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Twine Health SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

Case Study SWOT Analysis Solution

Case Study Description of Twine Health


In late 2014, Dr. John Moore (CEO), Frank Moss (chairman), and Scott Gilroy (CTO) of Twine Health (Twine) had to resolve several challenges that threatened to restrict the widespread dissemination of its sole product, Twine. Twine was a cloud-based platform that enabled patients to create and manage chronic disease treatment plans in conjunction with their primary care providers and specialized coaches. Twine had already enjoyed impressive successes in early clinical trials and among early adopters. The issues Twine's leadership team had to address included identifying clinical care providers willing to pay for Twine, ensuring adoption and effective use by both patients and health care providers, adding capabilities to support the management of additional chronic diseases, and seamlessly integrating Twine with a client organization's electronic medical record (EMR) system and information technology (IT) infrastructure. The need to solve these problems had become more pressing since Twine was named a finalist in the Health Acceleration Challenge (HAC) sponsored by Harvard Business School and Harvard Medical School.

Authors :: Robert S. Huckman, Ariel D. Stern, Matthew Preble

Topics :: Technology & Operations

Tags :: IT, Strategy, SWOT Analysis, SWOT Matrix, TOWS, Weighted SWOT Analysis

Swot Analysis of "Twine Health" written by Robert S. Huckman, Ariel D. Stern, Matthew Preble includes – strengths weakness that are internal strategic factors of the organization, and opportunities and threats that Twine Providers facing as an external strategic factors. Some of the topics covered in Twine Health case study are - Strategic Management Strategies, IT, Strategy and Technology & Operations.


Some of the macro environment factors that can be used to understand the Twine Health casestudy better are - – increasing government debt because of Covid-19 spendings, increasing transportation and logistics costs, talent flight as more people leaving formal jobs, cloud computing is disrupting traditional business models, increasing energy prices, wage bills are increasing, supply chains are disrupted by pandemic , central banks are concerned over increasing inflation, there is backlash against globalization, etc



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Introduction to SWOT Analysis of Twine Health


SWOT stands for an organization’s Strengths, Weaknesses, Opportunities and Threats . At Oak Spring University , we believe that protagonist in Twine Health case study can use SWOT analysis as a strategic management tool to assess the current internal strengths and weaknesses of the Twine Providers, and to figure out the opportunities and threats in the macro environment – technological, environmental, political, economic, social, demographic, etc in which Twine Providers operates in.

According to Harvard Business Review, 75% of the managers use SWOT analysis for various purposes such as – evaluating current scenario, strategic planning, new venture feasibility, personal growth goals, new market entry, Go To market strategies, portfolio management and strategic trade-off assessment, organizational restructuring, etc.




SWOT Objectives / Importance of SWOT Analysis and SWOT Matrix


SWOT analysis of Twine Health can be done for the following purposes –
1. Strategic planning using facts provided in Twine Health case study
2. Improving business portfolio management of Twine Providers
3. Assessing feasibility of the new initiative in Technology & Operations field.
4. Making a Technology & Operations topic specific business decision
5. Set goals for the organization
6. Organizational restructuring of Twine Providers




Strengths Twine Health | Internal Strategic Factors
What are Strengths in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The strengths of Twine Providers in Twine Health Harvard Business Review case study are -

Low bargaining power of suppliers

– Suppliers of Twine Providers in the sector have low bargaining power. Twine Health has further diversified its suppliers portfolio by building a robust supply chain across various countries. This helps Twine Providers to manage not only supply disruptions but also source products at highly competitive prices.

Superior customer experience

– The customer experience strategy of Twine Providers in the segment is based on four key concepts – personalization, simplification of complex needs, prompt response, and continuous engagement.

Effective Research and Development (R&D)

– Twine Providers has innovation driven culture where significant part of the revenues are spent on the research and development activities. This has resulted in, as mentioned in case study Twine Health - staying ahead in the industry in terms of – new product launches, superior customer experience, highly competitive pricing strategies, and great returns to the shareholders.

Cross disciplinary teams

– Horizontal connected teams at the Twine Providers are driving operational speed, building greater agility, and keeping the organization nimble to compete with new competitors. It helps are organization to ideate new ideas, and execute them swiftly in the marketplace.

High brand equity

– Twine Providers has strong brand awareness and brand recognition among both - the exiting customers and potential new customers. Strong brand equity has enabled Twine Providers to keep acquiring new customers and building profitable relationship with both the new and loyal customers.

Sustainable margins compare to other players in Technology & Operations industry

– Twine Health firm has clearly differentiated products in the market place. This has enabled Twine Providers to fetch slight price premium compare to the competitors in the Technology & Operations industry. The sustainable margins have also helped Twine Providers to invest into research and development (R&D) and innovation.

