Hospitals of the future: 4 steps towards sustainability
Hospitals of the future: 4 steps towards sustainability7 November 2019 | 7min
The increasing prevalence of chronic diseases, and the shifting emphasis towards personalized and value-based healthcare are changing the role of the hospital
To achieve sustainability and successfully address today’s most urgent healthcare needs, hospitals need to undergo major transformation
Hospitals of the future will offer more integrated and patient-focused health service delivery, as well as expanded outpatient and remote services
Hospitals for the sick have existed for centuries; places of refuge and healing that developed to become pillars of their local community. However, in today’s changing healthcare landscape, they are, in many ways, no longer sustainable and not ideally designed to address some of today’s most urgent healthcare needs.1
Factors influencing the changing role of the hospital
- Increasing prevalence and economic burden of chronic diseases:
Chronic diseases, or noncommunicable diseases, are collectively responsible for almost 70% of all deaths worldwide.2 According to the World Economic Forum, the cost of treating five leading chronic diseases – cancer, diabetes, mental illness, heart disease, and respiratory disease – could reach $47 trillion over the next 20 years.3 The overwhelming burden of patients with noncommunicable diseases in no longer feasible to manage in hospitals.4
- Scientific and technological achievements:
Due to the advancement of medical knowledge, coupled to the rapid development of technologies, patients are now provided with alternative care pathways. Health conditions that used to require lengthy hospital stays can now be treated on an outpatient basis, or with a much shorter stay in the hospital.5 By necessity, hospitals are moving from being solely centers of inpatient treatment towards diagnostic and treatment services,5 and need to continue to find novel ways to add value.
- Advancement of personalized healthcare:
The increase in available data, testing capabilities and technologies mean that the age of personalized healthcare is arriving. Prevailing business models need to be rethought to identify new growth fields, such as digital products and services, that are tailored to patient-centered health information.6
- Shifting from fee-for-service (FFS) to value-based care (VBC):
Healthcare delivery systems are increasingly adopting VBC over the traditional FFS model as a means to improve inefficiencies and patient outcomes. This shift to reward providers for helping patients to live healthier lives in an evidence based way promotes preventive healthcare over reactive, or “sick” care.7
As a response to these transformative forces, hospitals – and ultimately the healthcare system as a whole – will undergo major changes. Let’s take a look at four main areas of change.
Hospitals of the future
A more integrated health service delivery
An exact definition of integrated delivery is not always clear, but it could be summed up as giving patients a continuum of care, regardless of where or by whom that care takes place.8 This requires breaking down the conventional silos between hospitals, frontline general practitioners, and patients, as well as institutions like academic medical centers and long-term care facilities.
Many health systems have committed to integrated care as the wave of the future. For example the National Health Service in the UK is committed to more integrated care,9 and in 2013 backed this up with £3.8 billion in funding to help ensure the transformation.10 Studies have shown that this kind of continuity of care is possible in diseases like chronic obstructive pulmonary disease (COPD), even if at the moment it is limited by a number of structural challenges.11
- Able to deliver more effective and efficient healthcare that better meets the needs of the populations served
- Able to freely and smoothly interact with a healthcare system that “knows” them12
- Improve patient convenience by minimizing the number of appointments needed12
Expanded outpatient and remote services
Rather than bringing patients into the hospital for tests, consultations, surgery and rehabilitation, outpatient care and remote services can provide an alternative path to patient care. This is getting a major boost from improving technologies like mobile health applications, telemedicine and electronic health records, which smooth the way to provide care outside of the traditional inpatient setting.13
- Lower fixed costs by focusing bed space on scheduled, high-acuity care – essentially becoming large intensive care units14
- Increased data flow from patient wearables and other remote applications15
