Temporal Strategies and Firms’ Speedy Responses to COVID‐19
研究了亚洲企业如何运用时间策略（如并行流程、授权下放、用户共同开发）加速应对COVID-19，尤其聚焦医疗行业在药物测试和开发中的快速响应实践。
Countries around the world have suffered widespread disruption from the COVID-19 pandemic. Tens of millions have been infected and economies have suffered severe downturns. Yet the early projections of millions of fatalities in the pandemic’s first months have proved overblown as firms and governments acted swiftly and individuals generally cooperated by altering their behaviours (Ioannidis, 2020). In the developing and newly developed economies of Asia, many firms have responded promptly to the pandemic with temporal strategies in the struggle against COVID-19 (Baker and Koons, 2020; Shi and Prescott, 2012). It is not unexpected that the new normal of the pandemic would have a major impact on firm activities (Ahlstrom et al., 2020; Bradley et al., 2020). Yet it has also created new strategic imperatives for speed. Firms and governments have redoubled their efforts in utilizing temporal strategies (Shi and Prescott, 2012; Tan, 2020) and some re-engineering (Hargadon and Eisenhardt, 2000) to speed their responses. Temporal strategies hold that rather than providing the most value for the lowest cost, organizations should provide value in the lowest practical time (Shi and Prescott, 2011). This shift from a cost orientation to a time orientation, is suited to the pandemic’s demands (Baker and Koons, 2020; Lin et al., 2019). Variables such as speed and downtime have long been part of organizational operations (Hargadon and Eisenhardt, 2000). Recent research has also reinforced the notion that temporal variables also have a role in strategy, such as in strategic alliance research, sequences of mergers and acquisitions, and product development (Bradley et al., 2020; Shi et al., 2012). Many firms were able to make fast adjustments as traditional methodical approaches to developing and delivering products were proving inadequate (Bradley et al., 2020). In particular, many healthcare organizations in Asia have been applying temporal thinking to the pandemic's imperatives (Le Deu, 2020; Shi and Prescott, 2011).[1] Firms in Asia quickly took up central roles in developing novel responses to the pandemic (Le Deu, 2020; Tan, 2020). They innovated with randomized controlled trial (RCT) designs in the testing of new drugs and sped the application of new (and sometimes older) medicines through newer development and testing methods, some of which are being adopted outside of Asia (Baker and Koons, 2020). These approaches have centred on modifications to the randomized controlled trial (RCT), applications of alternative assessment approaches when RCTs are contra-indicated, and the acceleration of drug production and distribution (Kones et al., 2014; Sinopharm, 2020). Prospective RCTs, conducted across multiple hospitals or clinics, are considered as the ‘gold standard’ for drug testing (Bothwell et al., 2016). Yet RCTs can require two years or more years – a long time in the current situation. Thus, accelerated RCTs are underway in parts of Asia (and elsewhere). One way this is done through running the three main phases of the RCT partly together. In April of 2020, China’s Sinopharm obtained early clinical trial approval for the coronavirus inactivated vaccine using a faster RCT protocol (Sinopharm, 2020; Tan, 2020). In running phases 2 and 3 together, the clinical subjects’ conditions after vaccination has been generally good, though must be watched carefully (Wang et al., 2020). India’s Serum Institute is already manufacturing millions of doses of another vaccine in hopes for its approval (Balachandran and Karmali, 2020). Apart from RCTs, other testing designs can provide valid evidence (Kones et al., 2014. Alternative methods can also evaluate new therapies, and may be superior to RCTs in some situations (Kones et al., 2014). These include phenomenological evidence observed from new clinical approaches, retrospective and epidemiologic examinations of off-label medicines (Kones et al., 2014) and industry-government-academic development collaborations (Baker and Koons, 2020; Tan, 2020). With healthcare organizations in Asia experimenting with new approaches to testing therapies, they have been switching from a cost orientation to more of a time orientation in building speed-by-design strategies and structures (Lin et al., 2019; Tan, 2020). Firms have been learning to do more work ‘in parallel’, by resequencing steps so they can be done at about the same time, with problems dealt with ‘on the fly’ as one hospital executive from China put it. In doing so, responsibility is delegated downward (Le Deu, 2020). Another healthcare executive from Taiwan assisting in COVID-19 related clinical trials added that the inevitable safety and quality issues arising in the