In their session at HEALTHCARE DESIGN.11 on Monday, Terri Kurrasch, Steven Steinberg, and Ross Levy of Ratcliff outlined some concepts and ideas that may not have seemed radical on the surface, but add up to a major shift in the way healthcare–and healthcare design–is delivered. Kurrasch outlined several of today's major healthcare trends: an aging society, rising healthcare consumerism and education, a changing physician/patient relationship, and, of course, rising costs despite our best efforts to the contrary.

The conclusion? The current mode of care is not sustainable. The three "cans of spending waste" — behavioral, operational, and clinical — add up to half of all healthcare dollars. So how do we fix it and apply new models of care for a new delivery system? And more relevant to the HEALTHCARE DESIGN audience, how do designers make this happen?

Steinberg did his best to answer that question, sketching out the features that the hospital tool box of the future would need: sustainability, modularity, patient focus, interconnectivity, mobility, integrated care, efficiency, and community involvement. A long and involved list to be sure, but the Steinberg's upshot at the end of the discussion was that healthcare currently treats the disease instead of keeping people healthy before they are sick, and that needs to change. Hosptials can be integrated into the community more to encourage wellness; designers can take simple steps like hiding the elevator banks in lobbies to encourage visitors to use the stairs. The list of small but effective changes goes on and on, but in any case, proactivity is needed — the healthcare delivery model needs to essentially reverse itself.

In the end, Steinberg may in fact be right about what needs to change. But the question remains — and likely will for some time, as healthcare reform continues to dangle in the wind — as to whether the country is equipped to make changes down to the level that they are needed.