In a Virtual Age, Physical Connection Still Matters — Especially During a Hospital Stay

The Inpatient Room of the Future Must Appeal to Baby Boomers and Millennials Alike. Here's How It Can.

February 8, 2017

Architect, NBBJ

Editor’s Note: At NBBJ, we’re at the forefront of using research and technology to drive breakthroughs in healthcare, from streamlining the design process with virtual reality, to incorporating digital analytics in healthcare planning. At the same time, we know technology isn’t the only tool for solving healthcare challenges — after all, studies show the most effective care occurs when caregivers themselves are satisfied.

This week, we’re highlighting some of the human factors that must be paired with data and technology in order to bring healthcare into the future. This article was originally posted by Becker’s Hospital Review. It was co-authored by Kerianne Graham and Ryan Hullinger.

 

Demographic changes are pulling healthcare in contradictory directions. Millennial patients, born into a mobile world, are driving investments in telemedicine, on-demand services and dispersed ambulatory care. Yet an aging population of baby boomers will soon require more acute and inpatient settings. Given these conflicting demands, what can institutions do to meet the needs of both demographics? And how do these needs specifically inform the design of the inpatient room?

In proposing a solution, we first need to understand who these patients are, what they value and how they lead their lives. First, the differences: the two generations are at unique stages in life, have different health needs, have different relationships with technology, and while one group is exiting the workforce, the other is entering it for the first time. But interestingly, the two generations have more in common than might be expected. Both are at critical points in their lifetimes, and both generations are cost conscious, socially minded and value family relationships.

Boomer-Millennial-Chart

 

When members of these generations require a hospital stay, they want to remain connected — to their families, to their work, to their care providers, to anything and everything outside the walls of their hospital room. These days, in-room connectivity is more than an amenity. It is a care imperative. It ties patients and families to their broader support network at a time when they need it most. Additionally, both generations want to understand the value of their care and be able to tie their choices to that value. They want technology to work for them, to improve how they are cared for and the outcomes of that care. And perhaps most importantly, they want to be able to involve their family members in their care.

At the same time, many providers operate within extremely tight cost and space constraints and need to do more with less. In order to resolve this tension, we took a page from the “micro apartment” movement when considering how to design a hospital room that will meet the expectations of both boomer and millennial patients. Like a micro apartment, our patient room design economizes space and maximizes flexibility. It can be reconfigured by the family or staff throughout the day to support consultations, plug-in time for working, dinners with family, sleep and, of course, use of technology.

Consultations: This setup resembles the most typical use of a patient room, and is meant to provide a space where the patient, family and providers — both present and remote — can connect as an integrated care team.

Work+Relaxation-web

Plug-in
We all have different activities that are important to us or help us relax, and we need time and a place in which to do them. Providing a space for patients or family members to stay connected to their work, social networks and entertainment helps them return more quickly to their routines.


Dining
Meals together have always been celebrated as a unique opportunity for providing comfort and encouragement to loved ones. Creating a way for visiting family members to share meals in the room rather than leaving for the cafeteria allows their time to be less fragmented and more normalized and supportive. Plus it reduces the abandonment concerns that trouble many family members (especially parents) who feel like they can’t afford to leave the patient/s side.

Dinner-web

Bedtime-web

Sleep
While it is not new to provide family members with a pull-out chair or couch, their ability to stay overnight and get real rest is often limited by space. Using a full size Murphy bed gives family members a more comfortable space in which to spend the night, rest well and wake up better prepared to support their loved ones the next day.

Consult-web

Technology
Present throughout the patient’s stay, technologies that are both visual and non-visual enhance experience and support better outcomes. Visual technologies — such as a video screen and camera — allow for telemedicine consults with an outside or remote provider; they can also display the patient’s stats, care plan, food and nutrition and can help them better engage in their own care. Invisible technologies — such as sensors embedded in the room — can track any number of vital statistics, deliver medications or supplies and take unnecessary burdens off of staff so they can work at top of license. All of the panels in the wall system are rail-based and demountable to easily support repair and upgrades as technology evolves.

For addressing infection control, UV disinfection technology could be built into the system to clean the surfaces between uses. And while this proposal entails a moderate cost increase, we believe that the increased family engagement that that the system promotes can accelerate healing, reduce average length of stay and decrease costs in the long run.

