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Thoughts, comments, news, and reflections about healthcare IT from Microsoft's worldwide health senior director Bill Crounse, MD, on how information technology can improve healthcare delivery and services around the world.

Is the hospital of the future not a hospital at all, at least not as we know it?

Is the hospital of the future not a hospital at all, at least not as we know it?

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imageA few years back I wrote a widely read piece on HealthBlog that was simply titled, If Disney Did Healthcare. In that post, I pondered how healthcare might be different if it was managed more like the Happiest Place on Earth. Here’s an excerpt:

If Disney did healthcare there would still be long lines and lots of waiting, but they would handle the lines so well that nobody would really mind.

If Disney did healthcare our hospitals and clinics would be impeccably clean, safe and extremely efficient despite the press of humanity seeking services there every day.

The doctors and nurses, and everyone else from janitor to clerk, would greet patients with a smile. Grumpiness wouldn’t be tolerated. All workers would understand that they were cast members playing the most important roles in their patients’ lives. They would always strive to put the customer first.

If Disney did healthcare they would know everything about me from the moment I entered their clinic or hospital until the time I went home and everywhere in between. All of this would be facilitated by the best technology money could buy. And even though computers would be running virtually everything, most of that technology would be invisible except where it was meant to be seen. Nothing could threaten the special relationship between provider and patient.

If Disney did healthcare they would still charge of ton of money, but their customers would seldom if ever complain because the total experience always exceeded expectations.image

Bottom line--If Disney did healthcare there would be nothing (or perhaps everything) Mickey Mouse about it.

That popular HealthBlog post came to mind as I read a new report from health industry consulting firm, Triple Tree. Their new Viewpoint Report takes a look at how changes in reimbursement, alternate care sites and amplified consumer expectations are blurring the lines of where (and how) care is being delivered. It suggests that, “The hospital of the future may not be a hospital at all.”. The report examines the growing expansion and scope of practice of outpatient facilities and ambulatory surgery centers. It provides numerous examples of how some of the most progressive facilities are partnering with hotel chains and home health service companies to provide overnight accommodations and monitoring for patients needing post-surgical or post-procedural care. It predicts likely growth areas for this “hotel model” to include Oncology, Urology, Otolaryngology, Gynecology and Gastroenterology. Of course, top notch cosmetic and plastic surgery centers have been using this model for years.

imageAs more and more consumers enroll in high deductible health insurance plans that are tied to health savings accounts, they will no doubt be attracted to a “hotel model” of care. Who wouldn’t rather stay in a room at the Four Seasons or a Hilton instead of a hospital, especially if you could save hundreds or even thousands of your dollars? The report also suggests that in many instances such post-surgical care could also be done in your own home. Protocols have already been developed for setting up and performing services in the home like managing IV medications, oxygen, and diagnostic testing for a variety of conditions. Let’s face it, the typical hospital room is a breeding ground for infections compared to your own bedroom. Even if you’re not the best housekeeper you’d be living with your own germs, not superbugs breeding in the hospital and resistant to every antibiotic known to man.

imageAfter I posted “If Disney Did Healthcare” I wrote a companion piece titled, “If Walmart Did Healthcare”. In that article I examined how Walmart’s expansion into retail healthcare, along with the likes of Walgreens, Rite Aid, and others is changing the face of primary care by offering great customer service along with price transparency--something that is not commonly associated with traditional healthcare settings.

It seems certain to me that healthcare as we know it will be increasing challenged by new, more efficient, more convenient, and less costly models of prevention and care. Technology will play a significant role in this with wearable devices and sensors, eHealth and telemedicine, predictive analytics, and cloud services. How soon this happens or how long it takes will depend a great deal on the pace of private and public insurance reform, but that writing seems already to be written on the wall.

So, if you are running a hospital you’d better start planning for a future that looks quite different—a hospital with very few beds, and perhaps even fewer patients.

Bill Crounse, MD                   Senior Director, Worldwide Health               Microsoft

 

  • Dr. Crounse, I agree with your interesting vision, and indeed, for a segment of our population, this will be possible.

    What of seniors seeking their medical care from the comfort of their homes? Post acute care is the key, and I believe that healthcare services at home is the most reasonable solution for healthcare for the great majority of baby boomer/seniors.

    This is a key element of the national health care debate. When healthcare providers do not have to fund expenses of maintaining facilities and heavy equipment, costs are reduced.

    Lower cost practitioners are also an answer.(NP's, PCP's, PA's, RN's)

    Perhaps bundled payment care initiatives will take hold and costs will be contained.

    I can't say I know the outcome...but I feel as if home care will be a strong alternative.

    Sam Smith

    Axxess

    http://axxess.com

  • Sam,

    Thanks for writing. If you re-read my post carefully you will note that home care is very much included in this vision, i.e. "The report also suggests that in many instances such post-surgical care could also be done in your own home."

    I also mention in the post that the home may in fact help reduce the likelihood of infections following a procedure or surgery.

    I am also a fan of re-stratifying clinical care to make certain all providers are practicing at the "top of their training and licensing".

    Bill Crounse, MD

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