Leadership in healthcare innovation

Leadership in healthcare innovation

Posted by: on Sep 18, 2018 | No Comments

In a previous blog post, I wrote about innovative care models. On 12 September, I was a key speaker at a healthcare conference in Riyadh (Saudi Global Health Exhibition). The title of my presentation was “Leadership in healthcare innovation: What does it take”? Sweden, my home country, has a long tradition of fostering innovations and this is what I will focus on in this blog post. In fact, Sweden is the leading innovative country within the European Union (EU), followed by Denmark and Finland.

So how has this come to be? I will go through some of the key factors below. Part of the answer lies in investments in research and development. Sweden currently invests well over 3% of its GDP in research and development (R&D) while the average within the EU is around 2%. That means that Sweden is investing 50% more – and investments in R&D is of course key for a nation to become innovative.

Without a strong education system as a foundation in a society, it is hard for any nation to equip its citizens with the skills needed to be innovative. The recipe is first a good overall education. Sweden has a long tradition of free schooling. Already in 1842, the Swedish parliament introduced the first free compulsory primary 4-year school. The compulsory school was extended to 9 years in 1949. Sweden also has a long tradition of world-class higher education. The Uppsala University was founded in 1477 and the Lund University in 1666. They are not among the oldest universities in Europe but their reputation has been very high for many decades, even centuries.

Another factor, which is important to mention, is Sweden’s long tradition of triple helix collaborations. A triple helix collaboration refers to a cooperation between Public and Private Institutions as well as the Academia.

Swedes are considered early adopters when it comes to technology in general and the music and entertainment industry in particular. Below are some examples of great inventions, which Sweden is famous for:

-Anders Celsius, the astronomer, invented the temperature scale.

-Since safety is part of the Swedish DNA, it was of course a Swede who invented the safety match.

-The ball bearing and the zipper are other examples of Swedish innovations.

-The video-chat app, Skype, was launched by Niclas Zennström in 2003. In 2011, Microsoft bought Skype for $8.5 bn. Not a bad return after 8 years!

-The music streaming service, Spotify, is another example of what has come out of the Swedish tech innovation hub. Spotify was launched on 7 October, 2008. On 3 April, 2018, Spotify was listed on the New York Stock Exchange. The listing was very successful and several Swedes became multibillionaires overnight. Spotify is currently valued at $30 bn.

I also talked about how every year, on 10 December, the Nobel Prize award ceremony is held in Sweden (except for the peace prize, which is awarded in Norway).  Prizewinners include early innovators such as Albert Einstein, Alexander Fleming and Marie Curie. The first Nobel Prize was awarded in 1901, this is now 117 years ago. Interesting to note is that apart from inventing the dynamite, Alfred Nobel also held 355 different patents.

I ended the section about Sweden by talking about some very famous healthcare innovations, which have changed the way patients receive care around the world. The first one is the very well-known Gamma Knife. The Gamma Knife is an advanced radiation treatment for adults and children with small to medium brain tumors. Lars Leksell invented the Gamma Knife technology in 1967 and founded the company Elekta. Today more than 6,000 hospitals around the world rely on Elekta technology.

Rune Elmqvist, who worked at Siemens in Sweden, developed the first implantable pacemaker in 1958, together with Åke Senning, senior physician and cardiac surgeon at the Karolinska University Hospital in Solna, Sweden. The same year the first pacemaker saved the life of a man who was just about to die. This man, 43 years at the time, lived to be 86 and outlived the man who saved his life.

I want to end this blog post with a special dedication to an invention, which lies especially close to my heart – the dialysis machine. It replaces kidney function for patients with renal failure and since I am active in the renal care industry, I have seen first-hand what this invention means to millions of people every day.

Nils Alwall invented the dialysis machine in 1949 and it became the foundation for the Swedish company Gambro. My company, Diaverum, was once part of Gambro and went under the name Gambro Health Care until 2007.

The introduction of the dialysis machine of course had an enormous impact on the lives of end-stage renal patients. Patients who have lost their kidney function need replacement therapy in order to survive (today this means dialysis or transplant). Before such treatment was available, their lives were not possible to save. Today however, they can live a long life if they receive high-quality dialysis care and take good care of themselves – and currently over 2 million people over the world do!

The concept of Integration Nurses

Posted by: on Nov 17, 2015 | No Comments

Integration is derived from the Latin integrare, which means renew, amend, mentally refresh. This is exactly what Diaverum is doing with the concept of the Integration Nurses. We are sending experienced nurses from our existing markets to the new markets where we are opening up new clinics. By doing so, Diaverum is renewing the local knowhow, amending processes and policies if required and refreshing the knowledge — all in the interest of the patients.