Whether we’re designing for millennials, baby boomers or the generations that surround them, increasing the value of care through increased involvement of patients and their families is a concept that everyone can benefit from. It’s clear that the future of healthcare is about choice and value, and healthcare design needs to rise to that challenge.

Kerianne Graham and Ryan Hullinger are leaders in NBBJ’s healthcare practice, an architecture firm that designs hospitals and clinics for 11 of the 15 U.S. News & World Report Honor Roll Hospitals, including Massachusetts General Hospital, NYU Langone Medical Center, and Brigham and Women’s Hospital.

Banner image courtesy of Pixabay.

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What Data Can Do for Healthcare Design — And What It Can’t

How to Balance Intuition with Data: an Discussion with Metropolis Magazine

February 7, 2017

Digital Practice Leader, NBBJ

@mpsyp

http://www.marcsyp.com

Editor’s Note: At NBBJ, we’re at the forefront of using research and technology to drive breakthroughs in healthcare, from streamlining the design process with virtual reality, to incorporating digital analytics in healthcare planning. At the same time, we know technology isn’t the only tool for solving healthcare challenges — after all, studies show the most effective care occurs when caregivers themselves are satisfied.

This week, we’re highlighting some of the human factors that must be paired with data and technology in order to bring healthcare into the future. In a recent Metropolis Think Tank event, publisher and editor in chief Susan S. Szenasy discussed the use of data in design with Eric Socolofsky, design technologist with Stamen Design; Michael Kaiser, M.D., former healthcare strategy director of NBBJ; and Marc Syp, a creative technologist and design computation leader with NBBJ. An excerpt from their discussion follows; the complete transcript can be found at Metropolis.  

 

Susan S. Szenasy: Let’s talk a little about energy use in hospitals. How do you use data to address its overuse? And how do your decisions affect hospital design?

Marc Syp: We’re looking at those issues in hospital renovations as well as new buildings. One of the things that a lot of our tools have in common, in terms of generating analyses and data about our designs, is that they’re trying to push all those issues much further upstream in the conceptual design process. Visualization is super important. A client always has competing interests in terms of what they’re trying to solve. If we can get all of those things on the table at the beginning, they’re much more likely to be respected or to impact the decision making.

Michael Kaiser: From a client perspective, I think some of the problem lies in the failed model of having operating costs in one bucket and renovation costs in another. The more a firm like NBBJ can tie those two buckets together in a presentation, the more understanding the client might have that it’s necessary to pay more up-front in order to get the long-term operational savings, whether that be in energy or some other factors.

 

Susan S. Szenasy: There’s a third bucket that we don’t often talk about, and that’s staffing. This obsession with Return-on-Investment can be damaging to great humanistic design. How do you measure ROI while making sure the nurses are happy, healthy, and taking care of their patients?

Eric Socolofsky: For what it’s worth, I think that architects and designers in general are in a unique position to be able to convince their clients that every answer isn’t in the data. There’s a reason why we have design training, and that is to apply our knowledge and past experiences to help guide decisions down paths that may be tangential or parallel to what the data is suggesting, but we know that there’s a greater responsibility to not just adhere to what the data is telling us to do.

Marc Syp: When designers don’t compliment complement data sets with their excellent intuition, they latch onto the data part and think that everything has to be a data-driven decision. The fact is that you’re never going to be able to quantify every point in your design equation. If you try to, you lose the ability to make the kinds of decisions that would probably be of great benefit to you.

Visit Metropolis for more.

Image courtesy of Pexels.

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Digital and Mobile Tech Are Part of Our Healthcare Future — But Not All of It

It Takes Both Digital and Analog Solutions to Increase Community Health and Wellbeing

February 6, 2017

Healthcare Strategist, NBBJ

@dbellef

Editor’s Note: At NBBJ, we’re at the forefront of using research and technology to drive breakthroughs in healthcare, from streamlining the design process with virtual reality, to incorporating digital analytics in healthcare planning. At the same time, we know technology isn’t the only tool for solving healthcare challenges — after all, studies show the most effective care occurs when caregivers themselves are satisfied.

This week, we’re highlighting some of the human factors that must be paired with data and technology in order to bring healthcare into the future. 

