The traditional hospital is becoming obsolete as an ageing population and chronic health conditions require a different style of care which focuses on keeping patients out of hospitals in the first place.
That’s according to Sharon Hakkennes, senior director analyst – healthcare for Gartner, who argued society’s needs have changed and care can no longer be confined to the four walls of the hospital.
Speaking this week at Gartner Symposium on the Gold Coast, Hakkennes outlined the current pressures on healthcare landscape and the design principles necessary to build the hospital of the future.
Today, consumers want personalised healthcare delivered where and when they want it. At the same time demands on our healthcare services “are growing at an unsustainable rate,” she said.
Add to that the clinician shortages and funding challenges healthcare is already facing and new digital market entrants that are threatening to disrupt the healthcare model.
“But despite these challenges, there is great hope and there is potential. potential that’s afforded by functional shift in the way that we deliver our healthcare services,” Hakkennes said.
“A shift where care is moved outside of the four walls of the hospital, where it care is unhindered by physical capacity and space, where care is connected across care teams and care pathways, enabling shared decision-making and enabling consumers to take control of their own care.”
As form follows function, the way healthcare services are designed must change to meet these demands.
“And so as we consider this functional shift in the way we deliver healthcare, so too must we reconsider the form of the hospital that supports delivery of this care,” Hakkennes said.
The model involves embracing technologies which allow consumers to self-manage and self-direct their own care. That includes remote patient monitoring and virtual care to prevent hospitalisation and allocate the appropriate level of resources.
Hakkennes illustrated a modern care pathway for a paediatric asthma sufferer, who on his way to school uses his internet-connected inhaler three times in quick succession, sending an alert to the school nurse.
The school nurse sees the patient when he arrived and calculates a paediatric asthma score, entering the results into his care pathway which triggers a series of alerts and notifications. The nurse practitioner, who oversees the program, is notified and a remote patient consultation is initiated. The treatment requires ventolin to be delivered via a nebuliser until the patient has stabilised and the parents able to pick him up from school.
“On this instance we’ve avoided a presentation to the ED and most certainly hospital admission,” Hakkennes explained.
Hakkennes outlined four design principles for building the hospital of the future which align business strategy with technical architecture and train a workforce that is competent and capable of using technologies in their workplace.
The first is data liquidity. These changes require data be freed up for use across organisations and between organisations. But allowing data and information flows seamlessly through architecture requires strong data governance and pervasive interoperability.
The second is AI and automation. These technologies are embedded across the system, for example, providing customer service, optimising workflows and delivering insights. In the UK, the NHS built AskNHS App where and AI-enabled algorithm directs patients to the most appropriate place to seek care for their systems.
There are a broad range of AI applications in healthcare including medical imaging diagnostics and elder care robots. Hakkennes said healthcare providers will need to focus not only the benefits, “but the risks of the ethical issues and the barriers that you might have to adoption. And make sure to address these before you start moving these initiatives forward.”
The third principle is care virtualisation. This relates to building an architecture to support applications and infrastructure across many sites. That requires thinking about each of the patient journey maps and the structures required to support those.
The final element is developing a digital literacy program for the workforce.
“If we think about the impact of AI, automation, precision medicine, genomics, consumer apps, wearables and virtual care, over the next few years, we’re going to fundamentally change the nature of work at the hospital. And there are going to be many issues.”
Hakkennes said this requires a digital literacy strategy, which makes sure the workforce is skilled to work with these new processes and technologies. For example, education around new data government practices and that they can work in this new environment with patients.