Promoting fundamental breakthroughs in health and health care through innovative projects, including those from nontraditional sources and fields.

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HE PIONEER PORTFOLIO promotes innovative projects that can lead to fundamental breakthroughs in health and health care. Similar to research and development investments in the for-profit sector, projects under this Portfolio are future-oriented and often look to nontraditional sources and fields to make significant improvements in health.

While the Foundation has always been interested in pursuing cutting-edge ideas to improve health and health care, establishing this Portfolio in 2003 marked the first time a discrete pool of funding had been set aside specifically for that purpose—to invest in high-risk ideas that could have major impact. The Pioneer Portfolio provides a distinct alternative to programming aimed at specific problems targeted by the Foundation.

The Foundation’s approach to developing the Pioneer Portfolio has been to challenge the field to submit breakthrough ideas, and to invest across a wide range of topics and strategies, starting with exploratory grants and then making subsequent investments in the projects that show the most promise. Consistent with that approach, our investments in 2004 included a series of grants that are largely exploratory, such as:

• Creating a set of universal symbols to help patients—especially those with limited English proficiency—more easily navigate health care facilities;

• Exploring how the emerging discipline of complexity science—an interdisciplinary approach to understanding how complex systems evolve—can inform health care quality and chronic illness management strategies;
• Examining the potential role of health impact assessments—akin to environmental impact statements—as a policy tool to improve health;
• Assessing the potential impact of advances in neuroscience on the delivery of nonprofit behavioral health services;
• Supporting and growing the community of developers and scientists who are seeking to use the medium of video games to improve health and health care;
• Convening and creating a loose network of innovative physicians who have created primary care practices based on a new model of care.

Progress on two topics—medical malpractice and information technology—could lead to long-term improvements in U.S. health care. In 2004 the Foundation invested in both areas. A joint grant to the Common Good Institute and the Harvard University School of Public Health is aimed at designing a prototype for a new medical injury compensation system that includes specialized administrative courts. A partnership with the Markle Foundation, the Connecting for Health initiative, seeks to lay the groundwork for an effective and secure national health information network that would make patients’ medical records available when they are needed, to those authorized to access them.