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Harvard Case - National University Cancer Institute Singapore: Pioneering an Innovative Healthcare Model

"National University Cancer Institute Singapore: Pioneering an Innovative Healthcare Model" Harvard business case study is written by Daniel Z. Mack, Katharina Lange, CW Chan, Adina Wong. It deals with the challenges in the field of Entrepreneurship. The case study is 10 page(s) long and it was first published on : Sep 11, 2020

At Fern Fort University, we recommend that the National University Cancer Institute Singapore (NCIS) continue to pursue its innovative healthcare model, focusing on three key strategic pillars: patient-centric care, research and innovation, and financial sustainability. This approach will allow NCIS to maintain its position as a leading cancer center in Asia and globally, while ensuring long-term financial viability.

2. Background

The case study focuses on the NCIS, a leading cancer center in Singapore, facing challenges in balancing its commitment to providing high-quality patient care with the need for financial sustainability. NCIS is a public-private partnership, with the National University of Singapore (NUS) as the majority shareholder and a significant minority stake held by private investors. This unique structure presents both opportunities and challenges for NCIS, requiring careful navigation of financial and strategic considerations.

The main protagonists in the case are:

  • Professor Tan, the Director of NCIS, responsible for leading the institute?s strategic direction and ensuring financial stability.
  • The Board of Directors, responsible for overseeing the institute?s operations and financial performance.
  • The private investors, who have a vested interest in the financial success of NCIS.

3. Analysis of the Case Study

We will analyze the case using a framework that combines strategic, financial, and operational considerations:

Strategic Analysis:

  • Competitive Advantage: NCIS?s competitive advantage lies in its unique public-private partnership model, allowing it to leverage the resources and expertise of both the public and private sectors. This enables NCIS to attract top talent, invest in cutting-edge technology, and offer comprehensive patient care.
  • Growth Strategy: The case highlights NCIS?s ambition to expand its services and reach, particularly in the international market. This can be achieved through strategic partnerships with hospitals and research institutions in the region, leveraging its expertise and technology to offer specialized cancer care services.
  • Mission and Vision: NCIS?s mission is to provide world-class cancer care and research, while its vision is to be a leading regional cancer center. This aligns with the growing demand for specialized cancer care in Asia and the increasing emphasis on research and innovation in the healthcare sector.

Financial Analysis:

  • Financial Sustainability: The case highlights the financial challenges faced by NCIS due to rising costs and increasing competition. To address this, NCIS needs to develop a robust financial strategy that balances investment in infrastructure and technology with the need to generate revenue.
  • Capital Structure: NCIS?s unique public-private partnership model presents a complex capital structure. The board needs to carefully consider the optimal mix of debt and equity financing to ensure financial stability and maximize shareholder value.
  • Cost Management: NCIS needs to implement cost-effective operational strategies, including activity-based costing to identify and manage costs effectively. This can be achieved through process optimization, technology adoption, and strategic partnerships.

Operational Analysis:

  • Patient-Centric Care: NCIS needs to prioritize patient-centric care by investing in technology and infrastructure to enhance patient experience and improve outcomes. This includes implementing technology and analytics to personalize treatment plans and improve communication with patients.
  • Research and Innovation: NCIS needs to continue investing in research and innovation to maintain its leadership position in the field. This can be achieved through strategic partnerships with universities and research institutions, attracting top talent, and fostering a culture of innovation.
  • Operations Strategy: NCIS needs to streamline its operations to improve efficiency and effectiveness. This includes optimizing manufacturing processes for drug development and production, and implementing a robust risk management framework to mitigate operational risks.

