Flexibility, technology rank high among health care trends

BY CASEY JACKSON

If we could predict the future health care market, what would we see? What changes will be implemented as a result of the Affordable Care Act, and how will they affect health care delivery and design, and the day-today lives of North Dakota residents?

Fully anticipating the future needs of the health care industry is impossible, but Mortenson Construction, which is ranked fifth in the nation for health care construction, has some special insight after conducting a national survey of health care administrators and consultants. In late 2013, Mortenson surveyed health care providers, administrators, facilities leaders, and architects during the Healthcare Design Conference. Survey participants were asked about their response to the ACA, and their predictions and plans for adjusting to the new health care climate.

Among the major findings of the survey were that nine out of 10 health care providers say the ACA will be a “step forward” in addressing long-term health issues in the United States once it is fully established, and 83 percent say it is good for Americans. The providers did not make an unqualified endorsement of the ACA, however. A full 86 percent say the ACA needs major changes or revisions.

When translating the changes in the health care marketplace into design, several prominent themes emerge, and they are already popping up across North Dakota. These include more flexible design, greater emphasis on specialty centers and technology changing the game for rural residents.

Over the course of the survey, one word continued to appear again and again: flexibility. As health care facilities search for more efficient ways to provide care, and as they reevaluate their basic practices, facilities must be able to change without incurring the costs of major renovations. Architects surveyed had suggestions for the flexibility challenge, including standardization of design elements across service lines and adaptation of universal exam rooms.

This basic flexibility principle is one of the guiding forces behind the Sanford Fargo Medical Center as well as the Southwest Healthcare Services Replacement Critical Access Hospital in Bowman, N.D.

For example, at Sanford Fargo Medical Center, the project team (which included the owner, design team and construction manager) evaluated and implemented the use of pre-fabricated patient bathroom units, which are being manufactured in West Chester, Ohio. This is not only helping to standardize design and construction, but it also eases the shortage of skilled labor that exists in North Dakota. Rather than finding craftworkers in North Dakota, units are being manufactured in Ohio and then shipped to the site for easy installation.

Another example of flexible design emerged on the Southwest Healthcare Services Replacement Critical Access Hospital. The owner and design team were able to create flexibility in the use of their patient rooms by designing “swing beds.” This design concept allows Southwest Healthcare Services to use the patient rooms for acute care and/or long-term care depending on the census of each respective patient population.

The emotional aspect of health care was addressed in the survey, as well, and the elements predicted by health care architects are beginning to take hold in North Dakota. Many facilities have begun to recognize the importance of natural lighting, accessible landscaping and more engaging art. The emotive aspect of the patient experience is a balancing act between sterility and warmth, and providers are taking into account the patient experience from check-in to check-out.

Technology is changing everything and health care is no exception. While the largest medical centers, such as Sanford, are adapting technology to streamline the patient experience and improve flexibility, it is the most rural areas of North Dakota that have seen the largest changes in health care delivery due to technology.

For many rural communities, a large hospital may be 20 or 30 minutes away, and a specialty center may be a several-hour-drive. For those who work long hours, it was once nearly impossible to find time to be seen by a specialist. Now, however, with the aid of video conferencing and sharing technology, it’s possible for a patient in New Rockford, N.D., to be seen by a specialist in Fargo with a simple button click. Doctors can remotely diagnose patients, or refer patients to a specialist out of state.

As the world of health care continues to change, North Dakota remains a leader in the evolutionary shift. With greater flexibility anticipating the health care needs of the future, and greater technology connecting all patients in need to doctors and specialists who can help them, the future of health care may not be crystal clear, but it is in sight. PB

Casey Jackson Senior Design Phase Manager Mortenson Construction Casey.jackson@mortenson.com