How can (eco)systemic innovation support your transformation journey in health & care?

This article was written by Klaus Niederl?nder and Victor Haze

‘Europe is really good in healthcare research & innovation. Yet, when it comes to getting those new services into the market, then companies often go rather across the Atlantic’. A typical sentence we have heard many times while working in health innovation. That’s why we wanted to look into more systemic innovation to overcome such typical project shortcomings. The past 18 months have been very insightful in discovering, exploring, collaborating & supporting regional health & care ecosystems around Europe and how innovation can be deployed and upscaled.

This article will share some of our experiences of this ecosystem learning journey, in particular our encounters, achieved progress and thoughts for the future.

So, what is actually an ‘ECOSYSTEM”?

The ‘ecosystem’ terminology has become widely used over the years when dealing with complex societal and economic issues, such as the demographic, digital or green transition. In order to better understand this concept and definition we went back to its biological origin - the natural ecosystem being ‘a community of organisms that interact with each other and with their environments by competing and collaborating over the available resources in order to thrive, thereby co-evolving and jointly adapting to external influences’ as expressed by the botanist Arthur Tansley in 1935. The ecosystem concept in the start-up and techworld often refers to a tech system around a strong player or proprietary platform.

When looking into systemic innovation in health & care, instead of just looking at technology development it is equally important to focus on organizational and social innovation.

Health & care innovation is very much about human ecosystems, i.e. ‘a phenomenon, when a group of people and organizations begin to act together from a shared sense of awareness of the whole situation’, as Prof. Otto Scharmer of MIT explained it. For us, human ecosystems are about the spontaneous interactions between people and organizations linked through formal and informal relationships, in order to move forward together and to achieve joint societal & socio-economic impact through collaboration. That is what we learned from our interviews with ecosystem players from around Europe and especially how we encountered those ecosystems ourselves.

Why are ecosystems relevant for health & care?

Life is complex and so is our health & wellbeing, especially as we age. All aspects of life are concerned, when looking holistically at health, i.e. positive health and not disease & cure.

An aging society will require a change of mindset about our health & care systems and how we allocate resources in the light of growing demand coupled with shrinking available professional & financial resources. This is a “wicked problem”, which will force health & care actors to get out of their accustomed silos and start collaborating beyond institutional, sectoral & professional borders while integrating neglected or new players, such as the informal carers.

Understanding the wider health & care ecosystem and the impact it has on your organization is a prerequisite for moving towards systemic innovation and new ways of working.?

What did we actually do?

We started this ecosystem learning journey with a series of interviews with selected stakeholders of a number of health & care? ecosystems across Europe. Learning from their experience, their experimentation, their successes and failures, helped us to better grasp the multi-dimensional spheres of the ecosystem, such as the various organizations involved across the care continuum from home to community to institutional care, the political, strategic and operational dimensions of ecosystem collaboration, the micro-project, the meso-platform and the macro-policy framework levels and so much more.?

From there we started to collaborate with regional ecosystems through online and in-person workshops to look at their current positioning, their ambition and priorities and their emerging development roadmap by testing a number of strategy tools as well as social interaction approaches. We looked into the AgeingCoimbra ecosystem in Portugal, the Health Innovation Aarhus in Denmark or Active Lancashire in the UK.

Over the months, clarity emerged about how to collaborate and what to focus on while developing an emerging network of regional health & care ecosystems around Europe.

How do I get started in integrating an ecosystem innovation perspective?

Rather than dealing with complicated problems, we need to accept that we are facing open, complex, dynamic and Inter-linked issues in our contemporary societies. Becoming aware of the different nature of those underlying challenges, such as an aging population, will allow us to move towards an ecosystemic innovation approach. And then, it’s really about getting started and diving into the ecosystem. It’s learning about the different players and actors involved, developing first priorities for collaborative action while moving in a joint direction based on agreed societal and social goals.?

Working together is about learning together, sharing experiences and little by little building trust between each other. This requires a regular strategic interaction process within the ecosystem and a framework, which captures the progress made. Over time a culture of collaboration emerges focused on the people-centered needs of health & care? in a region or community as a prerequisite for the development of new collaborative service, business, governance & ownership models. This regional innovation will require a learning policy framework at national and potentially European level, to allow for system transformation as well as for the efficient and effective provision and allocation of the necessary human, financial or institutional resources and data infrastructure.

What did we learn?

Dealing with complex issues, which in the end are always about human issues, require an ‘open heart, open mind & open will’ strategy as described in Otto Scharmer’s “moving from ego-to eco-system’, i.e. being open and empathetic to listen to others, being able to bring the future into the present and having the courage to quickly act through trial & error.

The goal is THE learning journey to sense and see your emerging ecosystem, to build warm/strong relationships with organizations in your ecosystem and to constantly prototype new solutions and test them in practice. By simply getting started with like-minded people and organizations in your ecosystem you take away the anxiety and actually move forward.

Every ecosystem is different, yet many challenges are similar. So there is vast scope for meaningful collaboration for long-lasting impact, especially when it is about societal transformation first. Just as structure follows strategy, so should financial benefit follow people.

How can our learnings help?

While this ecosystem learning journey within the AAL programme is coming to an end, we are only at the beginning of our own new professional journey.?

Are you asking yourself questions like:

• How can I get an ecosystem started?
• How can I integrate systemic innovation into health & care in my region?
• How do I mobilise key stakeholders within my ecosystem?
• How do I measure progress in this collaborative ecosystem process?

If the above questions, challenges and experiences resonate with you, be it in health & care or in other complex domains, then we would be happy to share our experience and learnings with you and possibly collaborate with you in the future.

Feel free to contact us, so we can set up a first conversation.

#ecosystem #healthcare #systemsthinking #collaboration

Klaus Niederl?nder

Victor Haze