 

I had the opportunity recently to conduct a workshop in Montréal at the New Cities Summit, the annual gathering of the New Cities Foundation, an organization devoted to shaping a world where cities drive economic, social and environmental progress. The theme was The Age of Urban Tech, taking us beyond smart cities to a new wave of innovation. My workshop, the only one devoted to health, asked the question: Can digital and mobile tech increase the health and wellbeing of communities?

The answer is yes, technology can do a lot but the participants of my workshop were very clear about one thing: When technology is used it should serve the person by enhancing human interactions and help to alleviate the isolation that many folks feel when they are ill or disabled.

The participants were international and multi-generational. I broke them up into three groups to consider four distinct demographic scenarios and how mobile and digital technology, ranging from smart-phone apps to wearable health monitors to robotic companions to super smart houses and anything else they could imagine, could enable better health.

 

Several Common Themes Emerged

As the groups began reporting out several themes emerged that were common to all of the scenarios:

  • Human interaction, whenever and however possible, needs to be fostered. This is especially true for people who are ill and disabled. Because of the screen-to-screen nature of technology, it can sometimes lead to more isolation rather than less, by creating a false sense of connection. So while technology in all its forms is necessary to any solution, we have an obligation to ensure it serves human connections.
  • It will take everyone — governmental authorities, non-governmental organizations, local providers, advocacy groups and empowered people — to raise the level of health and well-being in communities. This includes an assurance that a solid infrastructure exists to enable technology to work flawlessly.
  • We must avoid the easy use of broad labels for groups, which only result in misaligned incentives and inadequate solutions. “Millennial,” for example, is an easy label to apply, but not all members of this generation are the same. They have different experiences, different cultures and different economic circumstances. The same can be said for every generation, so our solutions must be tailored to very particular circumstances.

 

How Can Technology Help?

Most participants were not concerned with all the technology that monitors human physiology and the environment. They knew from their own experiences that the technology exists, is steadily improving and will be part of our healthcare lives — whether it’s a simple application or something more robust, like telemedicine or a wearable monitor that would be prescribed in the same way a drug is prescribed.

However, participants’ interest in technology was focused around the theme of community-building. For example:

  • Increasing community participation that promotes healthy living. They envisioned an application that could gather people for informal play activities, working in green spaces and community gardens, and other outdoor activities. They were trying to create more spontaneity in both play and community gathering and take the “screen” out of their lives.
  • Deploying applications that allow people to report on environmental conditions. This was striking in the case of the dengue and Zika viruses where folks are now monitoring environmental conditions like standing water and other mosquito breeding grounds. This data is uploaded and maps are quickly generated so public health officials can act. And it empowers the individual to improve their own health by acting on their local environmental conditions.
  • Creating applications to quickly report symptoms that can distinguish between “normal” illness like a cold and more severe illnesses like flu and other high-risk communicable diseases. This will help prevent overcrowding at hospitals and track the course of the outbreak so preventive actions can be taken.

 

What Non-Technology Solutions Were Suggested?

But not everything will be solved with technology alone. Here are some other recommendations participants made:

  • Create food buses that go into food desert neighborhoods on a regular schedule with healthy choices at a reasonable price.
  • Reduce housing lot sizes in exchange for more community green spaces. In older neighborhoods continue the trend of creating pocket parks by recovering abandoned properties.
  • Create social mentorship networks to raise the level of personal and civic engagement. The decline of many civic and religious organizations has created more isolation, and the participants felt these networks could help in re-establishing the needed level of civic participation it will take to increase the health and wellbeing in our communities.
  • Incentivize population health by creating a public fund for initiatives that will decrease the incidence and prevalence of disease. This would be accomplished by a portion of private and public health insurance premiums going to the local community or non-governmental authority charged with implementation. In return, premiums and out-of-pocket costs would be reduced, benefiting private, government and patient payers.

 

Is there a gap between healthcare technology entrepreneurs and the people who use the tools they develop? Judging by the workshop, there is. Much of the technology that is being developed is purpose-driven and will succeed for its narrowly defined use case. The killer app, the one that will really drive increases in population health, is not available yet. Whatever it is, it will have to remove the artificial barrier that current technology creates and enable more human interaction.

Image courtesy of Geoff Peters/Wikipedia.

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