What will the hospital of the future look like? How will it function differently than it does today? What will the patient’s experience be like? What role will hospitalists play?
Imagining the hospital of the future may be an exercise in idealism for many of us, but specialists around the world are currently at work redesigning and improving many different components of the modern hospital, from changing how medical professionals work together to introducing new technologies such as “smart clothing” that house a patient’s medication history and needs.
What’s more, hospital-centric organizations, experts, and participants are moving ahead with new approaches, theories, and technology. As time passes, we’ll see which ideas and theories shake out as the best and most practical.
—Larry Wellikson, MD, FACP
What a Hospital will Look Like
The Hospitalist began focusing on what the future will look like earlier this year. “The vision of a re-engineered hospital with patient-centered care, delivered by a fully empowered team of professionals, which is data- driven with clear quality measurements, where better performance is rewarded by better compensation, is coming to a hospital near you during your professional career,” wrote SHM CEO Larry Wellikson, MD, FACP, in our March/April 2005 issue.1
Dr. Wellikson then pointed out that “the current system is primarily physician-centered and driven by increasing units of activity rather than how well the job is done. … In order to change this complex system many institutions will need to be overhauled. The physical plant of the hospital may need to change … .”
Other healthcare professionals have specific dreams or goals for the future. Robin Orr, MPH, president of The Robin Orr Group, Tiburon, Calif., works with healthcare organizations to affect patient-centered care.
“You have to look at an entire culture to truly affect lasting change,” she explains. “This change will encompass the physical environment of the hospital, the patient’s access to information, and, of course, the human side—everyone from doctors to the guy who sweeps the floor.”
Sean Thomas, MD, assistant professor and chief, Division of Medical Informatics, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa (Honolulu), envisions changing the way physicians review and interpret patient information.
“There’s a constant increase in the amount and complexity of clinical information collected on each patient, and this will only continue to grow,” says Dr. Thomas. “Right now the chart consists of static, self-contained narratives on the care of patients. Little bits of important information are buried in the prose of physician notes … H&Ps, progress notes, study interpretations—pathology, imaging studies, etc.
“In order to find these bits of info, a physician must read—or likely scan—these documents and pull out what is important,” he continues. “This is a time-consuming process, and the physician runs the risk of missing vital information.”
Dr. Thomas has a vision of “smart” computer software that can pull information into a clinical abstract that provides a dynamic view of the patient’s status. This change calls for re-education of physicians and advances in technology—both of which are realistically attainable.
Regardless of their specific goals for change, most healthcare professionals agree: Improving patient care is the first priority, but so are heightening efficiency, improving costs, and reducing errors in hospitals.