The Future of Healthcare Design

Care Will Extend Beyond the Hospital

According to two 2021 McKinsey surveys:

40% of patients prefer telehealth

55% of patients are more satisfied with virtual visits

Our healthcare system is based on human interaction, so it might seem strange to think that care could be delivered over a screen. But virtual visits have been happening for years, and their acceptance has been accelerated by the pandemic. In fact, according to two 2021 surveys by consulting firm McKinsey, 40% of patients said they will prefer telehealth even after the pandemic is over, and 55% of patients reported higher satisfaction with virtual visits than in-person ones.

On-screen consultations are only the beginning. Advances in wearable technology, like sports watches that can monitor and report health data, and off-site diagnostic testing, like at-home COVID tests, could eliminate the need for patients to drive to hospitals or clinics for routine tests and exams.

“The theme of the future isn’t that technology replaces humans,” says architect and healthcare strategist Ashley Dias. “It lets humans be better humans. Technology doesn’t have to disrupt human connections; it can contribute to them, and that’s going to make healthcare more meaningful and more pleasant.”

In Part 1 of this three-part series, healthcare administrators and designers from around the U.S. share their views on how technology can connect patients and providers.

Caring for Hospital Patients at Home

As hospitals struggled to expand capacity during pandemic surges, many of them offered in-home care for loweracuity patients in an attempt to free up resources for sicker ones. This has led to wider acceptance of the “hospital at home” model, which has been proven to result in reduced mortality rates and fewer readmissions to the hospital.

Shifting care to the home setting offers patients convenience and improved outcomes in familiar surroundings, says Eric Eskioglu, MD, MBA, a leading national healthcare physician executive. He predicts that people will soon be able to use technology installed in their own homes to test and monitor their vital signs, dispense medications, and share personal health data directly with their doctors. In this model, bedrooms, guest rooms, or hobby rooms could be quickly adapted for patient care when needed.

“The ‘hospital at home’ concept is not just putting a camera in a patient’s home and monitoring them,” Eskioglu says. “That’s a beginning. That’s a bare necessity. But there’s a lot more. I think rooms are going to be meta ready: We’re going to have three-dimensional experiences in these rooms. With a flip of a button, you should be able to convert a normal room in your house to a hospital at home if you need it.”

Videoconferencing for Telehealth Visits

The U.S. government’s announcement that telehealth video calls would be reimbursed by Medicare and Medicaid was a game-changer. As political support for telehealth grows over time, resource needs will shift, Dias says. She anticipates that less space will be needed for inperson exam rooms, and investments in communications infrastructure will boost connectivity. Meanwhile, exam and consultation rooms could be constructed in the metaverse. Hospital administrators are conflicted about the need to invest in both “bricks and clicks,” or physical plant and virtual technology. “It’s absolutely a struggle to figure out where to allocate bandwidth, time, resources, all of the things that are finite to us today,” says Chris Nicholas, chief executive officer of Renown Regional Medical Center in Reno, Nevada. “But we know that technology is our future. We’re journeying into a new frontier where technology will be the leading edge of healthcare as far as how we engage with our patients and how we provide care to them.”

Listen to Eric Eskioglu discuss how homes might be designed to support healthcare.

“The theme of the future isn’t that technology replaces humans. It lets humans be better humans."

Ashley Dias, architect and healthcare strategist at Perkins&Will

Performing More Procedures at Community Clinics

As technology improves, providers at smaller clinics will be able to perform more complex procedures and care for sicker patients. This is already the case for patients who need routine procedures in orthopedics, ophthalmology, and other fields. And the trend will continue. In fact, McKinsey has found that care services outside the hospital are the health industry’s fastest growing businesses.

“I think we’ll see more care being provided as close to the patient’s home as possible, so they don’t have to travel as far to get to get that care,” says Brian Crimmins, the recently retired vice president for facilities planning at Penn Medicine’s Lancaster General Health in Lancaster, Pennsylvania. “It can be delivered at a local hospital in conjunction with the large regional hospital.”

Connecting with Patients via Micro Clinics

Another option for remote care could be small, virtually staffed “micro clinics” conveniently located in shopping centers, offices, and other public spaces. This solution represents a middle ground between telehealth visits, which provide face time but often lack measurable data, and the hospital at home model, which requires a significant investment in space and equipment for the homeowner and the provider.

"We're journeying into a new frontier where technology will be the leading edge of healthcare as far as how we engage with our patients and how we provide care to them.”

― Chris Nicholas, chief executive officer at Renown Regional Medical Center

Health design researchers at Perkins&Will developed a conceptual model of a micro clinic that would allow patients to receive specialized care in three types of spaces: a stand-up clinic, an exam clinic, and a wellness clinic.

