SUNSIDE
SOLUTIONS FOR INDEPENDENT AND ACTIVE LIFE
EXECUTIVE REPORT 2014
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SUNSIDE EXECUTIVE REPORT
© Robotdalen 2014.
SUNSIDE EXECUTIVE REPORT
TABLE OF CONTENTS
1 This report_______________________________________________ 3
2 Introduction_____________________________________________ 3
2.1 Model and scope_________________________________ 3
3 Vision _________________________________________________ 4
4 Description of key barriers_________________________________ 4
4.1.1 Focus areas_____________________________________ 4
41.2 Entrepreneurs___________________________________ 5
4.1.3 Care givers _____________________________________ 5
4.2 International cooperation________________________________ 6
4.2.1 Description of attractiveness______________________ 6
4.2.2 Description of hurdles for international players______ 7
4.3 Recommendations______________________________________ 7
4.3.1 Swedish counties and municipalities________________ 8
4.3.2 International cooperation_________________________ 10
4.4 Moving forward________________________________________ 10
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SUNSIDE EXECUTIVE REPORT
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This report
This report is an executive summary of the findings and recommendations in the SUNSIDE project. For a more
insight and details we refer to the full report. The report is written by Adam Hagman at Robotdalen and Reidar
Gårdebäck – ReGarde AB
After meeting representatives from different testbeds and other organisations working with innovation within
the health care sector, we found that there is a great interest and drive among them to work together and share
their experiences to make the Swedish care system better and more efficient. There is also a great expectation
from them, that project SUNSIDE will result in swift action. We should use this interest and enthusiasm to start
building the infrastructure that we know is necessary in order to implement innovation into our health and care
processes.
2Introduction
Sweden and the world are facing a drastic change in the number of older people in our society. To maintain the
quality of care, greater efficiency in several areas are required. The overall goal of this project called SUNSIDE Solutions for Independent and Active Life is to establish a national process for implementation of innovations
and thus:
• _enable older people to remain independent as long as possible.
• enable older people to remain involved in the society as much as possible.
• allow for a more efficient healthcare
• in parallel with the above, create growth through new businesses and jobs that are created and
established, or are attracted to Sweden
Robotdalen has a very close collaboration with several municipalities and counties. Along with other organizations the intention is to build on the existing efforts in the different regions. The project would use the strengths
and initiatives in Sweden which in many cases already are supported by VINNOVA as a foundation.
Project goals are to be achieved by:
• Actively promote the development and implementation of innovations in the health sector.
• Ensure that the above innovations are realized in the form of products and services in viable
businesses.
• Attracting international cooperation in the development and use of new innovations.
Project SUNSIDE have involved a number of stakeholders and together with them identified the barriers that
exist today and for each one suggested measures and solutions around these.
2.1 Model and scope
The seminar series was held with a number of key players who were invited to three seminars each with a
different theme. In each seminar a structured process was used where barriers, priorities and solutions where
discussed and defined for the most prioritized obstacles.
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Each seminar was arranged using a specific model following the process steps below.
The three seminars had the following scope:
Workshop 1, Entrepreneur: Define barriers and obstacles for entrepreneurs to offer their products / services to
the market and proposed solutions to these.
Workshop 2, Implementation: Focus on implementation of innovations. Seminar was held with a large number
of participants from test-beds, local authorities from all over Sweden. The major barriers were defined and
solutions to mitigate these was proposed and discussed.
Workshop 3, International cooperation: Focus on international cooperation both regarding export possibilities
for Swedish companies but also how to make Sweden more attractive to invest in and to collaborate with for
international companies and organizations.
3Vision
During the project a vision for implementation of innovations in care was defined.
A future where innovations are implemented in care services through a resource optimal process
that strengthen older people’s independence and participation in society and contribute to a more
efficient health care.
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Description of key barriers
4.1.1 Focus areas
In the workshops the most prioritized barriers for implementation where defined. In the workshop with entrepreneurs they were grouped into the following areas.
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Lack of coordination between municipalities and counties.
Lack of incitement for development of processes and organization
Financial systems and reimbursement models conserve existing structure and prevent
implementation of innovations and new technology or processes.
Negative and skeptical attitude within care organizations for new processes and or technology and
limited number of personal with change management skills.
Public procurement processes and regulatory hurdles. Existing organizations and financial systems sometimes creates unnecessary borders and limitations for usage and implementation of systems which are working cross borders and organizations.
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4.1.2Entrepreneurs
The barriers and solutions and their impact can be visualized by in a priority vs impact-on-solution diagram
as below.
It is obvious that the main tasks are related to the lack of incitement in the care to drive effectiveness. Also the
payment system divided into different cost centers are hindering implementation of systems or solutions that
are cross borders between these. The solutions on these prioritized barriers are described in section Recommendations.
4.1.3 Care givers
For caregivers the barriers and solution plot which was the result after the second workshop resulted in a plot
very similar to the one for the entrepreneurs.
Barriers are related to lack of coordination between municipalities but also in the interface between testbeds,
municipalities and counties. The organizations setup, reimbursement system and lack of process development
activities and incitement are seen as main barriers.
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4.2
International cooperation
Within the international cooperation the main areas where Sweden has an advantage compared with other
countries and where additional focus would strengthen these even more are within:
• Testbeds where the access is fairly good
• The long tradition of prescription of devices in Sweden
• User involvement in development and testing of prototypes
4.2.1 Description of attractiveness
Sweden and the Nordics are attractive as a market because of the following reasons:
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Public founded healthcare
Stable economy
Tradition of prescription of devices
User involvement
Testbeds
Coordination between counties and municipalities
User involvement in the above context is defined as when end users are involved in testing, design and development of new technique and solutions. To have users involved in a stage when the products is already ready
to be launched or is already commercially available is not seen as so valuable and is not the definition in this
case. New innovations are developed in cooperation with end-users which increase the probability of covering
their demands and requests and thereby have a faster market acceptance and introduction.
