In December, we asked our readers to tell us about the health care problems they felt were most in need of innovation—the tough problems, the crucial ones, maybe even those they’d seen firsthand. The number of comments we received was encouraging. It has also challenged our thinking, and generated a great deal of discussion on our team.

One thing is certain: The conversation that ensued from that post confirmed that our team needs to do more listening—listening to patients, caregivers, health care professionals, innovators, thought leaders—the list goes on and on.

We saw some common themes in the problems you shared. A few of them are reflected in areas in which the Robert Wood Johnson Foundation is already working. Clearly there are problems that, despite the intensive efforts of many really smart people, resist conventional solutions. Other themes showed us how important it is to always be examining what we’re doing from perspectives other than our own. 

So where do we go from here?  

In the Pioneer Portfolio, we’re all about ideas—big ones and little ones—the ones that will help solve some of the toughest problems in health and health care. We have clearly articulated our strategy for investing in innovations and innovators who have the potential to transform areas such as the health care delivery system, the patient-provider relationship, and the education of health care professionals. That strategy has yielded some significant breakthroughs, and the hope for much more to come. 

But we’re still missing a big piece of the puzzle. Why? Because right now, we only hear from the folks who have solutions to offer. That approach, by its very nature, limits the number of problems we know about. Those of us who work on the Pioneer team only see health care from the proverbial 30,000-foot vantage point. We are not on the front lines, so we don’t see firsthand the issues health care providers, patients, and families struggle with every single day.

This December marks my first year with the Robert Wood Johnson Foundation (RWJF) and with the Pioneer Portfolio. Throughout the year, I’ve been amazed by the team’s connection to health and health care innovation, and have been humbled to be part of RWJF as it celebrates its 40th anniversary.

As part of its anniversary celebration, RWJF announced its inaugural Young Leader Awards. I was excited that RWJF chose to honor 10 leaders, 40 and under, who offer promise for leading the way to improved health and health care. The Foundation recently announced the 10 winners who represent great diversity in the future of health care innovation.

Forty years ago, smallpox still existed. We hadn’t heard the acronyms HIV or AIDS. The Nixon administration had declared war on cancer and was about to introduce America to the health maintenance organization, aka HMO. Meanwhile, a couple of paramedics on a TV show called “Emergency!” and a new philanthropy, the Robert Wood Johnson Foundation, were introducing the nation to the life-saving concept of 911 and another acronym: EMS (emergency medical services).

Four decades later, the Robert Wood Johnson Foundation is the nation’s largest philanthropy devoted exclusively to health and health care, and we are still in the business of searching for solutions that will improve the health and health care of millions. As the Foundation marks its 40th anniversary this week, we remain committed not only to proven, evidence-based strategies, but also to new ideas that push boundaries.

How can design affect health and the delivery of care? Last year I and a group of Pioneer's guests interested in Project ECHO went to Mayo Clinic’s Center for Innovation Transform Symposium without knowing much about the conference's focus of design and innovation in health. I entered as a skeptic but left a believer. This year, Pioneer brought no guests but we did provide funding so that a number of students in the design, pre-medical, and medical professions could attend.

What do I mean by design? You might think that design doesn’t have a place in delivering innovative health care. Design is predicated on understanding the way people and the environment react to how solutions are packaged and presented. This is critical in the acceptance and ultimate success of health care solutions, and successful outcomes are an essential health care goal.