In case you haven’t noticed over the past 18 months, people are being very cautious about spending money, and that includes healthcare systems.

You probably have observed that large and small hospitals’ long-held expansion plans are being laid aside for less expensive, smaller facilities.

The hope of hospitals as they reinvent themselves to survive an enduring tough economy, is that chronically ill people in the future will spend less time in the hospital yet stay in better health. Technology will help this concept take hold.

More and more, hospitals are adopting concepts like "patient-centered medical homes." It's not an actual home, but terminology that refers to patients with chronic illnesses staying well by being in frequent communication with a nurse or "care manager" through e-mail or cell phone.

Hospitals and physicians are identifying efficiencies by forming new partnerships and improving communication among each other through the sharing of patient’s electronic records. The changing environment has caused healthcare systems to consider "teams" of providers serving "communities" of similar patients at specialty centers.

In place of postponed capital projects, healthcare systems are looking at focusing on specialized centers within existing facilities. “Restacking” what services and providers are located in specific communities. These are initiatives that still require the skills and specialized input of healthcare design professionals.

Don’t let the slow-down or lack of large capital projects lead you to believe that there aren’t innovative niches that are providing great opportunities for healthcare architects and interior designers.