With all that I travel, I try to get a flu shot every year. Hard to say if it makes a difference or not, but it's something I'm committed to even if it's just for the placebo effect. There's nothing all that interesting about getting a flu shot; I'm one of millions who do. What's interesting is where I have actually gotten my inoculation these past two years. Three years ago, though I knew that I needed to get to my physician to get the shot, day after day, week after week, I just wasn't finding the time to stop and make it happen. Before I knew it, the window of opportunity had passed and it was too late for it to be very effective. Lo and behold, I got the flu that year. Not once, but twice.

The next year I started down the same road and was approaching the point of no return yet again, when I found myself in Chicago's O'Hare airport, traveling from one concourse to another to catch a connecting flight. There, out in the middle of the walkway, was a sign offering flu shots. Having never received any type of medical care outside of a traditional healthcare facility, I passed it by and caught my next flight. Two weeks later, there I was again, still not having made the time to get to my physician office, the window of opportunity closing… and I figured, why not, I'll try it. Less than five minutes later, I was on my way, inoculated against all the unseen bugs and germs that I expose myself to on a regular basis every time I get on an airplane.

This year, having gotten over the notion that healthcare has to happen in a traditional healthcare facility, I got my shot at the end of aisle five at my local grocery store chain store while I was picking up that weeks' groceries. Most interesting to me when I think about it is the fact that I didn't go to the grocery store for groceries; I went for the flu shot and while I was there, I picked up some groceries.

That's when it hit home for me personally that the definition of what is a healthcare building is changing, and it's changing rapidly. And though I'm quite confident that you will never be able to have get an appendectomy at your local grocery outlet, the list of ailments that can be treated at places like Minute Clinics at your local pharmacies is growing. As it grows, defining what a “healthcare building” is changes as well. As design professionals and healthcare leaders, we have key roles in continuing to push the boundaries of what constitutes a healthcare facility in our communities and how and where preventative care, ambulatory care, and even palliative care can be given.

This month's issue of HEALTHCARE DESIGN focuses on nonhospital healthcare. Throughout these pages you will see a variety of examples of how community leaders are thinking outside the box when it comes to how people interact with healthcare providers including this month's Pebble report on Palomar Pomerado's Second Life Hospital.

As our population ages, we will see an increase in the ability to provide healthcare in the home as advances in technology make remote patient monitoring and self-administered care easier and more reliable. In June of this year, Vendome—publisher of HEALTHCARE DESIGN—and The Center for Health Design will launch its latest partnership, a new conference called X3, which focuses entirely on how technology is shaping tomorrow's care environments. X3 will bring together a small group of executive-level participants for an interactive look at the convergence of physical design, quality of care, and technology. In the future, many new technological developments will be a direct response to the shift of healthcare from traditional hospital environments to smaller healthcare facilities that are integrated throughout our communities in ways we can only begin to imagine. In that same vein, nanotechnology and less invasive procedures will drive us to rethink what we envision when we think of a healthcare building.

All in all, these are exciting and interesting times for us in healthcare design, on so many levels. With the economic shake-up, the influx of new technologies, and the blurring of so many boundaries, we have unprecedented opportunities to revise the status quo and great incentives to challenge our belief systems. If you can get your flu shot in the same building that you are picking up milk and paper towels, then getting allergy tested while you are seeing a movie may not be too far behind.

I look forward to hearing from you about new models of healthcare spaces you have come across in your work and travels and how we can all learn from these cutting-edge ideas, as well as build on them for things we have yet to imagine.

Visit The Center's blog at http://www.healthdesign.org/blog and share your thoughts. HD

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The Center for Health Design is located in Concord, California. For more information, visit http://www.healthdesign.org.

Healthcare Design 2009 February;9(2):8