Strong track record of project management

– Twine Providers is known for sticking to its project targets. This enables the firm to manage – time, project costs, and have sustainable margins on the projects.

Digital Transformation in Technology & Operations segment

- digital transformation varies from industry to industry. For Twine Providers digital transformation journey comprises differing goals based on market maturity, customer technology acceptance, and organizational culture. Twine Providers has successfully integrated the four key components of digital transformation – digital integration in processes, digital integration in marketing and customer relationship management, digital integration into the value chain, and using technology to explore new products and market opportunities.

Training and development

– Twine Providers has one of the best training and development program in the industry. The effectiveness of the training programs can be measured in Twine Health Harvard Business Review case study by analyzing – employees retention, in-house promotion, loyalty, new venture initiation, lack of conflict, and high level of both employees and customer engagement.

High switching costs

– The high switching costs that Twine Providers has built up over years in its products and services combo offer has resulted in high retention of customers, lower marketing costs, and greater ability of the firm to focus on its customers.

Highly skilled collaborators

– Twine Providers has highly efficient outsourcing and offshoring strategy. It has resulted in greater operational flexibility and bringing down the costs in highly price sensitive segment. Secondly the value chain collaborators of the firm in Twine Health HBR case study have helped the firm to develop new products and bring them quickly to the marketplace.

Learning organization

- Twine Providers is a learning organization. It has inculcated three key characters of learning organization in its processes and operations – exploration, creativity, and expansiveness. The work place at Twine Providers is open place that encourages instructiveness, ideation, open minded discussions, and creativity. Employees and leaders in Twine Health Harvard Business Review case study emphasize – knowledge, initiative, and innovation.






Weaknesses Twine Health | Internal Strategic Factors
What are Weaknesses in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The weaknesses of Twine Health are -

High dependence on existing supply chain

– The disruption in the global supply chains because of the Covid-19 pandemic and blockage of the Suez Canal illustrated the fragile nature of Twine Providers supply chain. Even after few cautionary changes mentioned in the HBR case study - Twine Health, it is still heavily dependent upon the existing supply chain. The existing supply chain though brings in cost efficiencies but it has left Twine Providers vulnerable to further global disruptions in South East Asia.

Products dominated business model

– Even though Twine Providers has some of the most successful products in the industry, this business model has made each new product launch extremely critical for continuous financial growth of the organization. firm in the HBR case study - Twine Health should strive to include more intangible value offerings along with its core products and services.

Need for greater diversity

– Twine Providers has taken concrete steps on diversity, equity, and inclusion. But the efforts so far has resulted in limited success. It needs to expand the recruitment and selection process to hire more people from the minorities and underprivileged background.

High bargaining power of channel partners

– Because of the regulatory requirements, Robert S. Huckman, Ariel D. Stern, Matthew Preble suggests that, Twine Providers is facing high bargaining power of the channel partners. So far it has not able to streamline the operations to reduce the bargaining power of the value chain partners in the industry.

Compensation and incentives

– The revenue per employee as mentioned in the HBR case study Twine Health, is just above the industry average. Twine Providers needs to redesign the compensation structure and incentives to increase the revenue per employees. Some of the steps that it can take are – hiring more specialists on project basis, etc.

Slow decision making process

– As mentioned earlier in the report, Twine Providers has a very deliberative decision making approach. This approach has resulted in prudent decisions, but it has also resulted in missing opportunities in the industry over the last five years. Twine Providers even though has strong showing on digital transformation primary two stages, it has struggled to capitalize the power of digital transformation in marketing efforts and new venture efforts.

High operating costs

– Compare to the competitors, firm in the HBR case study Twine Health has high operating costs in the. This can be harder to sustain given the new emerging competition from nimble players who are using technology to attract Twine Providers 's lucrative customers.

Skills based hiring

– The stress on hiring functional specialists at Twine Providers has created an environment where the organization is dominated by functional specialists rather than management generalist. This has resulted into product oriented approach rather than marketing oriented approach or consumers oriented approach.

Low market penetration in new markets

– Outside its home market of Twine Providers, firm in the HBR case study Twine Health needs to spend more promotional, marketing, and advertising efforts to penetrate international markets.

No frontier risks strategy

– After analyzing the HBR case study Twine Health, it seems that company is thinking about the frontier risks that can impact Technology & Operations strategy. But it has very little resources allocation to manage the risks emerging from events such as natural disasters, climate change, melting of permafrost, tacking the rise of artificial intelligence, opportunities and threats emerging from commercialization of space etc.