Stand-Up Clinic

A stand-up clinic equipped with easy-to-use technology would record and report vital signs like blood pressure, temperature, and heart rate. Patients could pick up prescriptions or drop off lab samples via secure lockers.

Exam Clinic

Equipped with multiple cameras, a large screen, and exam tools like an AI-powered blood draw machine, an exam clinic would allow patients to virtually interact with a healthcare professional in a setting similar to an in-person experience.

Wellness Clinic

This private, soothing space would allow patients to attend mental health and well-being therapy sessions. It could even be equipped with a robotic puppy or other therapy aids.

Technology Will Improve the In-Patient Experience

In Part 2 of this three-part series, healthcare administrators and designers from around the U.S. share their views on how hospitals are changing to meet the needs of patients and medical professionals.

Although many patients will enjoy expanded opportunities for remote and off-site healthcare in the future, the “sickest of the sick” will still seek care at major brickand-mortar facilities. They’ll get surgeries that are unavailable at ambulatory centers, procedures that can’t be done at offices, and experimental treatments that must be delivered in highly controlled environments.

“The hospital will still be the hospital,” says Chris Nicholas, CEO of Renown Regional Medical Center in Reno, Nevada. “Especially large tertiary hospitals like ours: I see them becoming large intensive care units.”

Teaching hospitals will also continue to play a vital role in in-person healthcare by educating the next generation of practitioners and providing resources for medical research. “There will always be a need for the large academic medical centers,” says Brian Crimmins, the recently retired vice president for facilities planning at Penn Medicine Lancaster General Health in Lancaster, Pennsylvania. “I think they’ll focus more on the teaching and research aspects, as well as cutting-edge new therapies.”

Centering Patients and Families

Hospitals are likely to use technology to provide more personalized, streamlined experiences for patients and their caregivers. For instance, augmented reality could help people find their way around complex corridors. Frictionless processes, like online scheduling and app-based check-in, can save time for all involved.

Patient rooms will change, too. “We’re going to start seeing rooms that have more ambient intelligence,” says Eric Eskioglu, MD, MBA. He predicts that screens on patient room walls will one day be replaced by immersive technology that transports patients into a calming virtual environment to aid in prep and recovery.

Designing Flexible Spaces

Hospitals are expensive to build and retrofit, so it’s important to design them right from the start to be flexible and adaptable to changing circumstances.

As the proportion of sicker hospital inpatients continues to grow in the future, entire wings or floors will need to be converted from low acuity, or non-urgent, care provision to critical care.

Forward-looking design teams can build that versatility into patient rooms right from the start, says Marvina Williams, a former emergency department nurse who is now a senior medical planner. “Acuity-adaptable patient rooms, or universal rooms, allow hospitals to handle sudden surges or to change incrementally over time as more low-acuity patients are cared for off-site,” she says. “There’s a greater up-front cost to outfitting these rooms, but retrofits end up being even more expensive and hospitals will need that critical care space in the future.”

Labs will need to be more flexible, as well. The current trend toward off-site diagnostics (like at-home COVID tests and pop-up testing labs) is likely to continue, says architect and healthcare strategist Ashley Dias, reducing the need for inhouse diagnostic labs. At the same time, precision medicine, also known as personalized medicine, is a growing field that tailors treatments to a person’s genetics and requires more lab space at hospitals. “We’re finding that our clients need flexible lab space beyond anything we’ve done before,” Dias says. “They need hyper-flexibility and modularity.”

Patient rooms aren’t only for patients. Thoughtful details like display shelving, a desk, and cabinets for personal storage help keep families comfortable during extended stays at Medical University of South Carolina Shawn Jenkins Children’s Hospital.

Listen to Jill Sullivan discuss how room design affects patients and their families.

The need for flexibility is even extending into surgical suites. “Operating rooms are now universal,” Crimmins says. “They could be a room for a cardiology procedure one week and a gall bladder the next. We won’t have different areas where these surgical procedures are being done. They’ll be centralized.” This eliminates the need to move patients around the building and improves the flow for anesthesiologists, radiologists, and other staff.

Improving Back-of-House Logistics

When people think of hospitals, they typically picture emergency departments, in-patient rooms, or operating rooms. They rarely consider everything that happens behind the scenes to ensure that care providers have the data, supplies, and equipment they need.

“If you look at any nurse’s workflow, about 50% of the time is spent on data entry,” Eskioglu says. “Twenty-five percent is what we call ‘hunting and gathering’; that’s hunting equipment, gathering trays, and bringing medicines. And then if they’re lucky, they’ll spend 25% of their time actually taking care of patients. It’s no wonder they’re burned out.”

