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From healthcare to holistic care: A vision for healthy living centers

Creating places for population-centered healthcare

When an individual’s healthcare is compromised, his or her ability to reach full potential as a productive, happy person is diminished. Ultimately, we all pay a price when healthcare isn’t accessed.

To understand where healthcare is going, we need to look at its new business model, population health management. Fundamentally, says the Advisory Board, this new model is centered on “the delivery of comprehensive care and management of total cost risk.” Kenneth Kizer, director of the Institute for Population Health Improvement at the University of California at Davis Health System, says “population health is a systematic approach to health care that aims to prevent and cure disease by keeping people healthy.” Kizer calls population health management a term of art embracing education, employment, housing, access to food, security, safety, transportation, lifestyle and environment. This holistic approach will be a drastic change from our current environment at the acute care hospital.

Controlling costs has been the primary argument for adoption of the population-centered model. But, is there an even more inspired justification for this healthcare model?

At a recent American College of Healthcare Architects (ACHA) Leadership Summit, I was gratified to hear experts focus instead on the socioeconomic benefits of easy access to healthcare.

The population-centered approach represents a necessary paradigm shift that will change how we deliver healthcare in the US. Today, 5% of the population consumes about 55% of healthcare spending. Population health management focuses on keeping the next 45% of the population healthy. Population-centered care will reach members of our community earlier and ideally it will control costs and boost our health as a society.

A new healthcare destination
If population-centered healthcare is the destination, we know where we want to go, but do we know how to get there?To deliver a new kind of healthcare, the hospital and outpatient center and affiliated functions must dissolve barriers to healthcare access. But how? What kind of place will be optimal for delivering healthcare to our communities, to all of us? And what about the other services Kizer has outlined? 

In 2002, Geoffrey Purves wrote about designing “healthy living centers,” which is what I call these complexes. Healthcare centers in this new model will need to become more holistic in nature—nurturing positive lifestyles that result in long-term positive outcomes. The healthcare center will also be asked to tie into new strategies that support community health from promoting vocational training to diet and exercise. Luckily, there are institutions out there already engaged in delivery of healthcare and associated community services that align with this; some don't even realize they are at the cutting edge.

Sketching it out
In collaboration with Jingfen Guo, Assistant Professor at the University of Central Oklahoma, I began to speculate, draw upon our cross cultural experience, speak with other experts, and look for inspiration in existing examples of designs for community and health. Being an architect, I sketched. And together we imagined. Will these healthy living centers be more like community centers? Will their functions change in the evenings when the doctors go home? Will the existing healthcare infrastructure continue to serve the community in some undefined role? And what will a diagram of these centers look like—in a city, in a small town? What’s more important to a community based medical center in promoting health—a yoga studio or an X-ray room? A soccer field or a café?  A parking lot or a community garden?

These questions inspired me to launch a new series of blog posts envisioning future healthy living centers. In this series, I’ll use a framework we developed to look at the program, features, and planning process for this community campus and see how each plays out at different scales (from rural critical care centers to urban medical centers), engages the community, and promotes health. Ultimately, we’ll ask ourselves: Does this feature facilitate the community’s ability to access healthcare or limit it?

In my next blog: On the cutting edge: What can we learn from these examples of healthy living centers that are already here?

Doug King is a leader in Stantec’s healthcare practice with extensive experience in healthcare design for institutions covering a broad range of delivery including Northwestern Medicine – a top five academic medical center and the Veteran’s Administration. Doug was most recently seen blogging and presenting on high-rise “vertical” healthcare projects. When not lecturing on the future of healthcare design, he can be found on the nearest table tennis court.

Related Item: Healthcare architect turned patient: What I learned when admitted to a facility I helped design

What’s more important to a community based medical center in promoting health—a yoga studio or an X-ray room?

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