Lack of clear differentiation of Twine Providers products

– To increase the profitability and margins on the products, Twine Providers needs to provide more differentiated products than what it is currently offering in the marketplace.




Opportunities Twine Health | External Strategic Factors
What are Opportunities in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The opportunities highlighted in the Harvard Business Review case study Twine Health are -

Lowering marketing communication costs

– 5G expansion will open new opportunities for Twine Providers in the field of marketing communication. It will bring down the cost of doing business, provide technology platform to build new products in the Technology & Operations segment, and it will provide faster access to the consumers.

Better consumer reach

– The expansion of the 5G network will help Twine Providers to increase its market reach. Twine Providers will be able to reach out to new customers. Secondly 5G will also provide technology framework to build new tools and products that can help more immersive consumer experience and faster consumer journey.

Use of Bitcoin and other crypto currencies for transactions

– The popularity of Bitcoin and other crypto currencies as asset class and medium of transaction has opened new opportunities for Twine Providers in the consumer business. Now Twine Providers can target international markets with far fewer capital restrictions requirements than the existing system.

Harnessing reconfiguration of the global supply chains

– As the trade war between US and China heats up in the coming years, Twine Providers can build a diversified supply chain model across various countries in - South East Asia, India, and other parts of the world. This reconfiguration of global supply chain can help, as suggested in case study, Twine Health, to buy more products closer to the markets, and it can leverage its size and influence to get better deal from the local markets.

Developing new processes and practices

– Twine Providers can develop new processes and procedures in Technology & Operations industry using technology such as automation using artificial intelligence, real time transportation and products tracking, 3D modeling for concept development and new products pilot testing etc.

Changes in consumer behavior post Covid-19

– Consumer behavior has changed in the Technology & Operations industry because of Covid-19 restrictions. Some of this behavior will stay once things get back to normal. Twine Providers can take advantage of these changes in consumer behavior to build a far more efficient business model. For example consumer regular ordering of products can reduce both last mile delivery costs and market penetration costs. Twine Providers can further use this consumer data to build better customer loyalty, provide better products and service collection, and improve the value proposition in inflationary times.

Buying journey improvements

– Twine Providers can improve the customer journey of consumers in the industry by using analytics and artificial intelligence. Twine Health suggest that firm can provide automated chats to help consumers solve their own problems, provide online suggestions to get maximum out of the products and services, and help consumers to build a community where they can interact with each other to develop new features and uses.

Manufacturing automation

– Twine Providers can use the latest technology developments to improve its manufacturing and designing process in Technology & Operations segment. It can use CAD and 3D printing to build a quick prototype and pilot testing products. It can leverage automation using machine learning and artificial intelligence to do faster production at lowers costs, and it can leverage the growth in satellite and tracking technologies to improve inventory management, transportation, and shipping.

Reforming the budgeting process

- By establishing new metrics that will be used to evaluate both existing and potential projects Twine Providers can not only reduce the costs of the project but also help it in integrating the projects with other processes within the organization.

Learning at scale

– Online learning technologies has now opened space for Twine Providers to conduct training and development for its employees across the world. This will result in not only reducing the cost of training but also help employees in different part of the world to integrate with the headquarter work culture, ethos, and standards.

Reconfiguring business model

– The expansion of digital payment system, the bringing down of international transactions costs using Bitcoin and other blockchain based currencies, etc can help Twine Providers to reconfigure its entire business model. For example it can used blockchain based technologies to reduce piracy of its products in the big markets such as China. Secondly it can use the popularity of e-commerce in various developing markets to build a Direct to Customer business model rather than the current Channel Heavy distribution network.

Building a culture of innovation

– managers at Twine Providers can make experimentation a productive activity and build a culture of innovation using approaches such as – mining transaction data, A/B testing of websites and selling platforms, engaging potential customers over various needs, and building on small ideas in the Technology & Operations segment.

Remote work and new talent hiring opportunities

– The widespread usage of remote working technologies during Covid-19 has opened opportunities for Twine Providers to expand its talent hiring zone. According to McKinsey Global Institute, 20% of the high end workforce in fields such as finance, information technology, can continously work from remote local post Covid-19. This presents a really great opportunity for Twine Providers to hire the very best people irrespective of their geographical location.




Threats Twine Health External Strategic Factors
What are Threats in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The threats mentioned in the HBR case study Twine Health are -

Consumer confidence and its impact on Twine Providers demand

– There is a high probability of declining consumer confidence, given – high inflammation rate, rise of gig economy, lower job stability, increasing cost of living, higher interest rates, and aging demography. All the factors contribute to people saving higher rate of their income, resulting in lower consumer demand in the industry and other sectors.