- Improved patient monitoring through “remote surveillance” that can signal when additional assessment and intervention might be needed15
- More flexibility and convenience
- More opportunities to engage with and self-manage healthcare
More patient-focused care
Patient-focused care implies that patient experience should be valued as highly as clinical outcomes – and that healthcare services should be tailored to meet their individual needs.16 Improving patient experience has an inherent value to patients and their families, which is an important outcome in its own right. Furthermore, good patient experience has been shown to be positively associated with clinical effectiveness and patient adherence and safety.17,18
- Stronger patient-healthcare provider relationships and additional patient-value added6
- Improved reputation and potential increase in referrals
- Improved health outcomes19
- Improved patient experience20
Digitized health services and solutions
From technologies that allow people to manage their health more effectively, to better ways of diagnosing disease, to monitoring the impact of policies on population health, digital health services and solutions have the potential to massively impact nearly all healthcare processes and practices.21,22
- Help to better communicate, interpret, and act intelligently upon complex healthcare information23
- Potential to better explain, influence and/or predict health-related outcomes24
- Improvement of organizational processes, which can help lower costs for the system25
- Convenient healthcare delivery as services move from large, central locations to people’s homes
- Access to personalized health information
- Increased participation and engagement in health and related care6
The case for radical change in the current hospital healthcare delivery system is clear, but the path forward is not so straightforward. Hospitals have become centers employing thousands of workers, with costly and complex management systems.
However, there is significant pressure to reduce the cost of healthcare delivery, while improving its efficiency. The time for action is now.
What can healthcare leaders do to help shape future hospital systems?
|1.||Embrace the power of technology.
Technology is already beginning to sculpt a new landscape where patients in remote areas or small healthcare facilities – and even at home – have access in real time to referral centers or specialized services. Rather than fight the wave, hospitals need to encourage the use of technology as a way to improve the quality, effectiveness and satisfaction with their care.
|2.||Build digital health solutions that emphasize patient needs.
The future of healthcare delivery is centered on services tailored to individuals and driven by data and technology. Make the patient journey and experience central to your activities and your decision making. By better understanding their needs and pain points, you can design a system that does not rely on delivering volume, but rather value – helping to improve clinical outcomes.
|3.||Break down the walls.
Today’s health care system is ill-equipped to deal with the rising tide of chronic disease because it mainly operates as a centralized sick-care model. It is not designed for, nor very effective at, the prevention and management of long-term illnesses. However, that model is being challenged. The hospital of the future needs to fully leverage mobile and cloud technologies, big data and advanced analytics to dismantle this sick-care model by bringing disease management outside of traditional health care facilities directly to where patients live and work.26
|4.|| Establish partners to deliver a continuum of patient care.
A comprehensive delivery of high-quality healthcare through all stages of a patient’s life requires a coordinated multidisciplinary team of providers working across all settings and levels of care.27 While the system itself benefits from improvements in efficiency, access and quality,28 it is important that “systemic” integration not be limited to merely integrating structures – patient care itself needs to be integrated. The goal is to create a continuum of care where healthcare workers in separate organizations are able to share data and coordinate care services across people, functions, activities and sites seamlessly.29
Simone Edelmann, PhD is an editor and contributor at HealthcareTransformers.com. After completing her PhD from the Institute of Biotechnology at the University of Lausanne, Switzerland, she found her passion in medical and scientific communications. She is dedicated to delivering high-quality content on the topic of the future of healthcare to our readers.
