Sweden, and Stockholm Science City Foundation specifically, represented the last leg of a research effort understanding innovations in health care delivery and research in unique global contexts. As an Eisenhower Fellow for 2015, I was granted an opportunity to study health innovations in very different environments - I spent the spring in Kenya, studying care in the urban slums and in the peri-urban communities, understanding effective private efforts to bring basic primary and maternal care to a population that has very few health resources. Sweden, on the other hand, represented an opportunity to understand how an intentionally designed, and demonstrably effective, system is structured and managed.
In Sweden, I had an opportunity to study policy, governance, strategy, research and local variation in care delivery in visits to Stockholm, Gothenburg, Uppsala, Umea, and the tiny town of Storuman (where I studied rural medicine). I spoke with members of the Swedish parliament, governors of counties, county council members, hospital administrators, physicians, academicians, and researchers, all who have a role in the remarkably adaptive system that defines Sweden’s approach to societal health. To be fair, Sweden faces many challenges, similar to those of other developed economies around the world, but the structure of Sweden’s approach serves as a lesson for many.
Why the interest in Swedish healthcare and life sciences? I recently founded the Design Institute for Health at the University of Texas at Austin in the United States. What makes Austin interesting is a unique set of circumstances that give rise to the best opportunity in decades to build a model for what a future healthcare system in the United States could be. New funding models to change the traditional financial incentives, a new medical school to train physicians differently, new hospitals and clinical spaces to establish new care environments and protocols, one of the largest public research universities in the country, and a deeply engaged community that wants to see change happen all mean that we have the constituent elements to really rethink everything about how a modern healthcare system behaves. The Design Institute for Health brings a new creative design-based methodology to solving complex systemic problems. (See http://sites.utexas.edu/ihopedellmed/2015/05/27/what-does-design-have-t… for further explanation). In studying Sweden, I’m hoping to understand different approaches to building a more coherent system, and applying those learnings in the work we do in Texas.
Visiting Stockholm Science City Foundation was an opportunity to see how a coordinated effort, led by a small but influential foundation, can create innovation that sustains the aligned goals a much larger cohort of organizations and local governments. Austin, in relation, is at the start of a similar effort. The city and local government, along with several schools in the university, need to generate economic and entrepreneurial investment in research and development to really see the promise of the new health system come to fruition.
A few notable takeaways:
1. You need to declare an endpoint. Vision 2025 serves that purpose for Stockholm Life Solna-Stockholm. It would disingenuous to believe that every aspect described in Vision 2025 will come true. But what it does do is to help collaborators understand what the endpoint could look like, to create a common vernacular for what success could look like, so that the efforts in the interim have a direction in which to point. In Austin, we are busy with near-term challenges but haven’t yet published a bold statement for what an endpoint can look like. Not for lack of desire, but for lack of coordination, which brings us to the second point.
2. No single organization can bring about change in healthcare or life sciences independently. The industry sector is far too complex to be led by one institution to a new reality. It requires alignment of mutually dependent interests. The combination of Karolinska Institute, the Royal Institute of Technology, Stockholm University, Stockholm School of Economics and Stockholm and Solna can represent not only diverse interests, but diverse capabilities, all of which come to bear in realizing a new future.
3. Innovation in scientific discovery isn’t just about building new laboratories and hiring brilliant minds. It’s about building community – one that supports a way of life that is the broader ecosystem in which productive individuals thrive. For that reason, real estate development, urban planning, and social services development all play a critical role in a durable environment for sustained growth.
I left Stockholm Science City, and Sweden, excited by new models for discovery and care, and hope that Austin will be a model that can build on lessons previously learned.