The access to different testbeds is seen as a key area. The information about existing testbeds and their scope/
contact persons and status is not understood where to find. Today this information is found using personal
contacts and channels. As the information about status and what different testbeds exists there is a large risk
that possible exchange of information and experiences with international players are missed.
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4.2.2 Description of hurdles for international players
The biggest hurdles to get access to the market are:
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Need to understand the market& revenue stream. If not clearly understood energy and efforts are probably put on wrong tasks. Advice is to seek information about the market at existing
organizations like Rd, Business-Sweden, LMV, Swecare, Science Parks etc. Recommendation is
to have one entry point which also can be one of the existing organizations.
Proven driven purchase system. Studies, health economical calculations, references are needed.
“Do you home work” includes activities like defining customer need, clinical proof, revenue stream, understand the procurement process´, requirements and needs.
4.3Recommendations
During the project a number of recommendations where defined for the most prioritized barriers and are
described in short below.
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4.3.1 Swedish counties and municipalities
Challenge: Lack of coordination between municipalities and counties.
Recommendations:
Information sharing
• Establish a common communication platform
• Share information about projects and best practices
• Initiate pilot projects in selected areas to show health economic benefits
Testbeds
• Create a common education package for testbeds
• Improve collaboration between testbeds
Municipality clusters and cooperation
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Establish municipality clusters for regions and or municipalities with similar size and challenges.
Coordinate care and service initiatives between municipalities
Coordinate procurement of parallel submissions of similar technic or services.
Centralize some services today arranged by individual municipalities to increase efficiency and quality.
Establish a national body/organization to synchronize the initiatives listed above.
Challenge: Lack of incitement for development of processes and organization
Recommendations:
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Ensure that there are incentive models of economic nature that encourages the involvement of a test
environment. Spread information about the usefulness / soft skills to engage the staff.
Use the main points in the SKL & VINNOVA cooperation agreement
1) Change Management
2) User-driven innovation
3) Procurement of Innovation
Use materials and projects from VINNOVA call regarding compensation models.
Improve the compensation system to be more result and health economical oriented.
Group municipalities with similar demographics and size in coordination clusters.
Stimulate process development initiatives.
Use lessons learned from the testbeds currently investigating the compensation system in specific areas.
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Challenge: Financial system and reimbursement models conserve existing structure and prevent
implementation of innovations and new technology or processes.
Recommendations:
Financial structure and reimbursement models.
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Work for a more flexible remuneration system.
Consideration should be given to health economic parameters in procurement and in purchasing.
Give patients greater advocacy opportunity for treatment, systems.
Important that the model also benefits the person and or clinic, department who initiated the action for innovation activities.
Establish an implementation fund.
Add up the various levels to reduce bureaucratic requirements on smaller sums sought financially.
Challenge: Negative and skeptical attitude within care organizations for new processes and or technology
and limited number of personal with change management skills.
Recommendation:
Attitudes and skepticism
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Establish innovation ambassadors, idea coaches.
Training of staff in change management.
Personnel: Spread information in good practice.
Involve users in the change process.
Initiate activities driving a culture change where new ideas are welcome - Focus should be within ”How can we improve the business ...”.
Users will become customers. Establish a customer perspective.
There is an urgent need to get information on best practice from other municipalities. Establish a forum and or network where best practices can be spread.
Challenge: Public procurement processes and regulatory hurdles. Existing organizations and financial
systems sometimes creates unnecessary borders and limitations for usage and implementation of
systems which are working cross borders and organizations.
Recommendation:
Procurement and regulatory
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Increase usage of innovation friendly requirements in public procurements.
Increased usage of the existing types of Innovation procurement models.
Spread the word about successful innovation procurements.
Use to a larger extent the health economical material created by TLV.
Use a certification of counties and municipalities in innovation process and implementation.
Offer education packages for selected personal in implementation and change management skills.
Involve users in the implementation process.
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Operational obstacles
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Reaching a critical mass of stakeholders to understand the issues involved and the technology and the solution.
Introduce an implementation fund.
Create incentives for care when operations are improved.
Introduce more proactive management where error equals lesson learned.
Introduce awards like ”Implementer of the year”.
Clear targets and objectives defined where certified municipalities and counties have access to
implementation fund.
4.3.2 International cooperation
Strength: Access to testbeds is fairly good.
Recommendation: Testbeds are not regulated to only Swedish companies so international players can interact
with testbeds. Issue is to know which and who to contact. Create a forum where testbed activities can be connected and gathered.
Strength: User involvement
Recommendation: Increase cooperation between testbeds. Knowledge about testbeds can be improved. VINNOVA have a list of the testbeds they support but not the ones that VINNOVA aren’t founding. Some testbeds
see others as competitors as they apply for the same money and resources. Nordic collaborations between
testbeds have begun in Nordic Innovation Council. Liability needs to be defined and sorted out before any
evaluation begins.
4.4
Moving forward
Next step in the SUNSIDE project would be to define the organizations and stakeholders that can drive the
different recommended activities and to seek resources and funding to drive those.
As many of the recommendations and activities are split among different stakeholders a main task would be
to monitor the different activities and spread information and status about progress regarding these. This means that an organization or body that coordinates these different activities is key in order to measure progress
and fulfillment of set target and objectives.
To be continued !
Reidar Gårdebäck
Adam Hagman
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Robotdalen is partially financed by:
www.robotdalen.se