4. Recommendations

To address the challenges and opportunities outlined above, we recommend the following:

  1. Develop a comprehensive financial strategy: This strategy should focus on generating revenue through diverse sources, including:
    • Expanding services: Offering specialized cancer care services to international patients.
    • Developing partnerships: Collaborating with private healthcare providers to offer joint ventures and shared services.
    • Investing in research and development: Licensing technologies and intellectual property to pharmaceutical companies.
    • Optimizing operations: Implementing activity-based costing to identify and manage costs effectively.
  2. Refine the capital structure: The board should carefully consider the optimal mix of debt and equity financing. This may include exploring private equity investments or an IPO to raise capital and support growth.
  3. Invest in technology and infrastructure: This includes implementing technology and analytics to personalize treatment plans, improve patient experience, and enhance operational efficiency.
  4. Strengthen research and innovation: NCIS should continue to invest in research and innovation, focusing on developing new therapies and technologies. This can be achieved through strategic partnerships with universities and research institutions, attracting top talent, and fostering a culture of innovation.
  5. Develop a robust risk management framework: This framework should address financial, operational, and reputational risks, including hedging against currency fluctuations and implementing robust cybersecurity measures.

5. Basis of Recommendations

These recommendations are based on the following considerations:

  • Core competencies and consistency with mission: The recommendations align with NCIS?s core competencies in cancer care, research, and innovation, and are consistent with its mission to provide world-class cancer care.
  • External customers and internal clients: The recommendations prioritize patient-centric care and address the needs of external customers, while also considering the needs of internal clients, such as doctors, nurses, and researchers.
  • Competitors: The recommendations position NCIS to compete effectively in the increasingly competitive healthcare landscape by leveraging its unique public-private partnership model and investing in technology and innovation.
  • Attractiveness ? quantitative measures: The recommendations are expected to generate positive returns on investment (ROI), improve financial sustainability, and enhance NCIS?s competitive position.

6. Conclusion

By implementing these recommendations, NCIS can continue to pioneer an innovative healthcare model, maintaining its position as a leading cancer center in Asia and globally. This will require a strong commitment to patient-centric care, research and innovation, and financial sustainability.

7. Discussion

Other alternatives not selected include:

  • Privatization: This option could provide NCIS with greater financial flexibility but could also compromise its public service mission.
  • Merging with another healthcare institution: This could provide economies of scale but could also lead to cultural clashes and loss of identity.

The key risks and assumptions of our recommendations include:

  • Financial risk: The success of the financial strategy depends on the ability of NCIS to generate revenue from new sources.
  • Operational risk: Implementing new technologies and processes can be disruptive and require careful planning and execution.
  • Competitive risk: The healthcare landscape is constantly evolving, and NCIS needs to adapt its strategies to remain competitive.

8. Next Steps

To implement the recommendations, NCIS should take the following steps:

  • Develop a detailed implementation plan: This plan should outline specific actions, timelines, and resources required.
  • Engage stakeholders: The board, management, and staff should be involved in the implementation process to ensure buy-in and support.
  • Monitor progress: NCIS should regularly monitor the progress of implementation and make adjustments as needed.

By taking these steps, NCIS can successfully navigate the challenges and opportunities ahead, ensuring its continued success as a leading cancer center in Asia and globally.

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Case Description

Associate Professor Chng Wee Joo, Director of the National University Cancer Institute Singapore (NCIS), started to move the treatment of cancer patients out of the hospital to the community and patients' homes. This innovative business model was implemented to manage the lack of space in the hospital and to reduce costs for patients. Chng also believed that an environment of strong family and community support would strengthen the morale of patients and result in fewer hospital readmissions. While Singapore had a reliable and balanced healthcare system, it faced higher healthcare expenses due to prolonged life expectancies and an ageing population just like other industrialised countries. Sedentary lifestyles, traditional diet habits and an increasingly polluted environment had led to an increase in cancer cases and cancer becoming the leading cause of death. The rising demand for cancer treatment had pushed the existing infrastructure and resources in hospitals to its limits and the shortage of hospital beds had resulted in a strategy to keep patients "out of the hospital" as long as possible. Operating under the National University Health System (NUHS) healthcare cluster, NCIS was a specialty centre designed to gain synergy by addressing all aspects of care related to the disease. With the clustering of public healthcare services in Singapore in 2017, NCIS now had the opportunity to incorporate primary care and end of life considerations in the care journey of a cancer patient. With his specialty in myeloma, a type of blood cancer, Chng led his team to focus on shifting healthcare out of the hospital and into patients' communities and home and started experimenting to deliver treatment outside of the hospital. Chng succeeded in treating myeloma in the outpatient clinic and subsequently in the patient's home. After the initial success, his team began working on similar projects in other type of cancers.

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