A new kind of Hospital System
Experts say “There is a mismatch between physical Hospital infrastructure and the type and volume of activities carried out.”
Technology and processes must support the cost-effectiveness in the healthcare sector, as people will begin to expect more from healthcare systems. Not only are there demographic and epidemiological changes but social expectations and the shape of cities and transport systems evolve to create a new context. Previously, hospitals have been made to fulfill known demands & it had taken years to develop from scratch business plan to a concept than to an operational hospital. Now it is figured out that approximately 70 percent of the planned activities & digital technologies will be changed by their operation on the first day.
“It also raises questions like how to use technology to develop cost-effective patient care? What do we do with physical buildings: Do we repurpose existing spaces or do we have to go to hub-and-spokes models?”
It is evident that people expect and demand more from the Healthcare systems, no matter where they are living and the challenges faced in this are universal. The effect of the Internet on medicines from the use of remote sensing capability to cloud computing data will be immense. Patients may not have to visit hospitals for monitoring themselves.
In the current transformative era, design can be disruptive – we can really rethink over it that how care is delivered. Transfer of ideas into change will be drastic rather than incremental.
“The challenge for hospital designers is vast. With huge unmet needs and demand, we have to include existing infrastructure as well as the political and economic climate. Healthcare can drive the economy and become a national strategic priority as in developed countries where there is a major investment in healthcare.
Also, the large pool of aging population is often better served with extra care closer to home. The virtual hospital operating through data networks using telemedicine and outreach clinics is a real possibility. In some countries, approximately 70 percent of consultations now take place over the internet. This disruptive shift will change the nature of the hospital profoundly. The system requires allegiance and brand much as social media companies now promote themselves. This future will still require physical infrastructure but more dispersed, smaller but with a strong identity.
New classes of hospitals fall broadly into four categories. These are “academic medical centers” as tertiary or quaternary centers which are serving larger populations, integrated with university and technology campuses. They provide the highest level of trauma and complex care. Their requirements of big data analysis, genomic medicine and robotic surgery, etc will grow..
Emergency treatment centers are another emerging theme. Emergency departments have become increasingly ill-fitted in the slower-moving general hospitals. Stand-alone emergency center, operating theatres, and clinical decision unit with short-stay beds provides are a more effective model. One example of this is the specialist emergency care hospital at Cramlington, Northumberland, which cost £80 million – the first of its kind in the UK – and deals only with urgent and emergency cases, such as heart attacks, car crashes, industrial injuries, and falls.
Secondary level care may be better provided by “local hospitals” or polyclinics that provide outpatient diagnostics, urgent and planned elective care with some short-stay beds. The emphasis would be to reduce overhead costs but provide the natural step-up for GP referral.”
The last but probably the gateway to care should be the “community hospital” that can offer intermediate care for longer-term complex rehabilitation based on a lower-cost nursing model. These centers would form a hub providing an effective bridge between inpatient care and home care.
Some of these options could be offered as a hub-and-spoke model, where acute care is delivered in a centralized hospital with chronic issues catered for either at a local clinic, possibly even set up in a supermarket, or in your home. Whilst there may not be any generic ideal blueprint just yet; depending on the country and financial model you are going to come up with different flavors. But surely there is a trend to change the distribution of care.
That Bigger is mostly better may be challenged when analyzing the problem from a distance. Larger hospitals can support better technologies, deploy a wider range of specialisms and have a more economical operation. However, there seems to be a consensus that a hospital can become too large to be sustainable or viable. Efficiency lies in how the tiers of the health system integrate.”