The Hospital of the Future

"The idea is if you're a breast cancer patient and you've gone to our Betty Ford Breast Cancer Clinic and then move to a medical oncologist or surgical oncologist, all of the information and data will walk with you virtually from one setting to another. That's hard to do even when you have a unified approach where everyone is under the same umbrella," Van Vranken says.

As patient care becomes the foundation of the hospital of future, healthcare organizations are going to have to be more sophisticated about how they track patients and their data. Even the Home Shopping Network, Van Vranken says, knows who customers are and what their history is, but providers aren't able to quickly access that information on patients, even when the providers' offices are side by side.

"We've got a long way to go in terms of being savvier as an industry," Van Vranken says. "Boomers are going to expect us to have that kind of an understanding of who they are, what their experience was at the previous visit, and obviously what the clinical conditions were in the visit prior to them coming."

Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.

CREATING TOMORROW'S HOSPITALS

Hospitals are facing a future of significant change. Patients will be older and sicker than ever before, but they will also be better educated about their care and, as a result, more demanding about the patient experience. Hospitals will need to pay close attention to every detail—from the front door to the patient bed. And although hospitals will look drastically different, some of the biggest changes, like sound-proofing, wireless technology, and energy preservation, won't be visible to the patient eye.

1. Rather than report to a central admitting desk, patients and visitors are welcomed by greeters who escort them to appropriate locations.

2. Décor is focused on nature with earthy colors; indoor gardens, trees, and fountains; and ample natural light.

3. It's much quieter thanks to sound-absorbing tiles, wireless communication, and limited overhead paging.

4. The lobby is consumer-centric with coffee shops, sitting areas, and kiosks for requesting information and scheduling appointments.

5. More attention is paid to wayfinding and signage, and hospital departments are given names that are less "medical" in nature (e.g., "lung institute" rather than "pulmonary care").

6. Preventing disease and encouraging wellness are as important as diagnosing symptoms and treating illness.

7. Patient rooms are private, standardized, and bigger to allow overnight space for family members.

8. Patient rooms include built-in safety features like bathrooms located near patient beds to reduce falls and prominently placed sinks to encourage handwashing.

9. For patient education and family entertainment, patient rooms and waiting areas are equipped with flat-screen TVs and Internet access.

10. Electronic records are standard practice.

11. In-home monitoring and diagnostic tools make it possible for patients to be diagnosed, treated, and monitored in their own homes.

Common Traits

Ask a healthcare leader to describe the hospital of the future, and you'll likely hear a lot about pie-in-the-sky technologies and over-the-top designs. There are some simple concepts, however, on which multiple experts agree.

Hospitals will be patient-centric.Tomorrow's patients will expect more from hospitals in terms of surroundings and care, says Debra J. Levin, president and CEO of the Concord, CA-based Center for Health Design. As chronic disease is better managed or managed at home (see "The Medical Home," p. 36), hospitals will go from being places that diagnose and treat disease to being true "healthcare facilities" focused on wellness and disease prevention, says Levin. Wellness and complementary medicine won't just be add-ons; healthcare will truly become integrated medicine.

Although hospitals will pay more attention to the patient space in terms of comfort and quiet, Levin predicts less money will be spent on nonessentials such as, for example, an over-the-top lobby. "These past few years, money has not been tight. There's been money to do these grand things, but I think you're going to start to see those dollars get tighter. As they do, those limited funds will spread to the patient areas," predicts Levin.

Hospitals will be greener. Whether it's by making one-time-use products reusable or by installing recycling chutes beside trash chutes, hospitals are increasingly looking for ways to "reduce, reuse, recycle," says Patty McClimon, senior vice president of planning and business development at Nationwide Children's Hospital.

"Of all the places that should be environmentally friendly and safe to live and breathe in, you'd think a hospital would be high on the list. It's our responsibility to be thinking not only how it's happening today, but what it's going to be like 10 years from now," McClimon says.

Going green not only improves the environment, but it also reduces costs. Hospitals of the future will have to find ways to build in energy-saving systems and processes for reducing waste.

Hospitals will be safer. Designs that improve patient safety are among the biggest improvements being implemented into new hospitals today, says Levin. New hospitals are installing materials (e.g., nonslip flooring) and systems (e.g., electronic health records) that are safer for patients.

Hospitals will only become more focused on safety as the Centers for Medicare & Medicaid Services and private insurers refuse reimbursement for certain preventable conditions. At Nationwide, for example, patient rooms are designed to reduce patient risk. Sinks are prominently located to promote handwashing, and patient beds and bathrooms are along the same wall to reduce falls.

—Molly Rowe

The Medical Home

The hospital of the future may not be a hospital at all—at least not in the traditional sense. Health technology is going to allow for much of what happens in hospitals to happen outside—either through outpatient care or in patient homes, says the Center for Health Design's Debra J. Levin. "People are going to be able to be monitored, seen, overseen in their homes rather than having to go to doctors, check into hospitals, wait at ambulatory facilities for their next visit."

The "medical home" will alter the concept of disease management by enabling providers to continuously monitor patients who are chronically ill while keeping them out of the hospital (and saving hospital resources). Primary care providers who now struggle to see, say, 35 patients a day will be able to coordinate care for dozens of patients without actually seeing them in an office.

The medical home concept is gaining momentum with doctors, health plans, employers, and consumers, says Paul Keckley, PhD, executive director of the Deloitte Center for Health Solutions—but until now, incentives have not been in place to push the idea forward. That may change, Keckley says: The country's six biggest health plans have established pilot programs to test the medical home concept.

—Molly Rowe