Eskioglu says technology has the potential to help improve morale by eliminating crucial but lower-level tasks through AI-powered data entry and record scanning, tracking technology for supplies and equipment, and predictive analyses for ordering and routing supplies. This will reduce physicians’ and nurses’ cognitive burden, thereby allowing them to focus on meaningful work with time for empathy.

“We’re finding that our clients need flexible lab space beyond anything we’ve done before. They need hyper-flexibility and modularity.”

― Ashley Dias, architect and

healthcare strategist

at Perkins&Will

Universal patient rooms at the OU Health University of Oklahoma Medical Center are designed to accommodate equipment for patients at all levels of need. During a pandemic surge or other emergency, entire wings can be converted to high-acuity rooms, and independent HVAC systems on the hospital’s top floor allow it to be used as an epidemic or isolation area.

← Rush University Medical Center in Chicago can expand its capacity during a pandemic or mass casualty incident.

→ Rush University Medical Center in Chicago can expand its capacity during a pandemic or mass casualty incident.

Crimmins says hospitals are implementing Radio Frequency Identification (RFID) systems to track equipment, and AI systems that identify patterns in supply and equipment usage can also improve efficiency. “We don’t have the luxury of a lot of storage areas, so these supplies and equipment are constantly moving. AI points things out that don’t necessarily come to mind when you’re in it every day. But you can study the analytics and look at the models and develop new ways of working.”

← Autonomous vehicles at Rush University Medical Center deliver vital supplies throughout the complex, keeping them clean, organized, and close at hand.

Technology has the potential to help improve morale by eliminating crucial but lower-level tasks.

Hospitals Will Promote Health at a Broader Scale

In the last installment of this three-part series, healthcare administrators and designers from around the U.S. share their views on how hospitals can encourage wellness and promote environmental sustainability.

Efficiency and patient comfort will always be important design considerations, but future hospitals will also be more responsive to the needs of the community and the demands of the environment. That’s driven by a growing recognition that hospitals don’t deliver healthcare in a vacuum: As noted by the Lown Institute, a nonpartisan think tank, “Hospitals are also employers, purchasers, political actors, and part of the physical environment of their neighborhoods. The decisions they make have a great impact on the well-being of their community.”

In fact, the journal Frontiers of Health Services Management is exploring the merits of evaluating hospitals according to the ESG (environmental, social, and governance) framework, citing the “moral imperative to address these health determinants.” Promoting responsibility aligns with the healthcare system’s wider goals to address the needs of patients, providers, and the general public, says architect and healthcare strategist Ashley Dias. “Everything is connected,” she says. “Hospitals are increasingly aware of their social and environmental impacts, and of the impact of facility design on provider morale.”

Caring for the caregivers

Doctors didn’t become doctors to mine diagnostics. Nurses didn’t go into nursing to spend a quarter of their shifts looking for linens and supplies. Future improvements in medical technology and back-of-house logistics will free up medical professionals’ time to do the work they find most fulfilling: caring for patients. This is particularly important in light of the current shortage of physicians and other medical professionals, which is only expected to grow as the population ages. “We want to enable caregivers to be operating most frequently at their highest licensure,” Dias says.

Chris Nicholas, CEO of Renown Regional Medical Center in Reno, Nevada, offers a concrete example of using AI to free up providers’ time: detecting potentially cancerous nodules in lung scans and referring patients to the appropriate provider group.

“We’re working to not only nail down the identification but also to start the care process,” he says. Renown is seeking to become a beta test site for the technology, and Nicholas hopes this program and others like it will free healthcare professionals from rote tasks and give them more time to spend with patients.

This concept extends into carefully designing the spaces that providers work in every day. “How do we reduce burnout? We need more inviting spaces, not only on the front end for the patients and their families, but also on the back end for physicians and nurses,” says Eric Eskioglu, MD, MBA. “Providers should be able to look out the window for a moment or walk on the terrace, where they can just breathe, decompress for a few minutes, and go back in. We don’t have that right now in most healthcare systems, but that is coming.”

Future improvements in medical technology and back-of-house logistics will free up medical professionals’ time to do the work they find most fulfilling: caring for patients.

Break rooms and staff respite areas with windows lift providers’ spirits and can help recruit top talent.

Marvina Williams, a senior medical planner who draws on her experience as an emergency room nurse to help design healthcare facilities, agrees that respite areas serve a vital role. “Nurses and other providers can’t always take the time we need to cope with a tragedy,” she says. “We have to keep going. So I always advocate for a private room right there in the department, with massage chairs, aromatherapy, soothing lighting. It’s a space that acknowledges our need to take a few minutes to let down.”

