Case Studies in Innovation

Jonathan Feinstein is the author of Creativity in Large-Scale Contexts, winner of the Axiom Business Book Awards 2025 Gold Medal for Innovation/Intelligence.

I’ve spent a long time studying people engaged in creative activities—entrepreneurs, artists, scientists, and many others. That has led me to think about the creative process in a specific way. We sort of get hypnotized by stories about breakthrough moments that change everything. A moment where someone has a vision: “Wouldn’t that be wonderful? I could do that.” For anyone interested in entrepreneurship, a vision is important, but it’s one part of a longer journey.

The framework I developed out of my research is really about helping people understand the creative process and enabling them to develop that vision for what they want to do and guiding principles that will help them turn the vision, which is just an idea, into an innovation that exists in the world.

Attuning to Opportunity

One of the things I think about with creative development, including for entrepreneurs, is the idea that as they’re going along their life and their path, certain events have outsized importance. It could be something that they recognize right away or it might sit for years before its salience is recognized. It might be a development in their field; it could be more personal.

For Nneka Mobisson, her father’s medical history, and her perspective that his death could have been prevented, drew her attention to chronic health conditions. She was thinking, could I do something about this?

For Nick Callegari, many people in his extended family work in construction. It was work he thought he might do himself. Most Yale SOM students would not understand construction, would not be thinking about the field to the degree that Nick was because of his family’s background in that field.

Perception of opportunities is a really important part of creativity. It’s earlier experiences that put you in a position to see significance. Two people might experience the exact same event. For one person it’s nothing special. For the other, because of the unique accumulation of experiences and everything learned to that moment in their life—the event lights them up. They recognize an opportunity, a gap, a problem, a solution. They are poised to make a new connection where the rest of us walk by without noticing anything.

Creativity is connecting things in a new way

Nick has a range of fields and skills he can draw on. The engineering, his time at SpaceX, and family history are super important. The Yale housing class and the Tsai CITY experiences opened him up to understand we could build things in different ways.

But construction 3D printing is a crowded field. I think for Nick the business skills are the key pivot point. They let him see that to stand out, to deliver value that investors will want to back, the capital cost has to come down. The existing gantry-based systems, if you look at them online, are huge and expensive.

For Nneka, her training was obviously very important. She is navigating in a very complex world and drawing on a lot of multidisciplinary skills to see how she could have impact on an ecosystem of systems.

And her father was a big technologist. His idea that technology is going to be the way for Africa to move forward—that’s in her. Her husband works in telecom. They’re talking about how cell phone technology is becoming a very big thing in Africa. That primed her to see technology—cell phones—as a tool for helping people.

Something people misunderstand about creativity is believing it means doing the whole thing from scratch. It’s not about that. It’s about seeing stuff that’s already out there and making new connections. It’s building on top of stuff that’s there.

Nick started by thinking about 3D printing for affordable housing. His economics training had him looking for a different technological platform that wouldn’t need the extremely expensive gantry system. When someone mentioned slipform construction, he understood its potential significance as a way to reduce the capital cost.

With Nneka, lots of people saw the expanded use of cell phones in Africa. She recognized it as an opportunity to use phones to support people with chronic health conditions—a beautiful connection. A way to communicate with ordinary people and provide them with the thing her father did not have.

As mDoc expanded, they developed a version of their app that people can talk to. That’s another great example of making a new connection. Of course people know that some percentage of the population is illiterate. Of course people know AI tools can be conversational. Most people don’t put those two pieces of information together. Being able to make that connection comes from being attuned to an opportunity—a need within a segment of the community they serve.

Guiding Principles

Guiding principles help you find a pathway that you’re comfortable pursuing, what’s going to work for you, what’s consistent with your own belief system.

Entrepreneurs have lots of reasons for why they do what they do. For Nneka, she has a deep commitment to helping low-income people in Africa with chronic health conditions. That’s her guiding principle, and you can see how everything she is doing is trying to make that happen. She is leveraging it to adapt mDoc as it’s moving out into the world.

In Nick’s case, a guiding principle is building affordable housing. He’s always going to be looking for solution pathways that bring the cost down. He said literally by a factor of 10; that is huge. That’s going to rule out a lot of things. That guiding principle means he has to stay focused just on things that can get him there.

Nneka doesn’t shy away from training healthcare providers if it moves mDoc toward the ultimate objective of really helping people. She welcomes adding in-person locations to the app when she understood that you have to do that to get uptake.

Someone being guided by VC investors might have been told, “That’s not what we signed on for, that’s a whole new company. Why not just focus on people who have the newest smartphones and are going to pay the most money for a subscription?” You could easily see investors pushing a company onto that path. But for Nneka the whole point is to reach low-income people. So from her point of view, she sees that all of these different pieces of the company have to be there to actually help the people they’re trying to help.

The guiding principle of wanting to reach a specific population shaped how the pieces fit together into a holistic product, into a company that has several distinct elements.

Creativity versus innovation

One rough definition—which I don’t agree with every day of the year—is that creativity is having an idea—seeing the connection, the opportunity; innovation is actually making it a real thing in the world.

For Nick the innovation part is absolutely huge. He has to develop a technology that not only works, but also has to build houses at a lower cost. Of course, part of innovation is creative problem solving. Any time you start a project, problems come up. His undertaking is still very early stage. But he has got clear guiding principles that let him move to solutions that he’s going to be comfortable with.

Nneka is building this company on principles about helping the community. It’s a tough road. But a lot of highly creative people are stubborn in that regard. They have strong principles, and they find ways to carry them forward. It doesn’t always work, but it creates a lot of diversity and richness in our world, and they try stuff and other people can learn from what they’re doing.

I do think her education is just invaluable. She has clinical training; she understands the on-the-ground realities clinicians face. She has an MBA; she can talk the language of hospital CEOs. She had the years in consulting and understands what it means to work with larger clients, whether it’s corporations or government agencies. And she has that genuine drive to help people and communities. You can’t fake that. I don’t know if she’s aware of how drawing on all those different skills is helping her have some understanding of how to approach these different blockages and hurdles and find a way through. What she’s doing isn’t easy. She’s a great exemplar in a lot of ways.