Embrace Disruption Instead of Forced Reinvention
By Paul Stefanski, AIA, EDAC, LEED AP | EUA Healthcare Studio Director : Principal
Disruption often is perceived as a negative thing, but that is not always the case. Undoubtedly, the COVID-19 pandemic brought major disruptions to all industries, with healthcare being no exception and arguably shaken more than any. No person or industry is immune from change. Some disruptions are unpredictable, and some can be anticipated. The challenge moving forward will be choosing to innovate instead of being forced to reinvent. In my 23 years of working with healthcare facilities, I’ve noticed a clear pattern of those who adapt and embrace disruption faring better than those who do not. Some aspects of the “pre-COVID” world will return, and some will inevitably, be changed forever. Following are just a few of the healthcare industry disruptors today.
Self-triage
As the pandemic continues to slowly loosen its grip on society — largely thanks to the herculean efforts of care providers — healthcare systems need to transition from reactive, short-term planning to a focus on the post-crisis, long-term challenges that remain. Just as care providers perform triage to assess and treat the most urgent needs first, the same can be applied to health care systems. Urgent needs include managing capacity and staff resiliency through remaining pandemic surges.
The next priority is to stabilize financials and recover volume. Once these items have been addressed, it’s important to understand how new consumer behaviors and preferences are informing changing health status as well as equity and adjust accordingly.
Taking Advantage of the Crisis Recovery Period
It’s easy to feel overwhelmed by the challenges that remain from the pandemic. However, like it or not, it’s given us the opportunity to change ourselves. There perhaps has never been a better time to reorganize governance and leadership structures to better serve the system. Emergency response efforts highlight organizational structures that slow down decision-making and hinder coordination.
Financial pressures also can jump-start conversations with difficult, but necessary, decisions about which business functions to keep in-house and which can be outsourced to third parties. Conversely, this is a good time to evaluate which services should be brought back and where; a recovery period could provide the chance to sunset underperforming programs or shift settings. Capacity and where procedures occur always can be re-evaluated. While more outpatient capacity is needed, health systems will be even more reluctant to down-size acute inpatient capacity. After clinging to hospital-based reimbursement, hospitals will confront which services can safely move to alternative sites of care.
Virtual Healthcare is Here to Stay
Although the size of the role virtual care will play moving forward is contested, most people agree it has been incredibly influential. Many aspects of virtual care are sure to be permanent parts of the care landscape moving forward. After being forced to use telehealth, consumers (and some physicians) will expect continued availability of virtual care services. Some patients even prefer virtual visits to in-person ones. Although it has its limitations, virtual care is particularly beneficial for those who don’t have readily available, close access to health care, such as those in rural communities. If the choice is between a virtual appointment and not being seen by a physician at all, something is better than nothing. Dr. Eric Topol, physician, scientist and author, said, “In the years ahead, I expect some 50 to 70% of office visits to become redundant, replaced by remote monitoring, digital health records and virtual house calls.” Although technology certainly has its limitations and always will, as it continues to progress, the limitations will decrease. Digital disruption has and will continue to cause some drastic industry changes, but the focus should be on how the changes can enhance and further personalize our health care experiences. Technologies such as artificial intelligence, precision medicine, robotics, drones, 3D printing, virtual reality, Internet of Things and mobility have allowed major advancements to occur in the field and provided conveniences that we didn’t even realize we wanted. Things that would’ve been hard to imagine 50 years ago are starting to become relatively common now. It’s exciting to think about how much further technology will advance medicine.
Retailers Are Relevant
Retailers have been playing an increasing role in the health care industry for several years now, with hybrid companies such as Walgreens, CVS and even BestBuy providing patients and customers with a streamlined experience. With increasing interest from big tech companies, retailer involvement could look quite different in the future. The Advisory Board recently published a report summarizing Google, Amazon and Apple’s respective goals in the health care space and provides considerations for health care leaders preparing for their lasting impact. Companies such as these are known for breaking boundaries and they’re taking the healthcare industry along with them.
Disruptors’ Effects on Healthcare Facility Design
No one knows exactly what the future holds or how these disruptors will play out, but I believe they will all aim to improve the patient experience. From an architectural standpoint, I anticipate designing more decentralized facilities, such as neighborhood or micro-hospitals, that are accessible to a community rather than having to go to a large campus. Spaces also will continue to be shaped by technology; this could include special conference rooms with neutral backgrounds that are equipped for virtual patient visits, hoteling stations for physicians or even Smart Rooms that offer patients a large amount of control over their experience. For example, in Smart Rooms, patients are able to answer preliminary health questions, adjust the temperature and lighting levels to meet their preferences, review their personalized health plan or progress toward goals since their last visit, or just watch some entertainment while they wait — all from a flat-screen panel in their room. Even pre-pandemic, our healthcare clients already were testing ways to consolidate the registration process. People no longer need to register with each department individually but now can check in at a single, centralized location. This has resulted in shrinking waiting areas because people are waiting less. This improves the patient experience and frees up real estate for other uses, such as enhanced technology or hospitality amenities.
Challenges Are Inevitable, Fear Is Not
With any disruptors, challenges are inevitable. While many of the disruptors listed above hold enormous promise, it would be unwise to gloss over their limitations. For example, everyone — patients and care providers alike — have different levels of comfort with technology. Also, the more we rely on technology, the more crucial it will be for our systems to be reliable and secure. When cloud-based systems began to emerge several years ago, most health care systems were extremely hesitant to embrace the technology — and for good reason. Patient confidentiality must be protected at all costs. Now, many of the initial concerns have been addressed and security measures enforced to the point where cloud-based systems are largely the norm, regardless of industry. That being said, there’s never a time to not be vigilant, especially when it comes to the protection of health data being breached, be it through a hospital system or personal devices such as Fitbits or Apple watches.
Although the risks disruptors pose are very real, I believe there is more room for enthusiasm than fear and encourage those in the health care industry to embrace coming changes, even if it means you’ll be adapting and adjusting along the way. Healthcare systems should consult experts at the start of facility planning and design to stay ahead of patient and consumer demand and establish themselves as providers of choice for the present and the future.
Originally Published in the Colorado Real Estate Journal (CREJ) Health Care & Senior Housing Quarterly
Also published at www.eua.com and LinkedIn.
