Healthcare Design - November 2016 - 74

P R E V I E W

You'll be focusing specifically on technology
in your presentation at the HCD Expo. What
do attendees need to understand about
how technology is influencing care delivery
today and where the built environment fits
into the equation?

make recommendations based on that evidence. We've

which supports services provided in any
number of settings outside the traditional
hospital environment. What do you think this
model looks like in the future, and what are
barriers to achieving it?

succeeded in helping to foster innovation when we've

It's hard to say exactly what this model will look like,

shed light on issues and problems in healthcare and

and given the heterogeneity of our healthcare sys-

workable solutions to them.

tem, and our country, I suspect several models will

of data and the ability to engage in meaningful

in innovating the industry and how did you
manage to do it?

conversations.

Susan Dentzer: NEHI is a think tank, and most of what

tion areas that lack privacy all inhibit the free flow

we do is collect and distill the existing evidence and

An example is medication adherence. Many patients

come into being. But it's not unrealistic to envision

don't take their medications as prescribed and, in many

a day when the vast majority of Americans will re-

I will focus on how the new era of health information

instances, don't even fill a prescription-sometimes

ceive what we would call healthcare outside of the

technology has led to great diagnostic challenges

because of costs. They may see their conditions worsen

institutional settings (like hospitals and physicians'

but can also create diagnostic opportunities.

and undergo more costly healthcare as a result. The

offices) that we now consider standard.

Technology has led to great advancements, but

estimates are that these avoidable costs approach $300

it has also led to great frustrations. Medicine is

billion a year.

undergoing a massive transformation-from volume

NEHI's research has pointed to ways to improve

people at home for conditions such as pneumonia,

to value, from individual care to population health,

medication adherence that have been adopted by the

and to deliver medications by drones. It would be

and from solo practice to teamwork and systems.

healthcare sector, including companies like CVS Health.

possible today to have a system in which you would

Despite all of that, doctors remained wired to focus

One recommendation shown to be helpful is having

only need to go to an institution for surgery, or be

on this one question: What is ailing the person in

pharmacists or nurses contact patients once they've

treated for a serious condition in an intensive care

front of me and how can I get them better? I hope to

been discharged from hospitals to make sure that they

unit. We already have over-capacity in inpatient

convey how the ecosystem around the doctor-patient

understand what drugs have been prescribed for them

hospitals in many areas of the country, and we

relationship influences doctors' ability to answer that

and that they have the medications on hand and are, in

probably have too much capital committed to

question. I will illustrate how the patient-provider-

fact, taking them as prescribed.

medical office space. So arguably the biggest

computer relationship and the electronic medical

obstacle in moving to more distributed care models
is inertia-overcoming all the forces militating

design and technology can enhance the traditional

What's currently on your agenda? What areas
of the care delivery system do you think could
stand to see some improvement?

parts of our identity (problem solving and thinking),

We have a lot on our agenda, and I'll focus on one

current healthcare system.

can enhance the move to high-value care, and can

project: bringing pharmaceutical spending into the

preserve our connections with patients.

broad U.S. agenda to move to more value-based care.

record have changed the experience in the exam
room. I look forward to sharing examples of how

CLOSING KEYNOTE

Susan Dentzer
president and chief executive
officer, Network for Excellence
in Health Innovation (NEHI),
"U.S. Healthcare
and Health
Policy: A Future
of Healthcare
without Walls?"
Healthcare Design:
The mission of NEHI is
to identify, analyze, and
resolve critical healthcare
issues, with innovation in particular viewed
as "the critical ingredient for improving
the healthcare system." It can be difficult
to innovate a risk-averse industry like
healthcare. Where has NEHI had success

74

We already have the capability to have a
doctor's visit over a smart phone, to "hospitalize"

NOVEMBER 2016

against change, starting with where and how we
have constructed the physical underpinnings of our

"value"-i.e., actually improving outcomes for patients.

What do you want HCD Expo attendees to take
away from your talk regarding the reality of
future building and space needs, particularly
the reality that we won't need as many?

