By Russell Lamb – Managing Director.

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What will hospitals of the future look like?

All of us who work in health design have a significant role to play in this, but keeping up with changes in technology and innovation, as well as understanding what people (not patients, users, or consumers) actually want from the health facilities that serve them can be tough to keep on top of.

In an effort to keep up with the latest thinking, I recently took a few days out of the office (never a mean feat) to attend both the 2018 World Hospital Congress in Brisbane, and the Health Care/Health Design Forum in Sydney. My goal was to better understand what hospitals of the future will look like….and how my team and I as designers, can play a role in helping to shape this future.

I heard some incredible presentations from the likes of Minister Greg Hunt, Professor Elizabeth Teisberg, Dr Daphne Khoo, Nigel Edwards, Dr Jeffrey Braithwaite, and Professor Keith McNeill to name a few. It was hard to distil the key insights down to just a handful, but here are the six that have stayed with me long after the conferences have ended, and the ones I have found myself talking to my team and clients about the most.

1. Inclusive, human-centred design is critical

It might be a buzz phrase, but we’d better get used to the idea of inclusive, human-centred design because it’s here to stay and it’s important.

What is it exactly? My view is that inclusive design is about meeting the needs of the widest number of people in our designs, and the human part is about focusing on the people that will experience the environment that we design – either through working in it, visiting it, or being the person receiving care in it, and not about us as designers. We are seeing a return of health care to its intended purpose, and the return of the patient as a person – not just as a bed number. Services will be delivered less from a position of authority and more on the terms of the patients’ needs and wants than years past.

To illustrate this, one of the presenters joked about the receptionist who called through to the Specialist and advised “Your patient is now ready to see you!”

So, for us as designers focused on inclusive human centred outcomes, we will need to be asking ourselves – how can we better immerse ourselves, listen, ask, prototype and co-create? How can we design health experiences – not just health care buildings, spaces, services and systems?

And when we get the answers – we need to truly take them on board in our designs, and not just focus on the design features that we might otherwise have thought were paramount, like an appealing external façade, a whizz-bang HVAC system or a break-neck speed communications network.

Architects and engineers need to be innovative leaders in this space, and not simply trailing what’s been done before.

2. Spaces will become more flexible: ‘Health Care’ and not necessarily Health Care Facilities

There’s going to be an increasing trend towards more flexible spaces, and this will go so far as to include more shared services such as bathrooms.

I hear a lot of talk in health and aged care like ‘as little bricks and mortar as possible’ and ‘knocking the walls down’ in the context of increasing connection to community, and maximising flexibility of health care spaces. A great idea even though it’s not physically possible in almost all cases – but the question is, how can we create spaces that facilitate better and more varied use, and that provide better connection between patients and community ?

3. Data (stay with me on this one)

If you listen to everyone who’s anyone, the future is all about data – having it, understanding it, using it. But what I took away from the conferences was the idea that it’s all about deep data, rather than big data.

The data that’s available and relevant to us as designers in the health care environment may seem overwhelming.

In the recent era of Big Data, it’s all too easy to struggle with the vast amount of data that has been stockpiled by capturing every piece of information available to us, not knowing how to pinpoint and extract the right information that will offer real benefit, when we need it.

The Deep Data framework is based on the premise of a there being a smaller number of information-rich data streams that, when wisely leveraged, produce much more meaningful information, with much less effort and at less cost.

I wonder whether the use of Deep Data may be the key to better understanding what matters in health care, allowing us to implement actionable and scalable insights – simultaneously improving patient outcomes and economic value, whether as part of the public or private health care systems?

Do we also need to think and treat data as a gold seam – and not as the tailings heap of an open cut mine?

4. Is technology our friend or foe?

We all have an inkling that technology is integral to future health care design, but are we relying on it too heavily as our saviour?

You may also ask whether technology actually makes things better in all cases – or can it actually undermine some critical aspects of what people need or want in health care, contributing to social isolation and worsening their mental and physical health outcomes?

