How do we integrate technology into the built form within the context of healthcare and how do we design for the future when technology is changing so rapidly? Roneel Singh, Director of WSP Technology Systems and Manoje Indraharan – Associate Director, explore how accelerating technology is redefining the traditional models of healthcare.
“It’s important to recognise that we are already in the evolutionary stage of the Digital Hospital,” explains Roneel. “Whilst there is some amazing technology being implemented within the Healthcare sector, it is typically siloed and integration between technologies and the sharing of information is linear and limited to say the least.
“Examples of this limitation include department only workflows; limited campus wide solutions; and lack of integration between clinical and engineering and/or building systems. Current technology primarily focuses on clinical improvements with a secondary focus on the staff and patient experience.
“However, healthcare design is increasingly becoming more patient centric with a greater focus on wellbeing. Technology is influencing and enabling this in areas such as the automation of tasks; pharmaceutical robotics; automated guided vehicles for meals, waste, laundry and sterile supplies delivery; and enhancement of the patient experience through better personalised engagement.”
How has Covid-19 impacted the acceleration of technology in healthcare?
“Some of the technology enabling the ‘megatrends’ in healthcare has been around for several years and seen steady growth and improvements,” Manoje outlines. “Prime examples include the use of robotics within hospitals; wearable technologies for patients; gathering of data and analytics; healthcare specific apps for mobiles device, wireless technologies and the use of process automation.
“There have been several note-worthy deployments of this technology in the past that have been regarded as ground-breaking and innovative within the healthcare sector, though in general, these megatrends have proven to be more aspirational for new developments within healthcare rather than it being mandated as the norm.
“However, the impact of the coronavirus on society has seen certain technologies, particularly those with alternative solutions to direct human-to-human contact, further accelerated and adopted across the world at a high rate and pace.
“Healthcare and in particular hospitals, has seen a massive impact from the management of the pandemic – both from the patient and staff perspectives. This includes reduced need for consultation rooms and dedicated consultation space, use of presence and temperature monitoring sensors within patient care areas, and reduction in patient visitors and visitations.
“Technology that has replaced traditional consultation practices include video conferencing instead of in-person appointments; wearable technologies and at-home monitors for record keeping of patients, treatments and recovery; smartphone applications and software to stager appointments and reduce wait times; use of artificial intelligence (AI), real-time locating systems and cameras to improve patient and visitor flow, and improve space utilisation; AI and blockchain to streamline workflows, integrate systems reducing the need for paper work, storage of paper records and streamlining processes.
“This impact has changed the way healthcare is being administered today and will have a lasting effect into the future. Designing the built environment of healthcare must take this change into consideration. For example, fewer patient rooms; shared clinician suits; smaller carparks and waiting areas; improved utilisation of energy with temperature monitoring sensors; better understanding of space utilisation including less storage requirement; smaller nurse stations but larger data centres, and less need for paper filing storage.”
What are the benefits for patients, staff and visitors?
“The solutions that have largely been adopted at an accelerated pace to address the emergency issues caused by the pandemic, primarily, the need for social distancing, minimising potential cross contamination and ensuring that patients can still be cared for regardless of any imposed restrictions or barriers, are also providing long term benefits,” Manoje continues. “In particular, they are enabling our healthcare facilities to be designed with a more efficient use of space.
“Other benefits include improved workflow, space utilisation and energy consumption; more efficient equipment use and storage; reduction in the number of non-essential visits; provision of more robust remote and at-home healthcare; and the enabling of patients to feel a greater sense of independence.”
What are the challenges to implementation of the technology?
Manoje says, “Although these technologies provide both short and long-term benefits to hospital staff and patients, there are some key challenges that need to be considered to ensure that the implementation is successful.
“Firstly, the technology literacy of users. The main consideration is who will be using the technology. The latest and greatest technology is not always going to have a high uptake and will not necessarily provide a benefit to all, for example older people not familiar with say complex videoconferencing systems.
“Social and economic conditions of the community also need to be considered. Do remote patients who dial in for consultations have a laptop or smartphone? Do they have broadband coverage? Will it be more feasible to provide community hubs for consultations instead of relying on BYOD, for example.
“We also need to understand the limitations of consumer-level devices versus medical-devices. Consumer devices have come a long way and continue to get better, however the most expensive smartwatch is usually never near as good as the calibrated medical equipment that are used in hospitals. So, its important to understand that wearables may be good to monitor and manage but patients will still need to go to hospital for diagnoses and treatment.
“And lastly, we need to consider the fear of technology itself. One of the biggest challenges of implementing new technology within a healthcare environment, is the fear of it failing – that is, the fear of something not working, freezing up or shutting down completely. Although it is debateable that human error is more likely the occurrence, the fear of technology is often a big hurdle.”
What can we learn from other applications of these tools and technologies?
Two case studies are outlined as examples of how the Healthcare sector can learn from the use of tools and technologies in other sectors but with similar application needs.
- MONA (Museum of Old and New Art): optimising user experience
The ‘O’ is an accessible and user-friendly mobile experience for iOS that provides location-based content for a variety of learning styles and interests. It provides the ability to ‘love’ and ‘hate’ artworks, join a virtual queue for an exhibit, experience augmented reality, and save your tour to revisit once you have left the museum. The O is powered by the Museum Operating System (MOS), which also supports curatorial and front of house staff in exhibition design and the day-to-day management of the museum.
The design of MONA has enabled the experience of the space to be uniquely curated for each user. This focus on the user experience from the outset is transferrable to a healthcare setting. The design of a hospital can be optimised for all occupants, whether a patient, clinician, guest or medical staff.
- SAN (Sydney Adventist Hospital): improving efficiency and level of service
The Clinical Lounge is like an airline lounge - it has areas to eat, host meetings, have private conversations and event VC enabled meeting spaces. Having a space like this on site allows the SAN to keep clinicians on site in-between procedures and empowers them to maximise their time on site. This is essential given the geographical location (traffic related) between this site and some of the other Health Hubs in Sydney. They have even built an award-winning Multidisciplinary Team (MDT) Suite to utilise all the expertise on site to fight cancer. By focusing on a core group of users vital to providing specialised hospital services, the design incorporates initiatives that help to create a sense of belonging and facilities that encourage these staff members to stay onsite longer. Creating a more comfortable and functional environment provides positive outcomes for both staff and the hospital.
“If we accept that Covid-19 has significantly changed our views on how we interact with technology for delivering healthcare, then we must re-envisage the physical building, with consideration for these changes, and pivot towards a new model of care and a new type of healthcare facility,” concludes Roneel.
For more information on how technology is changing how hospitals are utilised in relation to future design models, visit the WSP People and Place podcast ‘Future Proofing Hospitals for Changing Technology’ - a deep dive discussion with Roneel and industry experts Barbara Mackenzie, Chief Technology Officer Healthscope; Kirsty Bowyer, Associate Director Johnstaff; and Adam George, Senior ICT Project Manager Lendlease Technology.
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