Many people are talking about the changes happening in the healthcare industry and how they could affect building design and construction. I hear at least one presentation on the topic at every program I attend. In our quest to stay ahead of major shifts that could alter how we do business, we’re constantly looking to experts to predict the future so we can skate to where the puck is going and not to where it currently is.

This past spring, I attended a meeting of the Built Environment Network, a cadre of senior-level facilities executives from systems large and small, who gather three times a year to learn from one another and from invited speakers who are experts in their field. This meeting’s focus was on healthcare facility trends and innovations.

On the final day of the meeting, we heard from Susan Dentzer, president and CEO of The Network for Excellence in Health Innovation, a nonprofit, nonpartisan health policy institute focused on enabling innovations that improve the quality and lower the costs of healthcare. She crafted her talk in a way that made for a very powerful message.

Like everyone, Dentzer acknowledges that there’s a major transformation underway in U.S. healthcaresome brought on by the Affordable Care Act (ACA), but most predating the ACA and far more powerful. Those include the aging population; dramatic advances in science and technology; changes in the types of care provided; new consumers, locations, and methods of care delivery; and consumerism around healthcare services and the “retailization” of healthcare in general.

Her statistics showed that the ACA is influencing healthcare in many positive ways: 20 million more adults are now insured, there’s been a substantial reduction in racial and ethnic health coverage disparities, and a there’s been a surge in newly identified conditions like diabetes within Medicaid expansion states, leading to earlier treatment that will result in better quality of life and long-term outcomes for those patients.

On the negative side of our nation’s health, Americans are now dying at younger ages than people in almost all other high-income countries and have had health issues throughout their lives. The baby boomers tend to have poorer health overall than previous generations, with 41 percent of boomers already having three or more chronic health conditions by middle age.

The sobering reality of these statistics has led to a more proactive approach to how we’re looking at healthcare delivery and is creating a more prevention-focused healthcare system, generating not only better health outcomes but a reduction in the overall cost of care.

This new prevention focus provides opportunities for the architecture and design community through innovative built environment solutions. For example, according to, 10 percent of what determines the quality of a person’s health is their physical environment. An additional 30 percent can be attributed to healthy behaviors and 20 percent is attributed to clinical care—and the physical environment can positively impact both of these factors. The remaining 40 percent is affected by socioeconomic issues.

On another front, a combination of large players, like Apple, IBM, and Intel, are entering the healthcare technology marketplace with higher quality interfaces that help telehealth and telemedicine be more reliable. New technologies that provide mobile health options are driving care out of large institutions and expanding exponentially the number and types of spaces that can be considered “healthcare” environments.

This move has led to the  trend of “hospital at home,” where acute patients who previously were only able to be monitored and cared for in an acute care setting can now be cared for at home, at lower costs and with better outcomes and higher patient satisfaction.

One of the interesting parts of Dentzer’s presentation was about our ability to predict the future. As Bill Gates once said: “We always overestimate the change that will happen in the next two years but underestimate the change that will occur in the next 10.” Absorbing as much information as you possibly can through conferences, books, magazines, webinars, and your colleagues and then synapsing these ideas together in a way that makes the most sense for you and your future is likely the best way to be prepared for the changes that are just around the corner, as well as those still miles away.

Debra Levin is president and CEO of The Center for Health Design. She can be reached at