We all know that we’ll see significant innovation in health care technology as we’ve seen in other industries – it’s only a matter of how much and how fast. We will see ever increasing community expectation to adopt the latest technologies as soon as possible, which is often at odds with the health industry being very risk averse and highly regulated.

So, with the increasing onset of technology and the clear understanding that technology can enable more patient centric-care and improve value-based care, the challenge will be in balancing the negatives that come with the positives.

5. Technologies supporting health care – what does that mean to us as designers?

Through my time spent at the Hospital Congress and the Health Design Forum I developed an increased appreciation of the ever growing list of technology integration into health care, like Augmented Reality (AR), Virtual reality (VR), Mixed Reality (MR), Mobile Health (MHealth), frugal technology (the use of smart phones for health care), wearable technology devices, and so on, and so on.

Dr Justin Yeung’s presentation on emerging technologies showcased Western Australia’s significant advances in this space with its 4th largest ED being delivered virtually. They serve some of the state’s most remote hospitals by health care professionals in various locations throughout the state, with staff soon to be in Sydney and New Zealand, and with consideration for staff to be in the UK to deliver night time services in WA by taking advantage of different world time zones.

Phygital (no, that’s not a typo) is another term that we’ll need to get used to; it’s the joining together the physical and digital, the blending together of digital experiences with physical ones.

On a different tack, an important question for the design fraternity is how Augmented Reality may help architects, design engineers and urban planners to communicate their designs to stakeholder groups, gaining important feedback and leading to more functional and fit-for-purpose designs with higher levels of user acceptance of new and refurbished building projects.

What’s going to be next? Will we see the huge players like Google and Facebook moving into health care and being real health care industry disruptors?

And what will the design community need to do to help accommodate these Phygital and Assisted Reality technologies and other technology changes that are just around the corner?

6. Innovation – get ready to fail!

All innovation environments and systems need opportunities to fail. As Hans Kedzierski (CEO Aga Khan University Hospital, Karachi) outlined, Sweden has a museum of failures, and have a culture of not being embarrassed by making mistakes.

Traditionally the health sector has not been great at this, and for good reason most times. As Finn Pedersen of Iredale Pedersen Hook Architects stated “in the health sector innovation needs to be done nine times before, and hopefully next door, before people will take it up”.

To hold things back even further, it’s widely considered that it can take in the order of 13 years to adopt something new or innovative, and only after there is full confidence and trust in it

So, if we want to introduce innovation into our health designs, we need to:

a) get comfortable with failures ourselves, and then…

b) help our clients get comfortable with making them as well, otherwise by the time they get the tick of approval, the person in need of the care will have missed out on the benefits of the innovation or new technology.

The big tip on innovation? Fail fast, pivot and move on.

What does the future look like?

As well as my six key insights, I took away a clear message that hospitals of the future will be less about the physical delivery of services and more about being hubs for the concentration of experts’ skills and leading-edge equipment and technology.

In a design sense, this means that we must keep abreast of emerging innovation and changes in health care, and the knock-on effects to the systems and facilities that we design. Particularly we must focus on maximising flexibility and adaptability of facilities to accommodate continuous change in health care delivery.

And as we design, we need to keep in the back of our minds some key principles about what the future health system should look like. It should be:

• Inclusive and equitable.
• More integrated.
• Patient focused – achieving better patient outcomes and better patient satisfaction.
• Workforce focused – achieving workforce satisfaction.
• More evidence-based.
• A learning system and not a forgetting one.
• Technology – applied wisely in its use.
• Cost-effective.

Finally, we must be mindful that it’s not about the technology or innovation that we use in undertaking our designs, nor is it about what technology or innovation is embedded in the systems and infrastructure that’s built, but it’s about the value of the health care people receive that would otherwise not be available without the use of the technology or innovation. Technology is not a panacea to health care – but it will certainly play a key role in shaping it.

At the end of the day our designs should support health care and better outcomes for individuals and their families, and be less about iconic buildings or master-stroke engineered systems.

If you’d like to discuss any of these or other health design insights in more detail, contact me on russell.lamb@dmaengineers.com.au

What are your thoughts on what our hospitals of the future will look like? To join the conversation, head over to my post on LinkedIn.