“This is an exciting time for healthcare,” said Sarah Dash, research fellow, Georgetown University's Health Policy Institute, as she kicked off the first Healthcare Design Academy event of the year in Washington, D.C.

Dash’s session, “Building a Better Health Care System: The Role of Healthcare Design,” gave the audience a compact overview on the Affordable Care Act, other health system reforms, trends in healthcare delivery, and the role of design in this new landscape.

Dash said that nearly 20 percent of GDP is spent on healthcare, and that 30 percent of healthcare spending is wasted on unnecessary procedures, missed opportunities for prevention, and other inefficiencies.

With the ACA, the market is transforming from the old way of doing business—“build it and they will come”—to efforts to right-size healthcare delivery that looks at putting the right types of services and facilities in the right places. She also talked about a future vision of triple-aim care where better health, better care, and lower cost are intricately linked.

“We need to move from widgets to more accountable care,” she said, including implementing better discharge and follow-up plans as well as new models of care, including team-based care, telemedicine, co-locating services (such as primary and behavioral healthcare), and group healthcare.

Among the opportunities for the design community are improving wayfinding to facilitate better patient experiences, incorporating ideas that focus on reducing HAIs, and improving accessibility for the un- and under-insured with more regional-based care centers.

“We have to do more than rearrange the deck chairs on the Titanic,” she said.

Curtis Skolnick, managing director, CBRE Healthcare (Richmond, Va.), who participated in the panel discussion, “Perspectives and Realities of ACA Implementation,” which followed Dash’s session, says one trend he’s seeing is a decline in inpatient visits while outpatient visits increase, which means fewer dollars going into systems. “The growth curve isn’t there anymore,” he said.

Skolnick, along with moderator Jason Towers, project designer, Perkins+ Will, and panelists Neil Rolfes, AVP, Strategic Planning, Inova (Falls Church, Va.), and Don Blanchon, executive director, Whitman-Walker Health (Washington, D.C.), said facilities should be looking at how to plan for more outpatient care, which will push people out into the community to manage their care.

“We’re not sure how this will look—will it be more retail clinics, small box, or large box?” Blanchon asked.

Rolfes said patients are picking doctors by who is closest and covered by insurance, which means facilities need to figure out what services people want and how that delivery is going to look, whether it’s big box, freestanding EDs, urgent care, or telemedicine.

“It’s a channel strategy,” he said. “We want to be able to contact our patients anywhere, anytime.”

The next Healthcare Design Academy is scheduled for June 19 - 20, 2014, in Portland, Ore.