Best Of 2014: How To Design A ‘Smart’ Hospital
This article was originally published on March 10, 2014, and is among Healthcare Design's Top 10 most-read articles of 2014. To see a full list, click here.
To respond to a technologically driven environment of care and prepare for its evolution in the future, healthcare providers must consider bolstering the patient experience both inside their facilities and out through a keen focus on connectivity, communication, and access to information.
Healthcare architects and designers have a unique opportunity to unite architecture and technology by creating dynamic and engaging settings that cater to the individualized needs of patients and identifying opportunities for staff and administrators that broaden treatment options as well as where that treatment is provided.
As such, planning for technology must be at the forefront of any new facility project to ensure it will be relevant to future care delivery. For example, at the new Winthrop University Hospital Research and Academic Center, located on Long Island in Mineola, N.Y., and slated to open in December, this approach was taken by exploring various technologies, ranging from interactive media to medical simulation to Web-based doctor/patient interactions.
However, visitors to the building—a translational research facility designed to bring together patient care, research, education, and community outreach focused on diabetes and other endocrinology issues—will experience the benefits of future-focused technologies most significantly on the clinical floor of the building.
Winthrop will provide patients a digital portal for secure, 24-hour access to electronic medical records, scheduling, billing, registration, and educational materials from any connective device. The patient portal is the core resource that facilitates many of the building’s other technological features and provides data that unifies the efforts of doctors, researchers, and patients to plan and discover the best prevention and treatment options for each illness.
There’s often a bottleneck of patients created at central registration. To solve that challenge, patient kiosks can be implemented and offer the added advantage of introducing patients to digital connectivity. A patient kiosk offers a convenient, on-site method of interface that patients can use to access a self-service system.
At Winthrop, check-in can be completed at any kiosk, or patients who have completed online appointment registration can simply scan their phone or a printout for identification and check in by using the kiosk’s barcode check-in feature. The Winthrop system also includes a patient-flow management system that will track room availability and ultimately reduce wait time. The entry sequence of the floor is designed so the kiosks are a central focal point between the elevator lobby and the circulation stair but are still adjacent to open staff workstations in case assistance is required.
Today, many patients and family members sitting in waiting rooms use personal mobile devices for entertainment, to review and update personal health information, or to make payments and arrange future appointments. Institutions must accommodate this constant interaction via mobile technology—and find ways to utilize the connectivity to their advantage. Winthrop has observed that when some patients experience slow (or no) Internet access and have insufficient access to outlets for charging personal devices, it causes some frustration within the waiting area. By enhancing waiting rooms with connective furniture—augmented with outlets for charging—and a robust Wi-Fi system, patients and their families can experience a new level of comfort and convenience not typically associated with healthcare facilities.
Connectivity should be considered at the very beginning of a project and utilized as a planning resource to help direct the program and, ultimately, the design. For example, at Winthrop’s new facility, multiple seating clusters seamlessly incorporate bariatric seating in a casual and comfortable lounge-like waiting environment that’s coordinated with floor outlets to provide power connections.
Hybrid exam/consult modules
As technology allows healthcare designers to add or expand options for diagnostic, clinical, and customer services, technology also allows the opportunity to rethink standard spaces to create a streamlined, optimized environment. For instance, careful planning can allow for flexibility between departments; the development of exam/consult modules can eliminate assigned, or physician-specified, rooms, creating overlap between different clinical spaces. This overlap allows the use of a digital scheduling system to flex between available rooms, thus optimizing usage and reducing wait times.
Winthrop’s hybrid exam/consult rooms—interconnecting the adult and pediatric clinical spaces—are designed to increase patient comfort and personalize doctor-patient interaction. Organized into a patient zone and a healthcare provider zone, the system eliminates the need to move a patient to an office with the physical barrier of a formalized desk for the physician. Instead, a “P-top” work surface organizes the doctor, patient, and family members around a wall-mounted screen for information sharing, while caregivers can chart on a portable computer docked on the work surface, allowing them to face the patient and simultaneously enter information.
Staff also has the ability to select specific information to shift onto the patient-doctor shared screen. Connection to the patient’s personal folder on the patient portal allows the doctor to easily drop in instructional videos, documents, or other important information that the patient can access later.
Education zones dispersed throughout clinical areas can introduce patients to the use of devices that monitor their condition, teaching them how to interpret and utilize real-time device-generated information. At Winthrop, with its focus on diabetes care, research, and education, this manifests in technology training rooms and insulin pump education rooms specifically designed to introduce patients to new technologies available to help them as they live with their disease.
Home scales and glucose monitors connected to the patient portal will update patient records daily and alert doctors of any important issues. Likewise, the information collected from the monitors is well documented in order to keep the option of retro analysis available to patients and doctors.
Current technology enables doctors and patients to connect remotely and share information in a variety of ways, through two-way video, email, smart phones, wireless tools, and more. All classrooms and conference rooms at Winthrop’s new facility are designed with interactive video conference capability, giving physicians the opportunity to work remotely with patients or provide information to family members, while both callers view the same information on their individual screens.
These same building resources can be used to enhance a patient consultation by connecting remotely with a specialist at an affiliate institution or by allowing a family member to conference-in on an education session. Additionally, devices that upload information to the patient’s records allow the healthcare provider to monitor a patient’s progress between visits and can provide an early indication of any alarming developments and conditions.
However, planning for telemedicine must go beyond current uses to anticipate future applications, such as traveling nurses c
onnecting to doctors in real-time or “robot doctor” specialists incorporated into care facilities.
EMR scanning room
While electronic medical records (EMR) become the standard, some healthcare facilities are still in transition. At Winthrop, a large room is being created with space for EMR scanning equipment and the storage of medical records while this transition is underway. When the scanning is complete, the room is designed to be repurposed. Scanning equipment and files will be removed and replaced with conference furniture and systems to support telemedicine.
Technology can entertain and stimulate while it educates—a critical tool in the planning and design of pediatric healthcare environments, especially. Offering a specialty area for pediatric diabetes, the design of the new Research and Academic Center aims to capture the attention of young patients through an interactive wall in the pediatric waiting area. The overall goal of the installation is to promote movement, an important prevention method for pediatric diabetes patients, through custom-designed interactive games that will be simultaneously entertaining and educational.
The rapid advancement and pervasive influence of technology has created the opportunity to re-imagine the delivery of healthcare. As designers, we’re tasked with the challenge of integrating known technology that will enhance the patient experience in current time while strategizing future technological advancements and possibilities. Our insights, resourcefulness, and ability to visualize physical space with emerging technology will help shape the future patient experience and care model.