Irene Svenonius – Chairman, Region Stockholm, Sweden

Region Stockholm is responsible for all publicly funded healthcare in the Stockholm region. Its chairman, Irene Svenonius, explains her agenda to transform and modernize the region’s healthcare system to improve its efficiency, enhance patient value and prepare it for the technological revolutions to come. A key part of her plan is to further integrate healthcare and research to implement innovations faster. In this area, increased collaboration between industry, the care sector and academia is needed.

 

Highly specialized care can be extremely expensive. We simply cannot afford to spread highly specialized care across regions and hospitals

What have been your key agenda priorities to improve healthcare since taking office?

My key agenda priority has been to ensure that the large investment made in the New Karolinska Hospital in Solna generates maximum benefits for healthcare as well as medical research and education, not only for the Stockholm region but the country as a whole.

Highly specialized care can be extremely expensive. We simply cannot afford to spread highly specialized care across regions and hospitals. The objective behind the construction of the new hospital was to create a state-of-the-art facility focused on highly specialized care and medical research and equipped with the latest cutting-edge equipment to diagnose, treat and monitor patients. This is something that has never been done before in Sweden. A key part of the puzzle to integrate healthcare and research is BioClinicum, Europe’s most modern translational research facility comprising 195 research laboratories where 900 researchers from different specializations work together to implement the outcomes of medical research faster in healthcare.

The New Karolinska Hospital is part of a larger plan to transform the entire region’s healthcare system. One goal is to make sure that patients receive treatment at the right care level, which will not only improve medical outcomes and healthcare access but also reduce costs for taxpayers. As part of this endeavour, less specialized healthcare services from the Karolinska hospital were moved to the other six hospitals in the region. Moreover, we are reinforcing primary care so that patients who do not need to receive treatment at a hospital can receive it elsewhere.

Another goal is to build the healthcare system of the future. Innovations such as digital health and AI technology will revolutionize diagnosis and treatment. Fewer patients will have to go to a hospital, and much more could be done at other care levels or even indirectly as doctors will be able to monitor patients’ vital information remotely.

This transformation in healthcare will necessarily impact the way research is conducted. Since patients will be at the right care level, which could change along the care pathway, research will have to follow patients. Research cannot be performed at one hospital anymore since patients are not going to be there. Therefore, all levels of care and research need to work closely together in a different way.

 

What are the key strengths of the Stockholm region’s healthcare system?

On the one hand, the Swedish healthcare system as a whole is ranked among the best in the world for medical outcomes, and the Stockholm region is no exception. On the other hand, access to care varies widely between regions. In Stockholm however, access to care is not an issue. As a matter of example, there are only two counties where there are hardly any waiting times; Halland, a small county in the south of Sweden, and Stockholm.

Besides outstanding medical outcomes and access to care, another strength of Stockholm is the strong cooperation between research and healthcare, allowing the results of research to be implemented much faster into our healthcare system.

Last but not least, the Stockholm Region manages its finances responsibly and regularly generates a surplus. As a result, we can afford to provide patients access to new treatments faster than in other regions. As therapies become more sophisticated and individualized, their costs have increased dramatically. We want to be able to bring them to our patients as fast as possible so they can live healthier and longer lives. But in order to afford them, we need to be much more efficient. This is the driving force behind the transformation of our healthcare system.

 

How does Region Stockholm collaborate with the industry to ensure its population has faster access to innovative medicines?

After the election last September, we formed a new board under the county council focused on monitoring new methods being developed by industry and academia, including pharmaceuticals, and implementing them faster into the healthcare system.

Region Stockholm has a close collaboration with the industry through our Board of Health and the Innovation Council, which was also formed after the last election. We have increased our expectations regarding research and development and collaboration between industry and the region. In particular, clinical research is an area in which the region can improve, and the industry shares our assessment. The process to apply for clinical trials is quite confusing as companies need to contact different hospitals and decision-makers. As a result, receiving an answer for requests is a lengthy process. Region Stockholm has pledged to create a one-stop shop which will give a response within 10 days if we are prepared to start the validation process. We also plan to organize a yearly conference discussing the unmet medical needs in our healthcare system with the industry and how we can find solutions.

Our aim is to increase the number of clinical trials by 50 percent by 2022. The objective is two-fold. First, our patients will be able to receive better treatments. Second, we want the life sciences industry to blossom as it is a major contributor to the Stockholm region’s economy. We wish to see more start-ups being created and for existing ones to grow larger and become global companies.

 

Every year, the regions receive a special state grant for financing pharmaceutical benefits. The review conducted by the Medical Products Agency (MPA) proposes to abolish this special grant and incorporate it into the general government grant to the regions. What is your opinion on this proposal?

This is a difficult question to answer. As I mentioned, access to innovative medicines is not equal in Sweden. Today, the Stockholm region implements new medicines faster than others. The idea behind this proposal is to equalize access between regions, which is a commendable goal. However, such a change in the system could have huge unforeseen negative impacts on the healthcare system and patients, as well as on the pharmaceutical industry. My only hope is that it does not create disadvantages for the inhabitants of the Stockholm region.

 

How does the region promote the development of its thriving life sciences sector?

The Stockholm region is one of the most innovative life sciences hubs in the world with the ICT cluster in Kista comparable to Silicon Valley, where a lot of medtech and digital health solutions are developed, the Stockholm Science City in Hagastaden, and the cluster in Karolinska University Hospital in Huddinge.

The Stockholm Region injects SEK 400 million per year into medical research, while the national government provides us with a research grant of about SEK 600 million. In total, SEK one billion is allocated each year to medical research in the Stockholm region. In addition, we collaborate closely with the KTH Royal Institute of Technology, the Karolinska Institute and Stockholm University. For instance, we have open labs between these universities, Region Stockholm and the city of Stockholm, pooling resources and researchers from different fields to find solutions to problems in our system, both on healthcare and on public transport. This promotes innovations that one day can turn into businesses.

Moreover, a lot of things have been done for many years, not just at the regional level, but also at the municipal level in cities such as Stockholm, Uppsala and Solna, to attract business and investment from abroad in the life sciences industry. The large investments made in the New Karolinska University Hospital in Solna, BioClinicum and the Karolinska Institute are already attracting businesses to come here and collaborate with the researchers at the universities and find new solutions together. There are new office buildings being constructed close to the Karolinska Institute designed to house both university departments and companies.

 

What would be your final message to our international audience?

We want to have a world-class healthcare system and research ecosystem in the Stockholm region and play a key role in bringing new solutions to old problems for the benefit of patients not just in Sweden but globally.

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