Increasing international competition and downward pressure on margins

– Apart from technology driven competitive advantage dilution, Twine Providers can face downward pressure on margins from increasing competition from international players. The international players have stable revenue in their home market and can use those resources to penetrate prominent markets illustrated in HBR case study Twine Health .

Barriers of entry lowering

– As technology is more democratized, the barriers to entry in the industry are lowering. It can presents Twine Providers with greater competitive threats in the near to medium future. Secondly it will also put downward pressure on pricing throughout the sector.

Aging population

– As the populations of most advanced economies are aging, it will lead to high social security costs, higher savings among population, and lower demand for goods and services in the economy. The household savings in US, France, UK, Germany, and Japan are growing faster than predicted because of uncertainty caused by pandemic.

Shortening product life cycle

– it is one of the major threat that Twine Providers is facing in Technology & Operations sector. It can lead to higher research and development costs, higher marketing expenses, lower customer loyalty, etc.

High dependence on third party suppliers

– Twine Providers high dependence on third party suppliers can disrupt its processes and delivery mechanism. For example -the current troubles of car makers because of chip shortage is because the chip companies started producing chips for electronic companies rather than car manufacturers.

Learning curve for new practices

– As the technology based on artificial intelligence and machine learning platform is getting complex, as highlighted in case study Twine Health, Twine Providers may face longer learning curve for training and development of existing employees. This can open space for more nimble competitors in the field of Technology & Operations .

Capital market disruption

– During the Covid-19, Dow Jones has touched record high. The valuations of a number of companies are way beyond their existing business model potential. This can lead to capital market correction which can put a number of suppliers, collaborators, value chain partners in great financial difficulty. It will directly impact the business of Twine Providers.

Regulatory challenges

– Twine Providers needs to prepare for regulatory challenges as consumer protection groups and other pressure groups are vigorously advocating for more regulations on big business - to reduce inequality, to create a level playing field, to product data privacy and consumer privacy, to reduce the influence of big money on democratic institutions, etc. This can lead to significant changes in the Technology & Operations industry regulations.

Stagnating economy with rate increase

– Twine Providers can face lack of demand in the market place because of Fed actions to reduce inflation. This can lead to sluggish growth in the economy, lower demands, lower investments, higher borrowing costs, and consolidation in the field.

Trade war between China and United States

– The trade war between two of the biggest economies can hugely impact the opportunities for Twine Providers in the Technology & Operations industry. The Technology & Operations industry is already at various protected from local competition in China, with the rise of trade war the protection levels may go up. This presents a clear threat of current business model in Chinese market.

Environmental challenges

– Twine Providers needs to have a robust strategy against the disruptions arising from climate change and energy requirements. EU has identified it as key priority area and spending 30% of its 880 billion Euros European post Covid-19 recovery funds on green technology. Twine Providers can take advantage of this fund but it will also bring new competitors in the Technology & Operations industry.

New competition

– After the dotcom bust of 2001, financial crisis of 2008-09, the business formation in US economy had declined. But in 2020 alone, there are more than 1.5 million new business applications in United States. This can lead to greater competition for Twine Providers in the Technology & Operations sector and impact the bottomline of the organization.




Weighted SWOT Analysis of Twine Health Template, Example


Not all factors mentioned under the Strengths, Weakness, Opportunities, and Threats quadrants in the SWOT Analysis are equal. Managers in the HBR case study Twine Health needs to zero down on the relative importance of each factor mentioned in the Strengths, Weakness, Opportunities, and Threats quadrants. We can provide the relative importance to each factor by assigning relative weights. Weighted SWOT analysis process is a three stage process –

First stage for doing weighted SWOT analysis of the case study Twine Health is to rank the strengths and weaknesses of the organization. This will help you to assess the most important strengths and weaknesses of the firm and which one of the strengths and weaknesses mentioned in the initial lists are marginal and can be left out.

Second stage for conducting weighted SWOT analysis of the Harvard case study Twine Health is to give probabilities to the external strategic factors thus better understanding the opportunities and threats arising out of macro environment changes and developments.

Third stage of constructing weighted SWOT analysis of Twine Health is to provide strategic recommendations includes – joining likelihood of external strategic factors such as opportunities and threats to the internal strategic factors – strengths and weaknesses. You should start with external factors as they will provide the direction of the overall industry. Secondly by joining probabilities with internal strategic factors can help the company not only strategic fit but also the most probably strategic trade-off that Twine Providers needs to make to build a sustainable competitive advantage.



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