The Future Of Healthcare Design – Outside The Point Of Care

By Bertalan Meskó, MD, PhD

When talking about the future of healthcare, we also have to talk about the future designs of the institutions providing medical services. However, with digital health technologies that democratise access to care, the point of care will not be limited to healthcare institutions. It will rather be split into two; with hospitals becoming health centres for disease prevention, acute care and surgical needs, while monitoring patients’ vitals will be done closer to patients themselves.

We explore these aspects of the future of hospital design in this two-part series. In the first article, we looked at design adjustments to accommodate digital health technologies to enhance the workplace of caregivers while providing a better patient experience. In this second article, we will look at how hospitals will also need to adapt their designs from outside the institutions.

For deeper insights into the subject, we turned to Diana Anderson, MD, M.Arch, and Principal of Jacobs, together with Cath Lewin RN, BN, senior health planner at Jacobs. Interviewing them for our Patreon site, they provided valuable insights to redesign healthcare from outside the point of care we also wanted to share here.

Ambulatory medicine transporting care outside of hospitals

One way medical services are already brought to the point of care is through emergency medicine; and in particular via ambulance services. Through these, first responders perform life-saving procedures where patients are.

Already, the largest public hospital system of the U. S., NYC Health + Hospitals, enables the use of telemedicine services by emergency medicine staff to treat patients on the spot. However, they can be further assisted by fitting ambulances with portable diagnostic devices. In fact, one can carry a department’s worth of diagnostic tools in their briefcase.

Handheld ultrasound devices like the Clarius and Philips Lumify allow first responders to easily assess a critically ill patient; no matter where they are. Abbott’s i-STAT blood analyser can make hours-long waits for laboratory blood test results a thing of the past. It allows caregivers to evaluate the patient’s blood sample on the spot and wirelessly transmit the results to colleagues. Another handheld device is the FDA-approved Viatom CheckMe Pro. It measures a number of vital signs from ECG through blood oxygen level to body temperature.

Equipping first responders with such tools will save valuable time. Thereby they can perform more tests and deliver appropriate care at the point-of-care. As Dr. Anderson told The Medical Futurist, healthcare of the future should occur across spatial scales; to include the micro-level of our homes and communities all the way up to the macro scale of the hospital campus within the urban context. And one space we can already conquer is emergency medicine, which already bridges hospitals and patients.

Patients as the point-of-care

As discussed in the previous section, portable diagnostic devices bring data to the point-of-care; but patients themselves can adopt personal health sensors and wearables to make more informed decisions about their health.

A smartwatch embedded with an ECG monitor like the Apple Watch can monitor their cardiac activity and notify them of suspicious signs. Others could use the FDA-cleared BioSticker smartpatch to continuously monitor vital signs like respiratory rate, activity levels, sleep status, gait and more. Subsequently, they can send the data to their physician to evaluate their health remotely. Similarly, there are a number of devices that can measure health parameters literally from head to toe.

“The emerging sophistication of wearable devices that goes beyond vital signs will likely reduce visits to hospital clinics and save time spent travelling,” Diana Anderson and Cath Lewin have told us. “This high-tech transition is challenging designers and architects to think about the future design of ambulatory centres and clinic space.”

But this design aspect will also require the input of physicians. They can serve as guides for patients adopting such tools. Physicians can instruct patients regarding how to analyse the metrics measured and when to seek medical attention.

Redesigning telemedicine for the receiving end

In the first article of this series, we discussed the increasing importance of telemedicine; and how designers must factor in the practice when planning future hospitals. “As a result of COVID-19 and funding changes, virtual visits have now become more accepted by providers and consumers,” said Dr. Anderson.

Already, 95% of providers are willing to use telemedicine. This indicates a trend that telemedicine is on track to become the new norm. To accommodate this need, Diana Anderson suggests “dedicated spaces for virtual consultations. These spaces should also include user-friendly sound and lighting control, with dual screens to simultaneously converse with the patient and access their medical records.”

But such redesigning is not only meant for healthcare institutions. It should also be applied on the receiving end – or the patients’ side. The latter could perform minor adjustments on their own; such as using a room with good internet connection and proper lighting. While minor, they also make the experience better for physicians consulting those patients. In particular, chronic care patients could heed to the advice; as even cancer patients continued their treatment thanks to telemedicine during the pandemic.

Democratising access to care

Ultimately, such redesigning of hospitals from the inside out aims to achieve a core principle of digital health: to democratise access to care. With health metrics obtained from wearables, patients are more empowered in managing their own health and can engage in an equal-level partnership with their physicians.

But while medical-grade tools become available at the comfort of one’s home, hospitals themselves won’t be obsolete. Rather, they could focus their resources on acute care treatment, surgical units, laboratories and imaging centres. Dr. Anderson and Cath Lewin share a similar view, seeing such high-tech facilities to be adequate for ‘very sick’ patients. “Those who are not critically ill could be supported in more expansive home-based care models and community programs, she suggests. In this model, virtual care will play a key role in the monitoring of chronic conditions, prevention and wellness.”

They also added a utopistic concept. “Perhaps our homes could contain a designated ‘health space’ or room; so that as we progress through life stages, we maintain our connectivity to care.”

As for the telemedicine service or app itself, a feature-rich and user-friendly interface could help. Our interviewees noted as a closing thought “more patients will likely need to be equipped with an at-home kit to help with monitoring metrics, from afar.” We couldn’t agree more.

Dr. Bertalan Mesko, PhD is The Medical Futurist and Director of The Medical Futurist Institute analyzing how science fiction technologies can become reality in medicine and healthcare. As a geek physician with a PhD in genomics, he is a keynote speaker and an Amazon Top 100 author.

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