course of the trials are being managed fairly well given the pressures of the speedier schedule, though this is being helped by the willingness of the patients to accept potential side effects as kinks in the vaccines and therapies are fixed. In terms of organizing for speed, a pharmaceutical executive from China spoke of his firm cutting some 90 per cent of handoffs on therapy development, helping to reduce testing time from 20 weeks to five. This was achievable due to the willingness of management to delegate decisions downward to the health professionals at the bedside. He added that they are granted extra authority with respect to signing off on completed study step or the management of patient side effects. Another pharmaceutical executive from Singapore commented that a number of promising therapies were fast-tracked in the early weeks of the pandemic, whereas their green light approval would have previously required several months or more. He also noted that the usual ‘serial-steps’ conducted in the development and assessment of therapies were now being done ‘in parallel’, expedited by the redesign and resequencing of processes (Shi and Prescott, 2011) as well as cross-sectional partnerships aiding in the development efforts (Baker and Koons, 2020; Doh et al., 2019). The Singapore executive added that this was inspired by the stories of how Henry Kaiser had reduced the time it took to build transport ships in California during the Second World War from months to two weeks, and also how Chinese construction firms had employed some similar methods to construct new hospitals in a matter of days. Chinese and Indian pharmaceutical firms have also employed a number of alternative approaches to assess several therapies for managing COVID-19 symptoms utilizing a time orientation to speed the development and assessment processes (Balachandran and Karmali, 2020; Le Deu, 2020; Tan, 2020). Utilizing such observational and retrospective data are broadly similar to how firms in many industries conduct less conventional market research by observing users utilizing a given product in an unexpected application and then trying to unravel their thinking about the product. Having a time orientation can shift the organization’s strategies toward more speed and flexible methods with respect to many aspects of product development, testing, and evaluation (Lin et al., 2019). Finally, a time orientation can also include customer co-development whereby users are involved in downstream assessment (Dunbar and Ahlstrom, 1995). This converges with work on innovation, which examines how users actually become codevelopers and decision-making is delegated as far downward to the field as possible. Firms are learning to design for speed in leveraging both line employees’ and users’ knowledge (and willingness to help) as part of product development, even with new healthcare products and their testing trials (DeMonaco et al., 2017). The imperatives of the pandemic have compelled healthcare professionals to further stress innovation at the bedside in addressing the many unknowns of COVID-19. The healthcare executives interviewed further observed that this bedside innovation has dovetailed well with the patients’ understanding of the potential side effects of the new, rapidly tested therapies and their willingness to assist pharmaceutical firms, hospitals, and testing agencies in their assessment and improvement of the new therapies. Customer co-development, long a common practice in the information technology industry, has been increasingly utilized in the healthcare field recently, and is emerging as another temporal strategy in speeding up the development of tools and therapies to defeat the pandemic (DeMonaco et al., 2017; Lin et al., 2019; Tan, 2020). The COVID-19 pandemic has created pressure for the refinement and implementation of temporal strategies to speed helpful therapies through testing and safely on to market. Facing this speed challenge, healthcare firms in Asia have responded with various alternative strategies to accelerate therapy development, testing, and distribution. They have also delegated decisions downward and have increasingly included users in the therapy development process while utilizing faster (and alternative) testing approaches. Firms outside of healthcare have also been learning (or perhaps relearning) from the examples of the innovative accelerated development and testing methods that healthcare firms are employing to treat COVID-19. An important lesson generally emerging from the pandemic is the importance for managers to acquire a time orientation (Lin et al., 2019) such that speed-by-design capabilities can be built into the firm’s strategic thinking. And that in turn can help lead to the wider implementation of temporal thinking across a firm’s activities and operations.