A culture of convenience is finding its way to healthcare

October 17, 2019 Martin Gillatt

In a world where we are all looking for better and faster, it was only a matter of time before that need reached healthcare

 

Making life easier has been front and center in our developing society for many years. Digital advances make it simpler to access information and technological advances are opening the door to modern construction techniques that make building hospitals less complex and therefore faster and simpler to build. Healthcare providers are also recognizing the value of convenience in the development of their customer base. One current trend in the US seeks to make healthcare more accessible by providing hospitals close to local neighborhoods. Another is locating services in places that people need to go—such as a clinic in a mall or on main street where a visit becomes another convenient daily activity.

 

As a result of the initial space planning exercise, Stantec developed a modular template where Cooper University Hospital could make an informed decision based on cost, schedule, and operational impact. Credit: Halkin Mason Photography.

 

Micro hospitals

One example of an emerging neighborhood model is the micro hospital—compact hospitals that are built in areas up to 20 miles from regional hospitals. They allow providers to capture local healthcare markets by making them accessible to their customer base, targeting the 40 percent of the population that does not have a primary care physician.

To date, this compact hospital format has been seen in 19 different states across the country. They are usually comprised of 8-12 beds with 24/7 emergency, low trauma (level 4/5), specialist, and outpatient departments. Micro hospitals can range from 15,000 – 60,000 square feet on three acres of land, cost approximately $10 to $25 million, and tend to have a high capital efficiency. Some also include women’s services, primary care, dietary services, and surgical services, depending on the needs of the neighborhood.

The model requires a high level of embedded technology, integrating hard facility infrastructure with telehealth, Biomed/Clinical IT, and admin systems. This digital backbone gives the facility the agility required to respond to future changes in demand. Micro hospitals are designed to be highly efficient, based around lean processes, and planned to be expandable to include community facilities such as wellness clinics.

 

Modular construction

Because micro hospitals tend to be built quickly and lend themselves to offsite construction methods, the use of modular components speeds up on-site work and provides a factory build quality. Modular construction is not new. Early examples include Isambard Kingdom Brunel’s Crimean war hospital built for Florene Nightingale in 1854. It was designed, constructed, prefabricated, and shipped to the war zone where it was constructed in five months. Since then, modular construction has been used where there was a need for quality in repetitive components, to simplify on site construction, or in remote areas where materials and subcontractors are scarce.

_q_tweetable:Providers capture local healthcare markets by making them accessible to their customer base._q_

We might ask, how much more convenient can modular be? Well, this year we see something very surprising. We can now buy a ‘Hospital Room in a Box’ from Amazon! Modular construction may have taken a while to catch on (150+ years), but we are now seeing the start of a steeper trajectory for this construction method.

Over the past few years, more and more factory-produced components are being bolted into new and old hospitals. Components range from modular mechanical and electrical distribution packs/plant rooms, to modular bathroom pods, headwalls, whole patient rooms, exam rooms, integrated plumbing systems, and trucks with imaging equipment that can connect into the hospital infrastructure.

Established European modular construction companies are now investing in factory space in the US to build whole prefabricated micro-hospitals. Reports show this is producing a six-month savings on similar projects using traditional building methods. An example of how significant modular construction can condense build periods can be seen with the proposed AC Hotel New York NoMad, where a 26-story building is set to be built in 90 days!

 

Cooper University Hospital. Credit: Halkin Mason Photography.

 

Consumerization and hotelization

Hospitals have been courting convenience for some time now by using ‘consumerization’ and ‘hotelization’ to attract patients and provide a welcoming, supportive environment. Behind the scenes, lean processes—developed in the automotive industry—are improving hospital efficiency and saving time and money, while reducing stress by making things easier.

In the marketplace, we see the recent merger between CVS Health/Aetna as an example of creating more accessible local healthcare based in existing shops. This way, making a visit to the clinic is now a part of the retail experience. This ‘small is better’ concept, based on ambulatory care, seems to be the current trend in facility design as bed occupancy levels decline. People don’t want to be inconvenienced by waiting a long time for an appointment, they would rather just walk in and wait.

Amazon is an example of a non-healthcare provider integrating into Medicare and the healthcare supply chain resulting in improved consumer convenience. The ‘hospital room in a box’ may be an extreme example, but it’s likely a sign of things to come.

 

A convenient future

The healthcare industry remains in a constant state of evolution. William Gibson famously said: “The future is already here—it's just not very evenly distributed.” It’s true that access to healthcare remains disparate in many parts of the US. However, by adopting a care model that prioritizes convenient access to care, providers can better serve patient populations while growing their customer base.

Whatever happens, the trend for ever more convenience does not seem to be slowing down.

About the Author

Martin Gillatt

Martin Gillatt has spent much of his professional career working internationally. He has over 30 years of experience as a registered architect in the UK, and he specializes in hospital design, having completed facilities in Canada, the UK, the US, Hong Kong, and Poland. He’s worked on projects from acute and tertiary hospitals to primary and secondary facilities, mental health units, senior living, and continuing care homes. Most of all, he enjoys the front end of projects—master planning and solving complex problems and concepts.

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