Sweden's AI Renaissance: Strategic Investments and Policy Reforms Shaping the Future

From Economic Growth to Societal Impact: Implementing the Quadruple Helix Model in Regional Innovation Systems

A Series on Innovation Ecosystems

In our previous analysis, "Unlocking Innovation: A Deep Dive into the Triple Helix Framework," we explored how the synergy between the University, Industry, and Government acts as the engine of the knowledge economy. We established that the Triple Helix is fundamental for generating intellectual capital and driving economic growth through technological advancements.

Building upon that foundation, this follow-up article expands the lens to the Quadruple Helix (QH). While the Triple Helix excels in economic development, it often treats society as a passive recipient of innovation. This article argues that to solve the "wicked problems" of the 21st century—such as climate change and public health crises—we must integrate Civil Society as an active co-creator. This shift marks an evolution from a closed system of expert-driven growth to an open, democratic ecosystem focused on a broad societal impact.

The Theoretical Evolution

The transition from Triple to Quadruple Helix is not merely an additive process; it is a paradigmatic shift in the functional logic of innovation systems.

• The Triple Helix (TH): Historically, this model focused on the "Knowledge Economy." The interaction between the three helices produces consensus spaces where innovation is commercialized. The primary metrics of success were economic wealth and patent generation.

• The Quadruple Helix (QH): This model focuses on the "Knowledge Society." It introduces media- and culture-based public (Civil Society) as the fourth helix. Here, the public is not just a consumer but also a source of creativity and a validator of utility. This creates a system of "knowledge democracy”, ensuring that innovation strategies align with the actual values and needs of the community.

Figure 1 – The Quadruple Helix Model, adapted from Carayannis & Campbell’s mode of knowledge production.

Operationalizing the Model: Innovation Spaces

Implementing the QH requires moving from abstract theory to physical or virtual "innovation spaces" where the four helices can collide and collaborate.

Living Labs

Living Labs are the most distinct operational mechanism of Quadruple Helix. Unlike traditional R&D labs, Living Labs operate in real-life contexts (e.g. city blocks, hospital wards, or transport networks). They practice user-centred open innovation, where citizens are involved in the co-creation, exploration, experimentation, and evaluation of innovative ideas.

Smart Cities

Smart Cities serve as a macroenvironment for QH. By utilising digital technologies, local governments can aggregate citizen data (the fourth helix) to improve decision-making. However, a true QH Smart City goes beyond sensors and data; it utilises "Smart Governance" to allow citizens to propose solutions for urban challenges, effectively turning the city into a platform for bottom-up innovations.

Figure 2 - The Quadruple Helix innovation Cycle adapted from The Living Lab methodology concept

Case Studies in Practice

Case Study A: Ageing@Coimbra (Portugal)

• Context: An initiative addressing the societal challenges of an aging population in the Coimbra region.
• Application: This project operationalized the QH by creating a synergy between the University of Coimbra, healthcare providers, municipal authorities, and older citizen associations. By treating the elderly as active co-creators rather than passive patients, the project aligned technological development with actual community needs.
• Outcome: The collaboration generated dual value: "tangible" medical products and "intangible" social capital, such as increased trust and health literacy. This created a self-reinforcing loop where social and economic values are mutually enhanced.

Case Study B: Digital Health Testbeds (Sweden)

• Context: Sweden has established numerous "testbeds" to accelerate healthcare digitalization, with studies of 15 sites showing a clear shift toward the QH model.
• Application: These testbeds function as "Living Labs"—collaborative meeting places where private companies, patients, and patient organizations interact in real-world environments. Unlike traditional expert-led clinical trials, these integrate real-time citizen feedback directly into the innovation loop.
• Outcome: Including the fourth helix (patients) effectively "de-risked" innovations before market entry. This ensured that digital solutions were not only technically viable but also socially adoptable, successfully bridging the gap between "invention" (technology) and "innovation" (societal impact).

Figure 3 - Three the Dual Value of the Quadruple Helix Projects

Challenges and Solutions

Although the Quadruple Helix offers a more holistic approach, it introduces significant complexity.

The Challenges

1. High Frictional Costs: Coordinating four distinct institutional logics is resource-intensive. Industry seeks profit, academia seeks publication, the government seeks stability, and Civil Society seeks value/equity.
2. Institutional Inertia: Traditional institutions are often resistant to opening their doors to non-experts. There is a fear that involving civil society will "dilute" scientific rigor or slow down commercialization.
3. The "Elite" Trap: There is a risk that the "Civil Society" representatives invited to the table are merely elites or special interest groups, rather than a true representation of the diverse public.

Strategic Solutions

1. Strong Intermediaries: The establishment of neutral "boundary spanners" or intermediate organisations is crucial. These entities translate the languages of the different helices and manage frictional collaboration.
2. The Entrepreneurial Discovery Process (EDP): Utilizing the EU’s EDP methodology allows for a structured, bottom-up approach, where priorities are identified through broad consultation rather than top-down decrees.
3. Digital Democracy Tools: Leveraging digital platforms for voting, crowdsourcing, and feedback reduces the cost of engagement and allows for a broader, more representative slice of civil society to participate.

Reference List

• Arnkil, R., Järvensivu, A., Koski, P., & Piirainen, T. (2010). Exploring Quadruple Helix: Outlining User-Oriented Innovation Models. University of Tampere Work Research Centre.
• Carayannis, E. G., & Campbell, D. F. J. (2009). 'Mode 3' and 'Quadruple Helix': Toward a 21st Century Fractal Innovation Ecosystem. International Journal of Technology Management, 46(3/4), 201–234.
• Carayannis, E. G., & Grigoroudis, E. (2016). Quadruple Helix Innovation and Smart Specialization: Knowledge Production and National Competitiveness. Journal of Knowledge Economy.
• Etzkowitz, H., & Leydesdorff, L. (2000). The Dynamics of Innovation: From National Systems and "Mode 2" to a Triple Helix of University–Industry–Government Relations. Research Policy, 29(2), 109–123.
• Hedin, B., et al. (2025). Digital Health Testbeds in Sweden: An exploratory study. PMC/NIH.
• Kolehmainen, J., Irvine, J., Stewart, L., et al. (2016). Quadruple Helix, Innovation and the Knowledge-based Development: Lessons from Remote, Rural and Less-favoured Regions. Journal of the Knowledge Economy, 7(1), 23–42.
• Ricciardelli, A., Mercurio, L., & Salvatore, C. (2025). Advancing Quadruple Helix Theory for Health Systems Innovation: Evidence from Ageing@Coimbra. BMC Health Services Research, 25:1346.
• Roman, M., Varga, H., Cvijanovic, V., & Reid, A. (2020). Quadruple Helix Models for Sustainable Regional Innovation: Engaging and Facilitating Civil Society Participation. Economies, 8(2), 48.