combined with its commitment to innovation, provide a foundation for sustainable competitive advantage.

Key Challenges:

  • Data Management and Security: Ensuring the secure and ethical collection, storage, and analysis of patient data is paramount.
  • Cost and Accessibility: Implementing precision medicine requires significant investment, raising concerns about accessibility for all patients.
  • Physician Adoption: Encouraging widespread adoption of precision medicine among clinicians requires comprehensive training and support.
  • Communication and Education: Effectively communicating the benefits and implications of precision medicine to patients is crucial for building trust and promoting engagement.

4. Recommendations

IHC should pursue a strategic approach to precision medicine that encompasses the following:

1. Data Infrastructure Development:

  • Invest in robust data infrastructure: Expand and enhance existing data platforms to accommodate the growing volume and complexity of genomic, clinical, and lifestyle data.
  • Develop data governance policies: Establish clear guidelines for data collection, use, and security, ensuring compliance with privacy regulations and ethical standards.
  • Foster data interoperability: Promote seamless data exchange across different healthcare systems and research institutions to facilitate collaborative research and clinical decision-making.

2. AI and Machine Learning Adoption:

  • Invest in AI and ML technologies: Develop and deploy AI-powered tools for data analysis, disease prediction, and treatment optimization.
  • Partner with technology companies: Collaborate with leading AI and ML companies to leverage their expertise and accelerate innovation.
  • Develop internal AI expertise: Invest in training and development programs to build in-house AI and ML capabilities.

3. Strategic Partnerships:

  • Collaborate with research institutions: Partner with universities and research centers to conduct clinical trials and advance precision medicine research.
  • Engage with pharmaceutical companies: Establish partnerships to develop and test personalized therapies and diagnostics.
  • Form strategic alliances with other healthcare providers: Collaborate with other hospitals and clinics to share data, resources, and expertise.

4. Communication and Education:

  • Develop patient-centered communication strategies: Clearly explain the benefits, risks, and limitations of precision medicine to patients.
  • Offer educational resources: Provide patients with accessible information about genetic testing, personalized treatment options, and their role in managing their health.
  • Engage with community stakeholders: Educate the public about precision medicine and its potential impact on healthcare.

5. Basis of Recommendations

These recommendations are grounded in the following considerations:

  • Core competencies and consistency with mission: IHC?s commitment to innovation and patient-centered care aligns with the goals of precision medicine.
  • External customers and internal clients: Patients are the primary beneficiaries of precision medicine, while clinicians and researchers are key stakeholders in its implementation.
  • Competitors: IHC?s proactive approach to precision medicine positions it as a leader in the field, giving it a competitive edge.
  • Attractiveness: Precision medicine offers the potential for improved patient outcomes, reduced healthcare costs, and new revenue streams.

Assumptions:

  • Continued advancements in AI and ML technologies will enable more sophisticated and effective applications in healthcare.
  • Public acceptance of precision medicine will grow as its benefits become more apparent.
  • Regulatory frameworks will evolve to support the ethical and responsible use of patient data.

6. Conclusion

By embracing a comprehensive and strategic approach to precision medicine, IHC can solidify its position as a leader in healthcare innovation, improve patient outcomes, and create sustainable value for its stakeholders.

7. Discussion

Alternatives:

  • Limited investment in precision medicine: This approach could lead to IHC falling behind competitors and missing out on potential benefits.
  • Focusing solely on research: While research is important, it is essential to translate research findings into clinical practice to benefit patients.

Risks:

  • Data breaches and privacy concerns: Stringent security measures are crucial to protect patient data.
  • High initial investment costs: Funding for precision medicine initiatives requires careful planning and resource allocation.
  • Resistance to change: Overcoming resistance from clinicians and patients to new technologies and approaches requires effective communication and education.

Key Assumptions:

  • The adoption of precision medicine will continue to grow in the coming years.
  • Advances in AI and ML will continue to enhance the effectiveness of precision medicine.
  • Regulatory frameworks will evolve to support the development and use of precision medicine technologies.

8. Next Steps

  • Develop a comprehensive strategic plan for precision medicine: Define goals, objectives, and timelines for implementation.
  • Establish a dedicated team to oversee precision medicine initiatives: Ensure coordination and collaboration across departments.
  • Pilot test precision medicine programs in specific clinical areas: Gather data and feedback to refine and scale successful initiatives.
  • Invest in training and education programs for clinicians and patients: Foster understanding and adoption of precision medicine.
  • Engage in public awareness campaigns: Educate the community about the benefits and implications of precision medicine.

By taking these steps, IHC can position itself at the forefront of precision medicine, leading the way towards a more personalized and effective healthcare system.

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Case Description

Headquartered in Salt Lake City, Intermountain Healthcare operates 23 hospitals and hundreds of clinics in Utah and Idaho and provides insurance to approximately 850,000 patients through its insurance arm, SelectHealth. In 2013, Intermountain, known for its commitment to improving health care outcomes and lowering costs by reducing treatment variation, made the surprising decision to invest significant resources in an innovative precision medicine unit, which would provide life-extending, genetically-targeted therapies to late-stage cancer patients. Precision medicine was associated with treatment variation and high costs, the latter of which was of particular concern given that Intermountain often served as both payer and provider for its patients. But Intermountain's management was convinced by Lincoln Nadauld, MD, PhD, who joined Intermountain's oncology team in 2013 and spearheaded the creation of Intermountain Precision Genomics (IPG). By 2016, IPG had a cutting-edge genomic sequencing laboratory that provided sequencing services to Intermountain and non-Intermountain physicians, and IPG's team had conducted research indicating that targeted therapies administered through IPG extended patient lifespans but increased overall costs. Now, in mid-2017, IPG is undergoing a major transition as it prepares to outsource the bulk of its genomic testing volume to Navican Genomics, a for-profit, Intermountain-owned spinoff. As Nadauld contemplates the future of IPG, he must evaluate two exciting opportunities, and students are asked to consider where Nadauld should focus IPG's resources: should IPG partner with Intermountain's behavioral health team to conduct joint research on the relationship between genetic markers and antidepressant effectiveness, or should IPG push for the testing of a large biorepository, which will cost $12 million but could lead to the identification of new precision medicine applications?

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