Serving as a juror for the annual Healthcare Design Showcase this past year, I saw several submissions that contained a host of excellent work related to hospitals and traditional health facilities. A number of other entries, however, captured a category not seen at this scale before: the multispecialty ambulatory facility.

Health systems have been challenged to develop broad geographic networks that deliver on the promises of population health, reduced cost, and improved service. One response has been the employment of physicians, and with this trend has come a desire to realize efficiencies through consolidation of their office space, particularly of specialists.

The 2015 Showcase (published in the September issue of Healthcare Design) highlighted some of the first fruits of those specialty center developments. The projects presented many desirable and patient-friendly features: wellness trails, fireplaces, pianos and ski-lodge ambiance in public spaces, ample and convenient parking, and great materials and building scale.

If we believe the future environment will reward value (outcome/cost) and consumer focus, what does this emerging building type also need to deliver?

It first needs to integrate services into unique market offerings, creating multispecialty programs that share identity, staff, and equipment. In provider-based clinics, (apparently) the lines between physician office and provider-based ambulatory care are disappearing and we may be left with only one definition in the future. Physically, this means, among other things, fungible exam room capacity that can be reconfigured every half-day of the week, if necessary. And programs must be not only unique in terms of service combinations but also be delivered at a radically lower cost.

With consolidation of physician practices into specialty centers will come a mandate to eliminate half of the staff and a third of the square footage consumed in standalone facilities. Finally, health systems will want to be able to nimbly move with the market, which will mean fewer purpose-built and system-owned facilities and more leased retail real estate.

Can the health facility design industry prove itself as not only a Lean delivery partner but a provider of tools to assist with health system integration and change management? The opportunity here is to create the breakthrough solutions our clients deserve: delivery vehicles that not only are eye-catching, but that offer significantly lower cost delivery and radically different and extraordinary patient experiences.

Who better to attack this design problem? Who better to deliver value beyond a building?


Scot Latimer, FAIA, ACHA, is president of Latimer Health Strategies. He is a member of the AIA Academy of Architecture for Health, a Knowledge Community of the American Institute of Architects, and served as that organization’s president in 2006. He can be reached at