Methodology and approach
Introducing the process and toolbox
The Nordic model has recieved increasing international interest for its ability to create both high quality social welfare and economic growth, but future demographic and economic challenges facing both the Nordic region and most of the western world, threatens its continued success. The program "Sustainable Nordic Welfare" was designed to address some of these challenges with a special focus on healthcare, the labour marked and education.
As the Nordic term "welfare technology" had gained considerable momentum as a new tool to innovate public healthcare in all five Nordic countries, "Sustainable Nordic Welfare" wanted a project within welfare technology in the program. The task fell to the Nordic Welfare Centre, an institution under the Nordic Council of Ministers working with issues within health and social affairs who already prioritized welfare technology highly.
The task for the Nordic Welfare Centre was to design and complete a project that strengthened the general competence level and implementation power within welfare technology in the public sector of the five Nordic countries.
Within this frame, the Nordic Welfare Centre decided to design a project directed at the more than 1200 municipalities in the Nordic region. Municipalities are the main service providers within the Nordic welfare model and they are also the public level most directly involved in working with welfare technology today – so a project with municipalities as the main target group would have the greatest impact.
From there the Nordic Welfare Centre looked at the municipal challenges when working with welfare technology – Are they similar across the Nordic border? Are we facing the same problems? – in short does it even make sense to cooperate at a Nordic level within this field?
The answer was a resounding yes. It turns out, that in spite of obvious differences in development, marked strength and competence level across the Nordic region, we all seem to face the same basic problems when trying to work with welfare technology. These main issues are:
Too many projects with too little end product
- A common Nordic problem. Municipalities loves projects, for various reasons, but unfortunately they remain projects and are often run as something extra and not as an embedded part of the actual everyday service delivery. This means that the knowledge obtained in the projects remain in the projects and are never integrated in the organization. This results in municipalities jumping from project to project with very little actual implementation or end product.
We are all unique
- We are still not good enough at sharing knowledge and experiences – acknowledging what others have already done. Too many municipalities tend to think that they are unique – their citizens are unique, their organization is unique etc. This means that whatever others have done before, simply does not apply to them. This "not invented here" thinking produces too many similar projects, which is wasting valuable resources.
Weak common Nordic market
- Surprisingly the common Nordic marked for welfare technology is fragmented. The Danish public sector prefers to buy from Danish suppliers, Swedish from Swedish etc. This does not apply to traditional assistive technology, but as soon as something is digital the markets weaken. This remains a barrier, naturally more so for the weakest of the Nordic markets. Overcoming these challenges and raising the knowledge and awareness regarding welfare technology at a municipal level would prove a significant boost for welfare technology in the five Nordic countries.
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Methodology and approach
The idea to counter the before mentioned challenges was to first create the optimal process for working with welfare technology. For each step in this process, we would create a best practice tool kit. This would give everyone easy access to best practice knowledge and it would help municipalities gain a structured approach to working with this area.
The CONNECT process and toolbox hope to:
Provide knowledge and experience
- Hopefully having a validated Nordic toolbox would help raise the general competence level, as knowledge is gathered and readily available.
Create a common frame for working with welfare technology
- Meaning if we all work within the connect frame, sharing experiences is much easier, as we know we all follow similar models or similar guidelines. If Copenhagen knows that Oslo has already evaluated a given technology, using the same or a similar evaluation model to themselves, then sharing experiences and learning from each other becomes much easier.
Structure helps embedding knowledge
- By working with a structured approach like connect, it will help you realize the complexity of working with welfare technology. This insight will help you follow the steps and integrate your projects into your organization better – to better learn and to optimize the chance that project becomes an implemented solution.
- Although indirectly, having a common Nordic frame will help suppliers sell across the Nordic borders. If we use the same framework, we will ask the same questions making it easier for suppliers.
To understand more about the process and toolkit see the section: Explaining the CONNECT process.
It was important to CONNECT that both the process and the toolkit was formed through a bottom-up process, meaning that the best practice knowledge the process and toolkit contains, should actually come from the municipalities themselves. For this reason it was decided that the project-consortium behind CONNECT should consist of ten Nordic municipalities, two from each country – and they should be considered front-runners within welfare technology in their respective countries. The selection process was made by the Nordic Welfare Centre in cooperation with national actors such as the respective national organizations for local and regional governments. For Norway a special consideration was made. Given the fact that Norway had a newly established national program for welfare technology, in which more than 30 municipalities participated, it was important that the two Norwegian participants in CONNECT also participated in the National program, to insure synergies and mutual learnings from each project.
In the end the following ten municipalities were selected:
- Denmark: Aarhus and Odense.
- Finland: Oulu and South Karelia.
- Iceland: Reykjavik and Akureyri.
- Norway: Lindås and Lister.
- Sweden: Västerås and Gothenburg.
