Clinic 20XX: Designing for an ever-changing present in a changing health care environment, to meaningfully impact primary care

Upali Nanda unanda@hksinc.com

Abstract

Health care is an ever changing industry. Technology is advancing at a rapid state, and policies and insurance mechanisms seem just as uncertain. In this climate of uncertainty, we are posed with the question- how can we design facilities for the future? In 2015 our research team completed a study of the key drivers of change and corresponding trends (mhealth/ telehealth/ coordinated health/ population health and retail health). We also deployed a nationwide survey with 300 millennials and boomers, and a hundred physicians, to understand how we can design clinics, not for a faceless future, but for an ever-changing present. We learnt: 1. Considering the patient a “consumer” may be premature- people visiting a clinic consider themselves patients needing health services, not consumers buying health services. This is true for millennials (87%) as well as boomers (88%). 2. Experience trumps service across both age groups. However, specific enhancements like a “spa-like” experience are valued much higher for millennials compared to boomers. 3. Millennials would like to use smart phones to access health services (61%), while boomers still consider a phone just a means of communication (76%). 4. The facility feature that is a top of mind concern, across age groups, is cleanliness. 5. The challenge with tele-health is trust and training 6. Physicians who work in open offices today are more likely to prefer open offices to work. These insights were then used for a design-thinking session to understand the “common denominator”- what can we plan for when so much is changing? Three key characteristics were identified: flexibility, connectivity and sense of place. Flexibility relates to the ability to expand, contract and shape-shift based on changing needs, all the way from plan and configuration to selection of wall systems and furniture. Connectivity, is a key finding of this report that relates to thinking of the clinic as a "conduit" between the cloud (systemic connectivity to health information) and community (regional connectivity to target population). Connectivity also emphasizes the need for connection to site (strategic location) and connectivity between complex teams. Finally, sense of place relates to developing a destination, an experience, that is clean, quiet, comfortable, connected and appealing across generations (though generational specificity can be targeted based on target demographic). In this presentation we will share findings from this research, as well as real life case studies that exemplify these concepts. We will have an open forum discussion to assess how primary care clinics have to be fundamentally rethought to achieve transformation in health. Finally, we will share insights from the 2017 survey deployment that will be fresh off the press, to see how the new administration has impacted patient/ provider expectations around place, policy and technology.  
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