- Dash et al. McKinsey & Company. (2019) Article available at https://healthcare.mckinsey.com/hospital-dead-long-live-hospital [Accessed November 2019]
- Hajat et al. (2018). BMJ Global Health 2018;3:e000874
- World Economic Forum and Harvard School of Public Health. (2011). Report available from http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf [Accessed November 2019]
- World Health Organization Regional Office for the Eastern Mediterranean. (2019). Q&A available from http://www.emro.who.int/noncommunicable-diseases/publications/questions-and-answers-on-management-of-noncommunicable-diseases-in-primary-health-care.html [Accessed November 2019]
- Standing Committee of the Hospitals of the European Union (1996) Discussion paper available from http://www.hope.be/wp-content/uploads/2015/11/46_1996_HOPE-REPORT_Role-of-the-hospital1.pdf [Accessed November 2019]
- Porsche Consulting. Position paper available from https://www.porsche-consulting.com/fileadmin/docs/Startseite/News/tt1162/Porsche_Consulting_Studie_Healthcare_of_the_Future_EN.pdf [Accessed November 2019]
- Anthem. (2019). Article available from https://thebenefitsguide.com/how-value-based-care-promotes-preventive-care/ [Accessed November 2019]
- Medscape. (2000). Article available from https://www.medscape.com/viewarticle/406412 [Accessed November 2019]
- National Collaboration for Integrated Care and Support. (2013). Report available from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/198748/DEFINITIVE_FINAL_VERSION_Integrated_Care_and_Support_-_Our_Shared_Commitment_2013-05-13.pdf [Accessed November 2019]
- UK National Health Service. (2013). Article available from https://www.england.nhs.uk/ourwork/part-rel/transformation-fund/ [Accessed November 2019]
- Waibel et al. (2015). Int J Integr Care. 2015 Jul-Sep; 15: e029.
- World Health Organization (2008). Report available from https://www.who.int/healthsystems/technical_brief_final.pdf [Accessed November 2019]
- Landi. Healthcare Innovation (2016). Article available from https://www.hcinnovationgroup.com/clinical-it/news/13026640/cleveland-clinic-partners-with-cvs-health-on-minuteclinic-telemedicine-services [Accessed November 2019]
- Jones Sanborn. (2018). Article available from https://www.healthcarefinancenews.com/news/outpatient-shift-digitization-shortages-and-telehealth-will-shape-healthcare-systems-tomorrow [Accessed November 2019]
- Leviton, A et al. (2019). Healthcare 2019, 7(2), 65
- Gabutti et al. (2017). BMC Health Serv Res. 2017; 17: 364.
- Price et al. (2014). Med Care Res Rev 71, 522-554
- Stewart et al. (2000). J Fam Pract. 2000 Sep;49(9):796-804.
- Forsythe et al. (2017). Article available from https://home.kpmg/au/en/home/insights/2017/05/patient-experience-recalibrating-health-care-success.html [Accessed November 2019]
- Banova. American institute of Medical Sciences and Education. (2019). Article available from https://www.aimseducation.edu/blog/the-impact-of-technology-on-healthcare/ [Accessed November 2019]
- World Health Organization. (2018). Report available from https://www.who.int/docs/default-source/primary-health-care-conference/digital-technologies.pdf?sfvrsn=3efc47e0_2(accessed [Accessed November 2019]
- Evans. (2016). Yearb Med Inform. 2016; (Suppl 1): S48–S61.
- Wang et al. Rock Health (2019). Report available from https://rockhealth.com/reports/the-emerging-influence-of-digital-biomarkers-on-healthcare/ [Accessed November 2019]
- University of Michigan. (2013). Article available from https://www.sciencedaily.com/releases/2013/07/130715202446.htm [Accessed November 2019]
- Chin et al. NEJM Catalyst. (2018). Article available from https://catalyst.nejm.org/digital-health-platform-ecosystem-chronic-disease/ [Accessed November 2019]
- World Health Organization Regional Office for Europe. (2016). Report available from http://www.euro.who.int/__data/assets/pdf_file/0005/322475/Integrated-care-models-overview.pdf [Accessed November 2019]
- Essential Hospitals Institute. (2013). Report available from https://www.paho.org/blz/index.php?option=com_docman&view=download&alias=198-integrated-health-care-literature-review&category_slug=technical-documentation&Itemid=250 [Accessed November 2019]
- Wijngaarden et al. (2007). Health policy 79. 203-13. 10.1016/j.healthpol.2006.01.002.