These municipalities formed the main core of the CONNECT project-consortium. But, it is important to CONNECT that the process and tools created could be used by all municipalities across the entire Nordic region. So, to counter any bias the above composition of municipalities may give, we decided to include certain relevant national authorities to give input along the way. This to ensure that our guidelines etc. was equally useful in a metropolitan municipality and a rural municipality.
The national authorities giving input in CONNECT is:
- Denmark: KL (National organization for local governments).
- Finland: THL (National institute for health and welfare).
- Iceland: Ministry for Welfare.
- Norway: KS (National organization for local governments) and The Norwegian directorate for eHealth.
- Sweden: SKL (National organization for regional and local governments) and The Swedish agency for participation.
You can read more about each participant in the "Participants" chapter.
The first objective for the project was to agree on the process. The team agreed on a nine step process which in theory is chronological. We say in theory, as we realize that in real life steps may intertwine – but thinking of the process as chronological can help you gain structure in your approach to working with welfare technology, and also insure that you have thought it though and covered all bases.
The steps were created using the following process: the Nordic Welfare Centre sent out a template gathering information from the municipalities. These input was then compiled into the first draft of the step. This first draft was then discussed in each country, through a national meeting between municipalities and authorities from each country. Each country then sent feed-back to the Nordic Welfare Centre, who in return produced a second draft. This second draft was then discussed in a common decision meeting in which all participants joined in. The resulting third draft was then open for input from other municipalities or relevant actors, in a hearing process. During the CONNECT project more than fifty municipalities gave input to the steps. The external input was discussed during the following decision meeting, meaning in the end it was still the CONNECT municipalities deciding the final content of each step.
Three years of close cooperation between ten very different municipalities and seven national authorities from five different countries naturally had its challenges, but turned out smoother than expected. Due to differences among the countries both when it comes to the definition of welfare technology, but also motivation for working with welfare technology more compromises was expected. But, as the project started to take form, it turned out that the ten municipalities were very much in line creating both the process and each step.
Naturally there have been discussions along the way and some had a greater focus and competence within certain steps over others, but overall welfare technology remains an area obvious for Nordic cooperation, as our service delivery and mindset towards public sector innovation is very alike. Furthermore, this is an area in which we can all learn from each other.
Working with welfare technology is complex and tightly connected with service delivery, organization, staff, end users, etc. The many aspects mean that you can always find inspiration and learn from others, even if you are among the absolute best within this area. The ten participating municipalities did not only learn from each other during the project it also facilitated closer cooperation between them. Closer cooperation not only across borders, but also between the municipalities from each country, a very positive byproduct from this project.
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Introducing the process and toolbox
The process is designed as a guideline for working with welfare technology in a municipality. These are the nine steps you need to be mindful of to optimize your chance of success, optimize your chance that your project becomes an implemented solution.
- Communication Plan
- Needs Analysis
- Market Screening
- Evaluation Model
- Procurement Plan
- Implementation Model
- Effect Monitoring
Unsurprisingly many of the steps are steps you would also find in any other innovation process and some are more specific to working with welfare technology.
CONNECT would like to underline that the above process is meant as inspiration and assistance. We are not trying to tell municipalities what to do or how to do it – everyone is free to pick and choose. You can use it all in the chronological order it is conceived or you can choose the steps that fits your organization and simply let those inspire you. We do however recommend you at least consider the entirety of the process, to ensure your work with welfare technology is properly integrated in your organization.
When going through each step of the toolbox, you will find a small introductory text for each step stating what this step means and why it is important to the entire process.
It is also important for the CONNECT team to underline that while this is what we consider to be best practice, it does not necessarily mean that all ten municipalities have done all of the steps exactly like it is presented here. All ten municipalities have experience with all steps and all ten municipalities agree that this is best practice, based on their experience – but it does not mean that all ten for instance have a specific procurement plan for welfare technology. The ten CONNECT municipalities are among the first movers, learning as they go – this document, these steps, are collecting that knowledge and these experiences for others to follow and avoid some of the challenges they faced (for instance by not doing one or more of the above steps). All steps contain a section in the end that is called "practical experience". This is examples of that given step from the ten CONNECT municipalities. However, not everything is available through links – so to get practical examples you will in many cases, need to contact the municipalities directly (contact information is provided under the "participants" section). You are welcome to contact all ten municipalities, even if they are not mentioned in the given example section. Given space restrictions in this publication, it is also likely that you will find more detailed information and more examples on our webpage: www.nordicwelfare.org/connect
The steps themselves are thought of as a toolbox. It is a relatively short document offering a few general recommendations, a host of specific guidelines based on experience from the ten CONNECT municipalities, a methods and tools section in which we point towards existing methodology that the municipalities have found useful. For instance, in the step for evaluation model, we point towards 4-5 different models and it is then up to the reader which evaluation model they think will best fit their purpose and their approach. Finally, there is the examples section – which is merely meant as a teaser. It does contain links, but we encourage readers to contact the municipalities for more detailed information. We hope you find our toolbox useful and welcome any input you may have.
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