I believe this is a win-win situation: renal nurses who are interested in experiencing another culture for a certain period of time can do so without risking their job “at home” and they really see the impact they are having on the health and well-being of the patients by introducing our globally recognized policies and procedures. On the other hand, the newly established clinics gain a lot of knowhow and experience from the Integration Nurses. The double-edged experience can be as ‘broad’ as a Portuguese nurse going to Saudi Arabia or as ‘close’ as Turkish nurses spending a few months working in Kazakhstan. The Integration Nurses are the link between management, medical and operation teams and the new nurses recruited in a given country. An excellent interpretation of ‘integration’ in my opinion.

Future challenges require firm leadership

Posted by: on Dec 12, 2014 | No Comments

Predicting the future is almost impossible and it takes strong, firm leadership to turn challenges into opportunities.

When I did my MBA at INSEAD many years ago, one of my professors told me that the only way to predict the future is by looking at the past — there is no such thing as a crystal ball which tells the future.

This might sound a little simplistic and maybe even brutal but this is the way things are.

Take trying to predict currency movements, stock market development, economic cycles, for example: all predictions are simply assumptions and these assumptions are typically based on past experience.

The likelihood is that someone will guess correctly but this is down to luck and experience rather than an ability to look into the future.

Who could foresee the economic meltdown in the Eurozone starting in 2008? Who would predict that the euro as a currency would come under threat? Who could predict that oil prices would plunge the way they have done lately? Who could predict that the tension in Russia and Ukraine would bring us back to the ‘Cold War sentiment’ where Russia once more was cast as the enemy?

Since nobody can predict the future it is important to listen to the views of many different people.

When running a global healthcare services company with presence in 18 countries, the only thing  that is (almost) certain is that there will be macroeconomic challenges in one or a few of these countries at any given time. We have seen the Russian rouble, Argentinian peso and Turkish lira plunge during the year; we have seen signs of recovery in Spain and Portugal; and we have seen the impact the falling oil price has had on the economies of Saudi Arabia and Russia.

What will happen in 2015 which we are not able to predict today? Will there be a sustainable economic recovery in Europe in 2015? Probably not. Will oil prices increase again to 100-plus dollars per barrel? Probably not. Will the situation in Syria and Iraq improve or will IS continue to seize more territory? Probably yes.

Will something significant happen in the world in 2015 which we cannot predict today? Definitely yes.

What are the implications for business in all this uncertainty? One thing which I always have believed in and which is going to be important for the foreseeable future is to manage cash flow as well as one possible can. Cash is king (or queen). This is for any company the most important measure of financial success. A company with strong cash flow will always fare better than a company not focusing strongly on cash flow.

I believe that any company today also needs to have mitigation plans ready to be implemented in case country performance is much lower than planned. To sit back and accept that performance goes down without implementing strong measures is nothing that shareholders or private equity owners appreciate. What we know is that shocks to the system do happen much quicker today than before due to increased volatility and shorter cycles. Therefore any successful organisation must always be prepared to mitigate, face the problem and turn it into an opportunity.

Strong leadership from the top is a prerequisite for success. Management by objectives and delegation is something I have practiced in all leading positions I have had, but one must always keep a firm hand on the steering wheel and be prepared to act quickly whenever things do go wrong. And the only thing we can be certain about is that things will go wrong. The only question is where, when and what the magnitude will be. Being prepared will help you turn these challenges into an opportunity and come out as a winner! There will be many losers in tomorrow’s world and a few winners. Which category do you want to belong to?

Looking in the mirror

Posted by: on Feb 25, 2014 | No Comments

I was asked the other day what I enjoy most with doing what I do for a living.

This is an interesting question and not easy to answer. I have come to the conclusion that I do like to be a leader — I enjoy leading people. Leading people is an enormous responsibility but also a true honour. There are of course less enjoyable parts of leadership: for example, having difficult discussions with employees or even firing employees, but this is something that does come with leadership. There will always be people who are not right for the company and then they should not be with the company.