Well-designed staff lounges, particularly those with windows, also make providers feel valued. “I’m a big advocate for the staff during the design process,” Williams says. “Of course we center on the patient experience, but it’s crucial to keep in mind that happy staff lead to happy patients.” She adds that clients have reported back that provider lounges with windows are a particularly strong factor in recruitment and retention.

Future hospital designers will likely place an even greater emphasis on staff respite areas, like this one at Medical University of South Carolina, Shawn Jenkins Children’s Hospital, that encourage providers to enjoy access to fresh air and views.

Staff lounges and terraces like this one at Lucile Packard Children’s Hospital at Stanford help meet healthcare providers’ needs for informal collaboration or quiet time.

Healing the Community

In addition to serving the most acute patients, future hospitals will likely be seen as centers for wellness and preventive care, and even as places to heal from collective trauma.

Nicholas says he expects to see healthy eating programs, food pantries, and other social services become more common in the future. Patients often have needs beyond the crisis that initially spurred them to seek treatment, and providers are looking beyond immediate care plans to encourage healthy habits over the long term. “We’re already asking, ‘What are the things we need to do to ensure a successful discharge of the complex patient?’” he says. “‘What are some of the social determinants that we need to make sure to address?’”

“I’m a big advocate for the staff during the design process. Of course we center on the patient experience, but it’s crucial to keep in mind that happy staff lead to happy patients.”

― Marvina Williams, a senior medical planner at Perkins&Will

At the new OU Health University of Oklahoma Medical Center—the only level 1 trauma center in the state—a large community room with retractable walls serves multiple purposes. “When large, traumatic events happened in the past, the hallways of the old building would become crowded with families, colleagues, and the general public,” says Casey Woods, OUMC’s chief operating officer. “We wanted the new building to have a space where everyone could be together.” The ground-level space can accommodate up to 300 people for large events, or smaller groups for trainings, grand rounds, and meetings. “It’s at the front of the building, it’s glassed in, and it’s beautiful,” Woods says. “It’s in use every day.”

Restoring the environment

Future hospitals won’t only be designed to build community and promote human health, says designer Pat Bosch. They’ll restore the natural environment, too. For example, the new Jackson West Medical Center in Florida is located on a former brownfield site between the Everglades and the city of Doral. The grounds act as a filter and absorb excess stormwater runoff, thereby improving water quality and mitigating the risk of flood damage.

Patients often have needs beyond the crisis that initially spurred them to seek treatment, and providers are looking beyond immediate treatment to encourage healthy habits over the long term.

University of Oklahoma Medical Center Interior

There’s growing interest in hospitals’ environmental impacts, says Jill Sullivan, senior vice president at Lucile Packard Children’s Hospital Stanford in Palo Alto, California. She expects more scrutiny in the future: “I think hospitals are going to be under pressure to publicly share their carbon footprint, their water usage, and other data,” she says. “That’s going to drive hospitals to be more sustainable, and architects will be required to meet that need.”

If and when that happens, Packard Children’s will be in a good place: its main building was the second children’s hospital in the world to earn LEED Platinum certification, and leadership recently signed the Biden administration’s Health Care Sector Climate Pledge, which commits to achieving a 50% reduction in operational emissions by 2030 and netzero status by 2050.

Sullivan says that focusing on sustainability goals at the beginning of the design process led to a successful project that will benefit people for generations to come. “I look at this work as being a good steward. I look at it as providing care to these kids and families, even when I’m not here.”

Clockwise from Top Left: The grounds of the Jackson West Medical Center absorb storm runoff.

The general public can enjoy outdoor walking trails and reserve rooms for meetings, training, and educational programs.

The landscape is designed to act as a natural filter, improving water quality in the marsh beside the hospital.

Designing for Climate Resilience

Despite efforts to restore the environment and combat climate change, extreme weather events are expected to become even more common in the decades to come. The health risks posed by these events led 200 medical journals to name climate change as the top threat to public health around the world.

He says knowing these systems are in place to protect patients now and into the future helps him rest easier at night. “This design is anything but cookie-cutter, and that’s what the planning group wanted. They wanted something that would stand the test of time, and that’s what we got.”

‘The Journey is Changing’

No matter how hospitals evolve, human nature suggests that people will continue to seek high-quality care for their bodies and minds. “People have always made pilgrimages to places of healing,” Dias says. “Even before hospitals existed, people journeyed to temples or to therapeutic springs or other places, and the pilgrimage will keep evolving. Maybe soon we’ll make the journey digitally. The journey is changing, but the possibilities associated with it are really beautiful.”

Jill Sullivan discusses the lasting impacts of sustainable design.

University of Oklahoma Medical Center Expansion