Background
Located in northern Europe and roughly the size of Arizona, Finland has a strong reputation for providing innovative and expansive social and healthcare services and producing excellent results. Among other innovations, the government is famous for offering expectant mothers a “Finnish Baby Box.” The box—which doubles as a baby’s first crib and contains toys, clothes, and sheets—is a key reason that Finland has one of the lowest infant mortality rates in the world. More broadly, the country is known for guaranteeing “social welfare and health services…as a basic and fundamental right of the whole population.” In part because of this broad support structure, Finland has a life expectancy of 81 years, one year higher than the average for countries belonging to the Organization for Economic Cooperation and Development.
May 2012-August 2013: Building A Team and An Effective Governance Structure
After formally launching the Apotti program in May 2012, Välimäki and his team focused on creating a shared vision—and, more broadly, fostering a common culture and understanding—for their endeavor. Developing this synergy was critical because Apotti brought together stakeholders from a wide array of backgrounds. For example, Välimäki was an IT professional, who had spent most of his career in the private sector; however, he would now be leading an initiative involving multiple public sector organizations. Similarly, the program involved leaders from different localities and providers from the healthcare and social services sectors, which, as noted earlier, had little coordination. At first blush, the divisions and disparities appeared stark.
Thus, Välimäki took steps to ensure that different stakeholders understood and embraced one another’s approach. To cite one example, healthcare professionals referred to the people they were treating as “patients,” whereas social services officials used the term “clients.” Välimäki emphasized that both identifiers were appropriate because they were now united by the common mission of improving the lives of the 1.6 million citizens they were serving. “We always need to talk about clients and patients,” Välimäki emphasized, “because we are now integrating the social care and healthcare system. That is very, very important.”
Välimäki complemented this shared vision with a staffing model and governance structure that allowed the team to draw on a wide array of opinions while still making quick, nimble decisions. Specifically, Välimäki hired 65 Apotti associates, who came from a wide variety of backgrounds (e.g., nurses, physicians, and social workers) and were therefore able to provide a “broad understanding of the workflows and strategies in their respective departments.” He also encouraged his associates to remain in close contact with 650 “subject matter experts” in the healthcare and social services systems. These experts were situated on the ground in their respective organizations but were also positioned to make observations and provide input on Apotti’s decisions for system design and implementation. Thus, senior-most officials were able to remain in touch with and learn from personnel on the frontlines of the reform effort while still maintaining a lean hierarchy so that they could move swiftly through the reform process.
This approach is telling for other agencies hoping to scale the Human Services Value Curve. Rather than immediately jumping to technological change and data-driven reform, Välimäki ensured that Apotti had a cohesive team and strong structure. In other words, he laid a human and institutional foundation for innovation.