Physicians, hospitals, and others will increasingly be

Since we can't accurately predict the future, the best

paid through arrangements that change that balance,

advice is, first, ask hard questions about whether we

so that more of their pay will be based on providing a

need to build new healthcare facilities at all or whether

higher quality of care for patients and achieving better

we should repurpose what we have, if at all possible.

Much of U.S. healthcare has been paid for on a fee-forservice basis, which incentivizes volume of care over

outcomes. It's widely agreed that payment for pharmaceuticals needs to move in this direction, as well.
In general, we should be willing to pay manu-

Second, if we do build new facilities, they should
be flexible and adaptable, and as environmentally
friendly as possible given the huge carbon footprint

facturers more for drugs that measurably improve

of our current system. We shouldn't build any

outcomes and improve health, and relatively little,

hospital space today that couldn't be adapted a few

or nothing, for drugs that don't. Yet pharmaceuti-

years from now to some entirely different purpose,

cal prices are all over the map and bear little
relationship to any definition of value. There are lots

such as housing.
If we could build the equivalent of pop-up facili-

of ideas about how to change that equation, and at

ties for healthcare that are attractive, functional,

NEHI we're working to help develop and shape these

and environmentally friendly, and that could earn

approaches.

public and industry acceptance, that would make
the most sense of all. Chances are good that in a

One trend that's anticipated to revolutionize
care delivery is the distributed care model,

HCDMAGAZINE.COM

few years, or a decade at most, we'd pronounce
them obsolete and build something else.


