Healthcare Design - June/July 2016 - 28

C THE CENTER | 07.16
A forecast for change
New methods of care delivery are creating opportunities for the architecture
and design community By Debra Levin
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 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. healthcare-
some 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 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
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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.

We're creating a more prevention-focused
healthcare system, generating better outcomes
and lower costs.
This new prevention focus provides opportunities
for the architecture and design community through
innovative built environment solutions.
For example, according to countyhealthrankings.
org, 10 percent of what determines the quality of
individuals' 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. HCD
Debra Levin is president and CEO of The Center
for Health Design. She can be reached at dlevin@
healthdesign.org.

Debra Levin

http://www.HCDmagazine.com

Healthcare Design - June/July 2016

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