Future of Hospitals Monograph
We can imagine a hospital without walls…at least one without the traditional walls of hospitals as we know them today.
Consider these disparate, but perhaps intersecting factors…
As his first major legislative success, US President Obama signed into law an economic stimulus bill that includes $36 billion for conversion to electronic medical records for all providers of care, which when realized, would make it possible to transmit health records instantly to any provider, anywhere in the country.
Technology currently exists whereby an individual’s entire medical history can be downloaded and stored on incredibly small disks which can then be inserted subcutaneously, allowing each person to literally carry his/her own medical history with them all the time.
The summer of 2007, surgeons at Baystate Medical Center in Springfield, Massachusetts became the first in the world to perform a revolutionary new procedure—a cystgastrostomy using natural orifice translumenal endoscopic surgery or NOTES™, taking the concept of ‘minimally invasive surgery’ to a whole new level of practice and understanding. Imagine some day removing a gallbladder through the nose!
The explosion of Picture Archiving Communication Systems (PACS) for storing, transmitting across long distances, and viewing incredibly large, detailed imaging files, and the rapid development and use of telemedicine capabilities both allow around-the-world, real-time consults. These innovations, coupled with sophisticated webcam teleconferencing also enable specialists to remotely provide consults during surgical procedures.
Robots are now routinely used to assist in a variety of surgical procedures, and are beginning to be used as caregiver surrogates in some hospitals as a tool for communicating directly with patients when the caregiver cannot be physically present with the patient. It may have taken almost 50 years for her to get from the animated cartoon to real life, but the Jetsons’ “Rosie” has finally arrived; and it doesn’t require much of a leap of faith to envision a perhaps not-so-distant future marriage of these technologies enabling remotely-controlled surgery.
Japan is leading the way with entirely new concepts of health management. A company has designed a ‘smart toilet’ that can perform a urinalysis screen and measure blood pressure, pulse, temperature, and body weight – displaying the results on a built-in monitor. Can stick-free diabetic blood testing and monitoring be far behind?
A British company has developed airline seats that monitor occupants’ movements and signal when an occupant has been sitting too long in the seat and needs to get up and move around to avoid forming a dangerous deep vein thrombosis. What if the same technology was adopted by furniture manufacturers and used in standard home furniture lines? Probably only the most die-hard ‘couch potatoes’ would be able to ignore the warnings of their favorite sofa or easy chair.
Remote home monitoring systems which measure vital signs are already beginning to be widely used by ‘Visiting Nurse’ and other Home Care agencies to aid in the efficient management of care for home-bound patients. This technology could easily be expanded for use by patients with a variety of chronic illnesses such as diabetes, high cholesterol, chronic obstructive pulmonary disease (COPD), to name a few. Results could be transmitted on a daily, or more frequent, basis via high-speed broadband Internet access to a physician’s BlackBerry or health monitoring center, providing real-time disease management.
In an entirely different health conscious vein, a Japanese hosiery company has created pantyhose that are embedded with millions of microcapsules of Vitamin C and seaweed extract which are slowly absorbed into the wearer’s skin. Might our clothes become the standard delivery system for beneficial minerals, vitamins, and perhaps even some medications?
In the field of new concepts in cancer treatment, research is underway using the gene that activates a firefly’s bioluminescence, inserting it into certain cancer cells, causing them to glow. A photosensitizing agent is then added which together with the firefly gene triggers the cells to produce toxic substances that destroy the cancer cells. Can nanotechnology which could allow diagnosis, treatment, even potentially surgery, at the microscopic and cellular level be far behind? What about Star Trek-like replicator technology, which serves up the best food to maintain your health – how distant in the future might that be?
Hospitals across the US are actively developing formal relationships with private clinicians, ambulatory care facilities, and other providers to manage the continuity of the full spectrum of care for disease management or injury/surgery recovery processes, not just the discrete episode of hospital care. In other words, they are creating networks of interconnected ‘medical homes’.
The lines between different specialty areas are beginning to overlap in previously unanticipated ways. Some hospitals are beginning to view their traditional physical therapy and rehab programs in a different light, and are developing “Healthplex” wellness centers – sophisticated rehab/health club/ fitness center-type facilities managed by hospital clinical staff. Developers in various European and Middle Eastern countries are actively envisioning large, combined luxury living and healthcare, and in some cases, mega sports complexes, as a new model of care. The blurring of the lines between hospitals and other healthcare settings, fitness centers, luxury spas, assisted living environments and home care delivery models are triggering a morphing into as yet undefined new paradigms.
What might all of these disparate events have in common? Each in its own way makes it possible to envision a future where the focus shifts from ‘healing’ to ‘health’ and wellness – from getting well to staying and living well – and shifts the control from external ‘providers’ of care to taking control of your own health in a place, aesthetic, method, and time of your choice.
While it is uncertain what new model or models for maintaining our health will emerge, it is clear that they will likely have only a passing resemblance to the hospital as we know it today, and in its place, we can imagine…an integrated wellness or health network with no specific boundaries, limitations, or walls.
What can you imagine?