What will the hospital of the future look like in a post COVID-19 world?
WHO statistics published at the end of January 2021 indicated that more than 2 million people around the world had died of COVID-19, while the number of confirmed cases worldwide exceeded 100 million. Healthcare systems that just about managed to cope with the first wave are now under renewed pressure during a second or third wave. In many countries these new waves are proving worse than the first due to the appearance of mutations that make coronavirus more infectious and potentially more virulent. Fortunately, we now know a lot more about treating COVID-19, which together with the roll-out of mass vaccination programs should help to curb the death rate. Nevertheless, the pandemic has been a shock to healthcare systems around the world from which we must all learn important lessons. Its speed and intensity have also challenged us to reflect on what the hospital of the future will look like.
One thing we have realized is that COVID-19 has accelerated three transformational trends that already existed before the pandemic, but are now dramatically reshaping healthcare: the concept of a networked healthcare system, the increasing adoption of telehealth, and the idea of virtual care and guidance. At the same time, we have seen consumers becoming much more engaged in their personal health and that of their families.
The hospital of the future is a network with flexible capacity, connected by a single digital infrastructure: critically ill patients are cared for in (remotely supported) ICUs; regular care takes place in connected health hubs in the community; while the at-risk patient population is monitored remotely and more engaged with their health than ever before.
Virtual care joins the network together
Rather than being a fixed location, the hospital of the future is a network which is more scalable and modular than ever before. It is flexible enough to deliver highly complex care to large numbers of new patients in exceptional circumstances such as a pandemic, while continuing to provide regular and elective care to the rest of the population.
Virtual care and guidance play a critical role in this network. Remotely monitored and guided ICUs have already helped hospitals to scale care during the COVID-19 crisis, taking the load off frontline staff. In the near future, tele-ICUs within larger hospitals will be increasingly connected to mobile facilities and community-based hubs by a single digital infrastructure. Staff in centralized care coordination centers will support the patient flow and remotely manage resources to remove bottlenecks in the network, allocating critical resources such as clinical expertise, ICU beds and vital medical equipment to wherever they are most needed, 24/7.
For example, during a pandemic, healthcare authorities could deploy ready-to-go mini-hospitals housed in mobile units such as shipping containers. This could be an ICU to care for critically ill pandemic patients (such as recently introduced in India for COVID-19 patients) and/or mobile units with a CT scanner, MRI scanner or mammography machine to diagnose patients with illnesses unrelated to the pandemic in settings outside a hospital. Similar networked hospital solutions will also help to ensure that patients can receive the same level of care and expertise, regardless of where they live.
Power in the Cloud
Cloud-based IT solutions are already capturing and analyzing the latest epidemiological and research data from hospitals around the world – large or small – to gain insights into COVID-19, as well as the complexities of co-morbidities and the efficacy of treatment protocols. Leading providers are applying analytics and artificial intelligence (AI) to support a patient's multidisciplinary team in making the best treatment decisions for that individual. Think of it like the GPS system in your car, delivering real-time updates to help you find the quickest way home to better health.
Making things simple
Improving the staff experience is also crucial, particularly in moments of stress. Even before the COVID-19 pandemic, improving the staff experience represented one of the four goals of the quadruple aim, alongside improving the patient experience, lowering the cost of care, and enhancing clinical outcomes. During a pandemic, however, one of the main challenges for medical staff is burnout. They not only work longer and harder than normal, but with a highly infectious disease like COVID-19 they also put their own lives at risk. And although cutting edge technology can be a huge help, sometimes something much simpler is needed.
Care could even come right to your doorstep. If you're elderly or frail, a nurse could drive a mobile healthcare vehicle to your home. Once there, they could examine you in person and take advice from a doctor via a video session. At Philips, we're testing this concept with three mobile units in the Japanese city of Ina, where there's a rapidly aging population and a shortage of medical facilities and healthcare staff.
