a_p's Profile

Thanks for a great read about the Partner’s healthcare system! It seems that digitization is a huge opportunity and cost for the healthcare system. Based on the solutions you posed, my argument would be three-fold.

1. There has been an increased investment in healthcare technology, however, the investment is not outcomes based. Often times, healthcare systems implement a new technology because a vendor convinced them that it would be great. There is a misalignment of incentives here to begin with. HITECH was a step towards assessing whether the capital expenditure was truly necessary. I spent a few months conducting reviews for these expenditures on behalf of the Department of Health in MN and observed that hospital rationale for justifying the expenditure was hardly adequate. Often times, it was an accountant who filled out the form to be submitted to the state because someone had to do it. The information on the form rarely ever indicated that “This expenditure for our healthcare system in machine X will reduce patient readmissions by Y%.” Therefore, I believe that there needs to be a healthy level of skepticism around digitization and technology investments in healthcare.

2. I echo the above point around implementation as a huge concern. The people using EMRs or other new technologies are often people who have done their job in a particular way for long time. As such, change management around option is always a long process. Even today, there are doctors who do manual dictations of patient notes despite the existence of technology that would theoretically make their jobs easier. There should be a strategy around which stakeholders are approached for buy in and in what order to ensure a more smooth implementation.

3. The proliferation of technology in medicine has been great for information sharing. However, my understanding is that with so many different systems, often times systems don’t speak to each other which is to the detriment of patient care. An EMR implemented through Epic v. Cerner may be slow to connect to the other. I recently read a story about a patient whose care was compromised because when he made it to one department of the hospital, the EMR from his primary care physician’s clinic had not updated in the system. As a result, the doctor/nurses did not realize that there was missing information and built a plan of care rooted in inaccurate/insufficient information and the patient had to go to the E.D. These situations have a human impact on the families of these people.

Really interesting read – thank you! I agree that human capital is of huge concern, especially for companies that employ immigrant groups (Uber, Apple, others mentioned above). However, I do think our political contexts makes me questions whether this is a long-term issue or short-term issue. Isolationist policies, immigration, and global perception of the United States are all contingent on the political climate and the administration in house (as Starry also indicated). In my mind, this does not and should not diminish the importance of immigrants losing their jobs today.

Arguably, there might even be more dramatic implications for Facebook, not only pertaining to the labor force. Isolationist policies reduce the impact of the network effect – Facebook’s core competency. We see this in countries like China where the government has placed restrictions around words or things that can be accessed online. If our isolationist policies endure and become even more drastic, as Facebook, I would be worried about multiple components of my business in addition to talent.

From a solutions perspective, I think policymaking is generally easier said than done. While it is important to partner with regulatory stakeholders, often times, incentives are misaligned (as we have observed with ride-sharing and local governments). I think it would be more effective to identify solutions within one’s own business model. For instance, is it feasible for Facebook to change it’s criteria for who it is willing to become a sponsor for? That would allow immigrants to continue accessing opportunities at the firm.

By the end of the read, I was craving a pint of half baked. This was really interesting – I did not realize how much of an issue cocoa production was in the supply chain. I agree that the company needs to do a lot more. Most of the solutions that it has worked towards or that have been posed accommodate the impact of climate change v. reduce the impact of climate change. The one proposal that will likely do the latter is to diversify the product portfolio. However, you hit the nail on the head in indicating that there might be other ingredients that will face the same challenge. Another one that is probably less realistic is finding a cocoa substitute?

To address the question you posed – no, there is no point at which such initiatives should not be pursued. Increased ice cream demand will probably be offset by the decline in population because of the adverse effects of a 2 degree increase in global temperature. Moreover, there is an ethical question rooted in this. Should you do the right thing, even as a corporation? I say yes, especially given the existing focus of Ben and Jerry’s around advocacy. I personally am skeptical of all CSR initiatives because they are often a PR stunt. By not engaging in any, it would only reinforce my skepticism that the initiatives were not motivated by appropriate intentions to begin with.

Great read around another positive story in the apparel industry. I am personally excited to see corporations like Nike and Patagonia take initiative around climate change. However, I think a health level of skepticism regarding CSR is still important. I don’t believe that all Nike consumer’s are aware and understand the value of Nike’s sustainability initiatives. Sure, it may be a source of competitive advantage for Nike (as we saw with IKEA), but if one is truly invested in the issue, the value of the work the firm is doing should be communicated sufficiently to those who are contributing tot he financial success of the firm.

While the figures around the apparel industry’s contribution to GHGs are astounding, I am curious to know the breakdown either by company or sub-category. I wondered about this will writing the Patagonia piece as well. Nike reported revenues of $32B in June 2017, whereas Patagonia stands at a mere $750M. How much is each contributing to that 10% in emissions? Moreover, with such a large market share, I see Nike as a corporation in a unique place to influence other firms in the industry. But, it will require a partnership with other stakeholders (government, non-profits, etc.) to move the needle around the issue. For instance, Patagonia invested $1M in a campaign to encourage more environmentally conscious individuals to vote. There is so much power amongst these organizations and I expect them to do more in actually leading policy change.

This is super fascinating! There are great benefits to the digitization of the election supply chain, specifically the voter registration component. It has the potential to increase accessibility to elections and likely result in higher civic participation. At the state, when we digitized service delivery, more individuals from low-income areas within Massachusetts were able to complete transactions with the government.

However, I think it’s important to underscore the issue of security. Information is doubling faster than ever. Cyber terrorism is an exploding problem and hackers are responsive to their environment. As such, they have become more sophisticated. We have observed this with the evolution of cyber attacks from a few years ago (Target) to today (OPM, Anthem, etc.) The way blockchain works, there is still potential for false data records (as you mentioned).

Another concern I have around this is the agency problem. Matt alluded to one component of it – does the government have resources and capability to even implement something like this? But, before even thinking about that, my worry is who will own the data? Especially if government partners with other stakeholders for the implementation, there will be a broader governance issue around data ownership.

Really interesting read – thanks for writing! While I agree that this is something business schools are grappling with, I do think our political contexts makes me questions whether this is a long-term issue or short-term issue. Isolationist policies, immigration, and global perception of the United States are all contingent on the political climate and the administration in house. In fact, Pew research reported that immediately after the election, favorability about the U.S. fell amongst most countries except Russia. Given our political system, it is easy to see that the gravity of the issue may increases or decrease every 4 years. As a result, we see international engagement as a component of the HBS education, but it seems that the leadership prioritizes it after other threats in the education sphere (i.e. online education, interconnectivity with other Harvard campuses, etc.) Moreover, Axios indicated that the impact of these policies is heavily tiered towards the mid-tier and lower-tier business school programs. It would be important to dissect the data by the level of program prior to drawing the causality relationship.

Broadly, I agree that HBS can do much more with regards to exposure to international contexts. While FGI is a great addition to the curriculum, competitors (University of Michigan – Ross School of Business among others) actually offer a similar opportunity for a complete semester. It is difficult to have a truly immersive experience that can provide one with adequate understanding of what it’s like to operate in a business capacity in another country only through a week long experience. There is an opportunity to create a much more powerful experience through FGI. Additionally, there are other ways to incentivize students to work abroad. Another solution that comes to mind is cases – how many cases have protagonists in other countries? I can name a few LEAD cases where we were reminded to think about the cultural context of the country, but I would imagine that there is opportunity for more.