Healthcare Facility Trends in the West

Percolate to Asian settings

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Sumandeep Singh

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Sumandeep Singh is a Health facility Planner with over 11 years of experience and currently works with HKS, a global Healthcare Design firm headquartered at Dallas, TX , USA. He has worked as an Exchange fellow at Dallas, Tx, USA with the International Healthcare planning team. He is immensely passionate about Hospitals and Laboratory Design and has planned projects of all scales starting from 100 beds to 1000 beds super specialty facilities. He is involved in all stages of the projects ranging from Programming, Planning, Medical Equipment Coordination and Parametric design for Healthcare projects in India, China, Hong Kong, Macau and Singapore.

Healthcare Delivery in the west and Asia has strong parallels, specially in the private sector. A tectonic shift is visible in the Healthcare sector in the US due to various factors. These may resonate with Asian healthcare settings. It is pertinent to look at trends such as Resilient design, Ambulatory focus, Technology with an Asian perspective.

Healthcare and disease for most part is geography agnostic. The Nature and spread of chronic ailments is similar and hence care for the same is also same globally. The kind of treatment a breast cancer patient needs in India is akin to that in another part of the world. Developed economies like the Unites States have developed refined processes with respect to healthcare as a resultant of market -economy and consumerism which is similar to the private sector-lead healthcare in Asian countries. This establishes the fact that there is much to learn from the successes and failures of those processes in the west. Healthcare facilities are seeing a radical shift in America due to various policy driven and technology driven measures. The same is being followed up in Asia, in part due to borrowed expertise and equipment, in addition to the education. What are the healthcare trends that are driving the building/facility arm of it. Let us analyse some of those.

Resilient design – Natural disasters have increased globally and ask for a change in priorities in construction methodologies. In the wake of rampant natural disasters, for instance the floods in the Indian state of Kerala which took more than 320 lives, resilient building design takes center stage. The same sentiment is echoed in the 2018 construction survey by HFM magazine, in which they suggest that a hospital building must be designed to protect its inhabitants and its service infrastructure from collapse. Major strategies including flood-gates, electricity-isolation from grid, refuge zones using water-resistant walls must be employed in buildings located in areas prone to flooding. Passive fire protection, a concept wherein, special fire-stops joints are fixed to seal-off or contain fires in specific zones, must be adopted.

Outpatient Focus - Increased focus on ambulatory or outpatient services. There is an underlying trend that is pointing towards a paradigm shift in how hospitals assess their performance. This is the slow but steady decline in the time spent on nursing a patient inside the facility. For most part it is due to more and more procedures being done in outpatient settings. The non-sterile procedures traditionally done in surgical settings no longer need the sterility thanks to the technological advances. An example of the same is the HIFU (High intensity focussed ultrasound) technology, a cutting edge technology used to cure prostrate tumors which is revolutionising this procedure and without the need of surgery, the whole process is over in a few hours. The King Fahad Medical City in the middle east uses this technology to cure prostrate cancer much faster with much less inpatient time required. What this leads to is decreased emphasis on Inpatient areas,which can then be assigned other functions like IT collaborations rooms and control centers.

Technology focus - Facility designs are being overhauled rapidly to accomodate IT and handheld device monitoring and control. Hospitals are increasingly feeling the need to renovate due to changing needs, for eg, the need to have more computer rooms, media centers and collaboration spaces to manage the hospital networks’ remotely located observation and treatment centres. AN eco-system driven geographical focus is seen at the hospital system level, where specialties are shared between facilities, services are overlapped to cut operational expenditure and staff is also shared and technologies like telehealth take precedence to save valuable time and physical infrastructure cost. Cameras inside OT lights are not a new phenomenon, these are used for live-training of students in medical education settings. Simulation labs to train paramedics and other staff are a serious investment that owners are willing to make. HPSN, the Human Patient Simulation Network is an organisation that carried our simulation workshops across the world , using latest technological tools like screen-based simulations, wearable simulation VRs etc.

Patients OR Consumers ? -Patient Experience- in addition to the clinical excellence expected, patients are acting more and more as consumers and appreciate the sensory experiences, hospitality quotient and facility design in general, and all this at convenience, ease of use and lower costs. Access of hospitals to patients and vice versa through wearable and remotely monitored devices will take most load off the diagnostics and will leave the critical spaces for the more serious cases only. Spaces will be optimised for the patients and operations and management will be rectified for the ‘consumer’. As Robert Pearl states in forbes article ‘Are You A Patient Or A Healthcare Consumer?’ by Robert Pearl, M.D., Pharma & Healthcare, the author concludes that we wear both hats at different times, that of a patient and of a consumer.

If these trends are to be considered, healthcare buildings will look and feel very different in a few years and will also alter our behaviour with them. Prevention will be the key underlying theme of healthcare and policies will keep driving the innovations and vice versa.