I read a book some years ago called From Good to Great. This book has fascinated me ever since. It was written by Jim Collins in the 1990s and is the best book on leadership I have ever read. The book is evidence-based which makes it even more compelling to read. The book describes ‘Level 5 Leadership’ and how level 5 leaders ‘look in the mirror’ when things go wrong. This is explored through a few key themes:

  1. People first, then strategy. Getting the right people on the bus and the wrong people off the bus. To achieve this, the recruitment processes in a company typically need to be amended (for example, attitude is more important than technical competence). Equally important is to realise when a person should be removed from the team. Having the wrong people on the bus is very dangerous for any organisation. Once you have the right people on the bus, the problem of how to motivate and manage people largely goes away. The right people do not need to be tightly managed or fired up; they will be self-motivated by the inner drive to produce the best results and to be part of creating something great.  According to Collins, “if you have the wrong people, it does not matter whether you find the right direction; you still will not have a great company. Great vision without great people is irrelevant.”
  2. Important to always confront the brutal facts. Remember Kodak: it did not realise it was in the imaging business and not in the photography business. They went bankrupt as a consequence. This involves understanding what the members of the organisation actually think about the company, an internal satisfaction survey. Establish the facts and not blame anybody for one’s own mistakes as a leader of a team.
  3. According to Collins, a great company does one big thing consistently. Trying to do many things and not understanding what the real priority is will not make a great company. It is all about securing that key priorities are agreed and that they are communicated at every opportunity. A great company does what this company is best in the world at. It is important to define what ‘best in the world’ means. For Diaverum, this could be to be the most patient-centred renal care company in the world. Good-to-great companies do what they can do best (as opposed to what they want to do best), what they are deeply passionate about, and they focus on what drives their economic engine.
  4. A great company also focuses on the key economic drivers and works hard to keep things very simple. Key economic drivers in the case of Diaverum could be share of clinics with more than 100 patients or a patient satisfaction score on or above a certain level. I am a strong believer in the concept of securing highest possible medical outcomes, patient satisfaction scores and staff satisfaction scores. Any Diaverum centre with great performance in these three areas will also be a profitable centre.

The ‘Level 5 Leadership’ is a very central theme in the book. What does it mean for a leader to ‘look in the mirror’? According to the author this means:

  • taking responsibility;
  • not blaming others;
  • setting high standards;
  • leading by example.

I do fully agree with this. A good leader assumes full responsibility; he does not blame others for mistakes. Setting high standards and leading by example is also truly key. In addition to this I believe that a good leader is someone who says “we” and not “I”.

How many of us have worked for leaders who say “I” when it should be “we”? I have had such leaders in the past and been very frustrated by this.

Level 5 leaders are not charismatic, media types. Chances are you’ve never heard of them. They are humble, self-effacing and more concerned about the prosperity of the company than their individual success.

I can recommend you to read the book if you have not already done so.


Listen up! Five leadership behaviours

Posted by: on Oct 2, 2013 | No Comments

During the summer I spent some time listening to a book by Patrick Lencioni called The Advantage. Yes, I did listen rather than read. The good thing with listening is that one can at the same time make notes of what one hears. This is a little bit harder to do when reading and both hands are busy with the book.

The first part of the book describes how a leader builds a cohesive leadership team, a team which creates an advantage over competitors. A cohesive leadership team is a team where members are open to each other; they debate passionately and focus on the collective good of the organisation.

What the ‘collective good’ means is that the individual is always inferior to the team. To be a successful member of a leadership team means focusing on what is right for the company at all times rather than focusing on what is right for the individual — easy to say but hard to put into practice. This naturally also goes back to the targets the individuals receive during their appraisal or in their incentive schemes. Leadership team members should not have individual targets, only group targets.

Patrick Lencioni also talks about five behaviours associated with cohesive leadership. The first behaviour is about building trust. This naturally takes time but for a team to function well there must be trust among the team members. If there is no trust, then the leadership team will not function.

Second behavour is about mastering conflict. To agree to disagree is something very powerful in a leadership team. In my own case with my leadership team members, I do not expect my team members to agree with what I say. Absolutely not. But disagreeing is something one does within the team. When decisions are reached, however, they must be accepted and embraced by all team members so that the rest of the organisation sees an aligned leadership team communicating clear messages which all members stand behind.

Third behaviour is about achieving commitment. Once again it is about daring to disagree. If people in a leadership team cannot disagree, commitment cannot be achieved. It is important to let different views be presented and then it is time for the leader to break ties.

Fourth behaviour is about embracing accountability. This can also only happen when there is true commitment. The leadership team must feel accountable for the company goals and objectives. True accountability will create passion for achievements and results. If someone does not feel accountable, how likely is it that the person will passionately work for the common good?

The fifth and final behaviour is about focusing on results. The leadership team must focus on results. The only true measure of a great leadership team is whether or not it accomplishes what it set out to accomplish. If the organisation rarely achieves its goals, the leadership team is not doing the job it should. Look at a sports team. What is it that counts for them? Only results of course. If a football team nearly won or nearly scored they have still lost. Once again, it is all about setting team goals first and individual goals second.


