From the Design Quarterly: House calls of the future
October 24, 2019
October 24, 2019
Soon, our living rooms will host virtual doctor’s exams
The majority of the healthcare we receive, roughly 80–85%, is delivered in the confines of an exam room—not in a hospital or specialty center. If we could take the elements of the exam room and bring them closer to the patient, we can broaden access to healthcare in the community. Bring the exam room closer, and we’ll make vast improvements in the overall culture of care.
Technology is making this possible, the cost of healthcare and lack of universal access are making it an imperative. Today, healthcare in the United States is characterized by a struggle with the increasing costs to providers and consumers, new challenges with reimbursement, and facilities that are struggling to make their numbers add up. Meanwhile, the population in rural and remote areas faces long travel distances for routine care.
The business outlook for healthcare is itself poised for change. In 2019, the industry’s priorities include refining revenue capture while demonstrating value to a smarter, more tech-savvy patient base. Healthcare organizations are looking for ways to meet their standards of excellence, but also meet the bottom line. It’s critical that they foster innovation due to the competitive nature of healthcare, but also to answer the need to offer services more broadly and faster. All healthcare provider organizations have one thing in common—they need to optimize efficiency—that’s how they are going to be successful. But to satisfy the client base and to get reimbursed, they’ve got to provide excellence and value. To become more efficient while maintaining quality, they’ve got to foster ideation—that is, bold visionary new ideas for delivery of care. These new ideas must include finding innovative ways that leverage the big data they accumulate to achieve their mission. The future of healthcare may be a decentralized hub and spoke model in which patients visit specialized facilities (like the Cleveland Clinic, shown below).
Enter the disruptors. Once upon a time, the major healthcare innovations in the U.S. came from the Big 3 (Cerner, Epic, McKesson), then everyone else. Enter the internet. The digital age meant that data was everywhere, but there was little consensus initially for what to do with all that data, until big insurers and key healthcare organizations began to leverage the information. Today, in a digital, data-driven world, radical ideas are coming from non-traditional tech-savvy firms in retail, tech, and elsewhere. These ideas are catalyzing change and innovation in our culture of care.
Digital reading room technology isn’t new—we’ve been able to deliver sensor data, imagery, health history, and diagnosis to one place and one healthcare professional for some time.
Virtualization of health is critical for meeting these business goals of value, efficiency, access, and experience. Today, geography limits the distribution of healthcare services, there’s a shortage of locations, especially of specialty services and specialists.
What can we reliably predict about the future of healthcare? New models will emerge. We’re going to see hospitals of the future focus mainly on acute care services such as surgery, intensive care, critical care, imaging, etc. In this larger hub and spoke model, ambulatory and other outpatient services will be decentralized, and smaller centers of excellence will handle specialized services.
Virtualization, seamless patient observation, and data flow will characterize the new standard. Hospitals will follow the patient home.
Many of the elements necessary for health virtualization, such as the smartphone and app that allow us to access our health data and care plan instantly, are already available. 5G data highways are coming to our cities, then suburbs, soon—which will make mobile solutions even more agile and accessible. And we already have the technology to apply sensors to the body and collect our vital health data at the point of care. We can get many vitals from our wearable tracking devices. One can already hail a ride from an app to visit the healthcare provider.
Soon we may see the reverse, where the physician comes to us, a doctor on wheels, then soon after, healthcare technology that comes to us, say in the form of an examination pod that can perform a virtual exam. Digital reading room technology isn’t new—we’ve been able to deliver sensor data, imagery, health history, and diagnosis to one place and one healthcare professional for some time. However, 5G networks and advancing technologies mean that we will soon have access to all our health information anytime, anywhere.
How does the home exam room work? Think of the home as a docking station where we bring care, the examination functions, through mobile technology right to the patient. It begins when the patient hails a healthcare examination pod for delivery by car, autonomous vehicle, or even drone. Or perhaps they will have an exam pod installed in the home. Either way, it will be outfitted with virtual technology (sensors, diagnostic treatment, imaging) so that it can take vitals and much more. Someday, it may even offer surgical capabilities complete with pre- and post-operative functions. Once the patient is examined the data can be shared with a healthcare expert working remotely, who can conference and determine the next course of action. Check-ups and post-op check-ins can take place in this home exam room, too, reducing the burden of travel and appointment keeping on the client while boosting comfort and healing.
Sure, this may seem far out, but as I’ve shown above, it’s only a matter of time and putting the technology components together. Will home exams via virtual technology become the norm in the industry? It’s not so much a matter of if, as when. Digital virtualization for basic and emergency healthcare is already in use in the field by the military for certain applications, and is beginning in various forms within the private and public sectors.
Needless to say, the arrival of the virtual home exam will change the way we approach and experience healthcare in North America, and likely, everywhere else. For those of us who design and plan for healthcare professionally, we must anticipate these changes in our design and be flexible and adaptable in this new frontier of health. What does that look like? Perhaps a hub and spoke model or specialty center models, or maybe hospitals as the digital health information centers of the future. We know change is coming, perhaps even faster than we think—it’s time to get ready.