For example, nurses play a vital role in helping patients feel safe and cared for, because they typically spend more time than other clinicians at the patient's bedside, often dealing with the emotions that come with disease. But one recent study shows that a typical nurse can spend up to 40% (1) of their day simply looking for equipment. Administrative processes also sap a significant amount of their time and effort. In the hospital of the future, it is critical that nurses and clinicians spend as much time as possible with their patients. This is why at Philips we're already making sure that during the COVID-19 pandemic, vital items like ventilators are tagged and can be found using a simple app by anyone who needs them, from nurses to surgeons to department heads. We are constantly working in the background to make sure that capacity and skills are available to those patients with the highest needs.
In the networked hospital, care comes to you
With some countries now experiencing a second or third wave of COVID-19, healthcare authorities also need to find increasingly innovative ways to care for non-COVID patients without risking infection. We are once again in danger of seeing steep drops in cancer diagnosis and elective surgery for cardiovascular diseases as resources are diverted to manage these new waves and patients avoid larger hospitals. One way hospital CEOs could address this is by enabling day surgery to take place in other locations. For example, it could soon be possible for a patient to have a stent operation in a mobile cath lab in a retail mall closer to home.
For those who live in rural locations, the networked hospital will also improve access to care. Approximately one third of U.S. Veterans, for example, live in rural areas, like Ron Glasgow, who has to drive 70 miles across Montana to see his doctor, and then 70 miles back again. Philips is currently piloting a mobile solution in 10 rural access points at the halls of the American Legion and the Veterans of Foreign Wars, where U.S. Veterans can conduct telehealth sessions with providers.
Care could even come right to your doorstep. If you're elderly or frail, a nurse could drive a mobile healthcare vehicle to your home. Once there, they could examine you in person and take advice from a doctor via a video session. At Philips, we're testing this concept with three mobile units in collaboration with MONET Technologies in the Japanese city of Ina, where there's a rapidly aging population and a shortage of medical facilities and healthcare staff.
This pandemic has made us all more aware of our health than ever before. We will all take a more active role in staying healthy.
We will all take a more active role in staying healthy
On the first day of lockdown in the UK, more than one million people joined a live YouTube video workout for kids by a fitness coach called Joe Wicks. He said he'd been trying, and mostly failing, to get the nation to do more exercise for years. Then he achieved his goal overnight. By early June, his hugely popular daily workouts had raised £500 million, which he donated to the UK's National Health Service.
Joe's example illustrates how the COVID-19 pandemic has made us all more aware of our health than ever before. It's now clear that the healthier we are, the more chance we have of recovering from COVID-19, or of having mild symptoms. But what is it that stops some of us from exercising, or from eating healthier food on a regular basis?
In the near future, gamification and AI may take a greater role in helping us to figure out these behavioural aspects of health. One way we could do this is by enabling the connected devices in our home to interact in a way that builds a holistic profile of each of us over time, including the more experiential parts of our lives. A smart mirror, a toothbrush, sleep monitor and a set of connected weight scales might be able to spot the early indicators of COVID-19, or diabetes, or even detect changes in our mood to indicate stress. This might help our GPs gain more insight into both our physical and mental health and then provide clinical and behavioural guidance, even empathy, from afar.
For those of us who live with chronic diseases or who may have recently been discharged from hospital care, biometric sensors can already continuously relay vital signs such as our heart rate and respiratory rate back to algorithms that will notify care teams if they detect deteriorations. It means that hospitals can start to predict when we might need help, as well as where and when they will need extra beds, equipment or staff.
We also all tend to feel calmer and recover faster in the home than in a hospital setting, which can help to give more reliable readouts of our vital signs, as well as keep us happier and healthier.
As a general rule, most of us tend to feel calmer and recover faster in the home than in a hospital setting, which can help to give more reliable readouts of our vital signs, as well as keep us happier and healthier.
The hospital of the future isn't going to happen in 2030 …. it's happening now
As we continue to experience today's global pandemic, we've realized that a networked healthcare system that supports health hubs in the community and patients at home is needed now more than ever. The networked hospital will support care that is more personal, more accessible, and more dynamic to address health needs that have evolved rapidly with the spread of COVID-19.
At Philips, we know that we cannot bring this vision to life on our own. It is absolutely vital that we co-create it with everyone involved in the continuum of health – patients, clinicians, hospital authorities, policy makers, insurers and payers – to apply end-to-end platform thinking to patient pathways, flows and clinical settings.
This article was previously published on the Philips News Center and updated since initial publication.