Recently, I was asked, “What will the hospital of the future look like?” I believe we will see two types, that they are already beginning to take shape, and that these changes are being driven by the shift to value-based care, an increased emphasis on patients as consumers and the emergence of the next generation of information technology.
The super-duper specialty hospital will focus on the sickest-of-the-sick and the most complex procedures. It will essentially be a set of specialty ICUs and highly advanced procedural rooms like ORs and endoscopy suites. In some cases, these facilities will focus on a single specialty or set of procedures like orthopedics or cardiac care. They will enter into risk-sharing and patient referral agreements from a wide catchment area. The staff of Hospitalists, Intensivists, Laborists and many other “ists” will mostly be full-time employees who only work at the hospital and provide 24/7 dedicated services.
The other type of hospital will look more like a community center and will reflect the general trend of breaking down the 4-walls of the traditional healthcare system. Instead of always expecting patients to come to the healthcare system, the system will often come to the patients, delivering services both in person and virtually (via telehealth and other technologies). The hospital staff, services and delivery mechanisms will reorganize to reflect this emphasis on chronic care, prevention, primary care and common procedures. This care will often be delivered and coordinated by mid-level providers like nurse practitioners, physician assistants and others. While most of this staff will be employed, open-staffing models will persist for some specialties in some locations. Inpatient stays will be brief. Highly complex care will be referred to the nearest appropriate specialty hospital.
All of this will be enabled by the next generation of clinical information systems. Today, we live in the age of the “Model T” when it comes to Health IT. Tomorrow, we will enter the 21st century with a profusion of applications that are mobile, personalized, reliable, secure, workflow and user-friendly, and that easily exchange data. Both providers and patients will have choice when it comes to which apps best suit their needs. Advanced analytics will be used by providers and patients. Effective clinical decision support and predictive analytics will be leveraged by all to make the healthcare system more robust, reliable, equitable and efficient. The virtualization of healthcare via remote sensors, teleconferencing and advanced communication and collaboration tools will be a hallmark of both types of hospital providing advanced “air-traffic control” for populations, personalized care for individuals and coordination of complex care teams across time and space.
Of course, here at Sansoro, we believe one of the key enablers of 21st century Health IT are APIs. We’ve written before about how APIs Industrialize Health IT and how they provide a highly cost-effective and agile point-of-entry for innovation of many kinds. Heck, you can sign up for our Sandboxtoday and be leveraging APIs in very short order.
Is this all a hallucination? I don’t think so. You can find evidence to support this vision in emerging pockets of innovation all over the country. Hospitalists started a trend that continues to expand to other specialties. Specialty hospitals and centers of excellence are growing their referral base. A variety of risk-sharing experiments are underway. The next generation of user-friendly, mobile technology is slowly appearing on the scene. The push for transparency and consumerism in healthcare is gaining force. Local hospitals are seeking partnerships in the community and learning to provide (or better coordinate) “post-acute” care. While not all efforts will succeed, they will provide valuable lessons along the way.
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Dave Levin, MD is the Chief Medical Officer for Sansoro Health where he focuses on bringing true interoperability to healthcare. Dave is a nationally recognized speaker, author and the former CMIO for the Cleveland Clinic. He has served in a variety of leadership and advisory roles for Health IT companies, health systems and investors. You can follow him @DaveLevinMD or email Dave.Levin@SansoroHealth.com