The transformative effects of healthcare reform and ARRA-HITECH are not always apparent to facility planners and architects, but the provisions are tightly linked to building and renovation plans, Healthcare Informatics Editor-in-Chief Mark Hagland told attendees at the Healthcare Design Executive Forum held Nov. 14 in Las Vegas. Cohosted by Hagland and HEALTHCARE DESIGN Editor-in-Chief Todd Hutlock, the day-long forum, which was part of HEALTHCARE DESIGN.10, focused on technology and its implications for current and future healthcare environments.

“ARRA-HITECH, along with HIPAA, is turbo-charging change, and the vast majority of hospital organizations that are identified as ‘eligible providers’ are unprepared,” Hagland says.

Although the legislation may appear straightforward, the requirements are extremely complex, Hagland emphasizes. Major changes for hospitals and health systems will be required. In addition to meeting mandates for meaningful use of electronic medical records (EMR), there will be pressure for care providers to be hyper-efficient and hyper-effective as accountability, transparency, and quality initiatives count for dollars.

These mandates also impact hospital architecture and design planning. “More healthcare is being delivered at the bedside, and the expectation is that wireless will be available everywhere. That is our challenge,” says Ed Lowell, director of IS infrastructure at Lucile Packard Children's Hospital at Stanford University in California. As the organization increases EMR usage, there will be more devices and more wiring in the ceiling, and the infrastructure to support them needs to be planned.

Walter Jones Jr., architect and senior vice president of facilities at Parkland Health and Hospital System in Dallas, leads a $1 billion building project and admits he doesn't really know what technology advancements will be needed when his hospital opens. But he is realistic: “We are not designing a hospital of the future because we don't know what that will be. We're building a hospital for the future.”

Infinite design flexibility to accommodate all potential options is possible with enough money, notes David Labuskes, vice president of the special systems design group at Dallas-based RTKL Associates. “We haven't found that project yet,” he says. And he does not expect to do so.

“People caring for people” remains the key mission of Dublin Methodist Hospital, says President Cheryl Herbert. The Dublin, Ohio-based facility opened in 2008 as an all-digital hospital and part of the OhioHealth family of care provider organizations. “We didn't see the sense of beginning [with the existing workflow] and took a leap by going down the [all-digital] path. Now we're the one hospital in the system that is ready for meaningful use,” she says.

But Herbert is clear about the role technology will play and emphasizes the need for human interaction with it in the healthcare space. “Planning for the human interface is the most important issue I have to deal with,” she says. “Ultimately, care delivery is people taking care of people.”

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Healthcare Design 2011 January;11(1):19