http://www.HCDMAGAZINE.COM

Healthcare Design - November 2016

Table of Contents for the Digital Edition of Healthcare Design - November 2016

HEALTHCARE DESIGN - NOVEMBER 2016
CONTENTS
EDITORIAL
SHOW TALK
PHOTO TOUR
MEETING OF THE MINDS
POWER TRIO
GET SMART
WHAT ARE WE WAITING FOR?
HAVING IT ALL
HERE & NOW
WELCOME ADDITION
FIVE BUILDING BLOCKS OF WAYFINDING
FINANCIAL MATTERS HEALTHY SAV-INGS
PRODUCT SPOTLIGHT DINING
THE CENTER
AIA-AAH
Healthcare Design - November 2016 - HEALTHCARE DESIGN - NOVEMBER 2016
Healthcare Design - November 2016 - Cover2
Healthcare Design - November 2016 - 1
Healthcare Design - November 2016 - 2
Healthcare Design - November 2016 - CONTENTS
Healthcare Design - November 2016 - 4
Healthcare Design - November 2016 - 5
Healthcare Design - November 2016 - 6
Healthcare Design - November 2016 - 7
Healthcare Design - November 2016 - 8
Healthcare Design - November 2016 - EDITORIAL
Healthcare Design - November 2016 - SHOW TALK
Healthcare Design - November 2016 - 11
Healthcare Design - November 2016 - PHOTO TOUR
Healthcare Design - November 2016 - 13
Healthcare Design - November 2016 - 14
Healthcare Design - November 2016 - 15
Healthcare Design - November 2016 - 16
Healthcare Design - November 2016 - 17
Healthcare Design - November 2016 - 18
Healthcare Design - November 2016 - 19
Healthcare Design - November 2016 - 20
Healthcare Design - November 2016 - MEETING OF THE MINDS
Healthcare Design - November 2016 - 22
Healthcare Design - November 2016 - 23
Healthcare Design - November 2016 - POWER TRIO
Healthcare Design - November 2016 - 25
Healthcare Design - November 2016 - 26
Healthcare Design - November 2016 - 27
Healthcare Design - November 2016 - 28
Healthcare Design - November 2016 - 29
Healthcare Design - November 2016 - 30
Healthcare Design - November 2016 - 31
Healthcare Design - November 2016 - 32
Healthcare Design - November 2016 - 33
Healthcare Design - November 2016 - GET SMART
Healthcare Design - November 2016 - 35
Healthcare Design - November 2016 - 36
Healthcare Design - November 2016 - 37
Healthcare Design - November 2016 - 38
Healthcare Design - November 2016 - 39
Healthcare Design - November 2016 - 40
Healthcare Design - November 2016 - 41
Healthcare Design - November 2016 - 42
Healthcare Design - November 2016 - 43
Healthcare Design - November 2016 - WHAT ARE WE WAITING FOR?
Healthcare Design - November 2016 - 45
Healthcare Design - November 2016 - 46
Healthcare Design - November 2016 - 47
Healthcare Design - November 2016 - 48
Healthcare Design - November 2016 - 49
Healthcare Design - November 2016 - 50
Healthcare Design - November 2016 - 51
Healthcare Design - November 2016 - 52
Healthcare Design - November 2016 - 53
Healthcare Design - November 2016 - 54
Healthcare Design - November 2016 - 55
Healthcare Design - November 2016 - 56
Healthcare Design - November 2016 - 57
Healthcare Design - November 2016 - HAVING IT ALL
Healthcare Design - November 2016 - 59
Healthcare Design - November 2016 - 60
Healthcare Design - November 2016 - 61
Healthcare Design - November 2016 - 62
Healthcare Design - November 2016 - 63
Healthcare Design - November 2016 - 64
Healthcare Design - November 2016 - 65
Healthcare Design - November 2016 - 66
Healthcare Design - November 2016 - 67
Healthcare Design - November 2016 - 68
Healthcare Design - November 2016 - 69
Healthcare Design - November 2016 - HERE & NOW
Healthcare Design - November 2016 - 71
Healthcare Design - November 2016 - 72
Healthcare Design - November 2016 - 73
Healthcare Design - November 2016 - 74
Healthcare Design - November 2016 - 75
Healthcare Design - November 2016 - 76
Healthcare Design - November 2016 - 77
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Healthcare Design - November 2016 - 85
Healthcare Design - November 2016 - 86
Healthcare Design - November 2016 - 87
Healthcare Design - November 2016 - 88
Healthcare Design - November 2016 - 89
Healthcare Design - November 2016 - 90
Healthcare Design - November 2016 - 91
Healthcare Design - November 2016 - WELCOME ADDITION
Healthcare Design - November 2016 - 93
Healthcare Design - November 2016 - 94
Healthcare Design - November 2016 - 95
Healthcare Design - November 2016 - 96
Healthcare Design - November 2016 - 97
Healthcare Design - November 2016 - FIVE BUILDING BLOCKS OF WAYFINDING
Healthcare Design - November 2016 - 99
Healthcare Design - November 2016 - 100
Healthcare Design - November 2016 - 101
Healthcare Design - November 2016 - 102
Healthcare Design - November 2016 - 103
Healthcare Design - November 2016 - 104
Healthcare Design - November 2016 - 105
Healthcare Design - November 2016 - 106
Healthcare Design - November 2016 - 107
Healthcare Design - November 2016 - 108
Healthcare Design - November 2016 - FINANCIAL MATTERS HEALTHY SAV-INGS
Healthcare Design - November 2016 - 110
Healthcare Design - November 2016 - 111
Healthcare Design - November 2016 - 112
Healthcare Design - November 2016 - 113
Healthcare Design - November 2016 - PRODUCT SPOTLIGHT DINING
Healthcare Design - November 2016 - 115
Healthcare Design - November 2016 - 116
Healthcare Design - November 2016 - 117
Healthcare Design - November 2016 - 118
Healthcare Design - November 2016 - 119
Healthcare Design - November 2016 - 120
Healthcare Design - November 2016 - 121
Healthcare Design - November 2016 - 122
Healthcare Design - November 2016 - THE CENTER
Healthcare Design - November 2016 - 124
Healthcare Design - November 2016 - AIA-AAH
Healthcare Design - November 2016 - 126
Healthcare Design - November 2016 - 127
Healthcare Design - November 2016 - 128
Healthcare Design - November 2016 - 129
Healthcare Design - November 2016 - 130
Healthcare Design - November 2016 - 131
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Healthcare Design - November 2016 - Cover3
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