The sounds of our lives?

Posted by: on Feb 10, 2012 | One Comment

There is  no doubt that smartphones have revolutionised how we live our lives. This is the information age, after all, and the smartphone keeps us plugged in to the information flow wherever we are in the world — we no longer have to wait till we’re back at our desks to read that important email, it’s right there in our hands.

Of course, the flipside can be seen when you peer inside today’s meeting rooms. The number of gadgets has exploded over the last couple of years — no longer is it the case where only laptops are present, but also smartphones, iPads and other such devices — and that also means that the number of distractions and unpleasant electronic sounds and signals which irritate people around the table has also increased.

Looking closer to home, I have recently added a ‘no gadgets’ rule to the executive meetings that I lead.

All of which has led me to think about this question: at what point does our dependence on electronic devices go too far?

Psychologists have a growing concern with smartphone dependence. People are displaying behaviour that shows they would rather interact with their phone than with other human beings. This is naturally a worrying behaviour, but is it too far, and is it really any different to addictive video-gaming?

Perhaps, but it appears too that it is not just an issue for the younger generations. Teens and adults are showing addictive behaviour to their smartphones that in some cases is causing harmful consequences.

Some are minor, such as teens talking in three letter words such as LOL and BRB — although this is more offensive on the ears rather than being anything sinister. Other behaviours are more destructive, however, such as car accidents caused by people texting or looking up information on smartphones. Clearly too far.

There has also been a lot of research into the area of the usage of smartphones, particularly teens’ attachment to their smartphones. The researchers found that when teens were separated from their phones, they were under-stimulated. The indicators were a low heart rate and the inability to entertain themselves.

Another study shows that 47% of teenagers admitted to using their smartphone when in the toilet (only 22% of adults confessed to the same habit). Too far? Probably, and certainly enough to make you think twice before borrowing someone else’s phone to call or text.

But back to the issue of gadgets in executive meetings. A meeting where people are constantly checking messages, emails etc. on their smartphones is not a productive meeting. People need to be present and focus on the ‘here and now’ in the room. Therefore, my personal view — and one that we live by in the meetings that I lead — is that smartphones and other such devices are forbidden. And this works fine when there are enough breaks during the meeting day to allow for people to check messages and or emails.

  • In case you were wondering, these are the rules by which I lead my executive meetings:We start always on time
    No computers / iPads / technical equipment on the table
    No mobile phone on or under the table
    There will be breaks to enable calls and other urgent matters
    One person speaks at a time
    Be present
    Prepare each point well

The true art of delegation

Posted by: on Sep 21, 2011 | One Comment

Delegation has been a buzz word for as long as management books and management training exist. There are millions of theories and “how-to´s” when it comes to delegation in business. But I am not talking about delegation of work, that one does not want to do oneself. I am not talking about delegating projects, but keeping the ownership and the responsibility. I am talking about getting a team involved, creating commitment, true ownership and accountability. Because this is what it needed in a successful company or organisation, especially in times of crisis. We need leaders that burn for the company, show true passion and drive excellent results.

When we at Diaverum started building our new brand, vision and mission (we were previously named Gambro Health Care, but changed the name when ownership changed in 2007), there were many “to do´s” and many decisions to be made. Time was an issue – as it always is – and it would have been easy for me to work with an experienced brand agency on a nice and fresh vision and mission.  To be cited on our website and in our documents. I am saying this, because this is how it is normally done: by an outside agency. But a vision and mission not involving people from within the organisation will never reach the heart and the soul of the employees. This is why I decided to get all country managers and executive team members around a table and jointly develop the brand platform including vision, mission and values. It took us a few days days, including late evening sessions and liters of coffee consumed to arrive at the brand platform which felt right for the company. And the outcome was very positive: There is today a highly motivated executive and country management team in Diaverum eager to deliver on the brand promise and to ensure that all 17 countries which we operate in work in a similar way. Everybody knows the important role he or she plays in making this a reality and it does pay off. Since then, this group of people is “co-owners” of our strategy. We meet twice a year to work on strategy and follow up on our plans and I know that I can fully trust this group of people, having full responsibilities, making their own mistakes and enjoining the results. Certainly it takes a bit of holding back as a leader , particularly when you want alignment, buy in from all key decision makers and therefore trusting one’s team and  not being afraid to delegate is absolutely key for successful leadership.


Foto på Dag Andersson