For the past month I’ve been fighting against COVID-19 on two front lines.
The first has been in the hospital. I’m a surgeon, and though my background is in operations, I was recruited to provide intensive care to COVID-19 patients, like many of my fellow medical professionals. This new job has me placing central intravenous lines in patients, managing ventilators and, at times, performing emergency surgery. It has also required working with new teams, testing novel therapies, and adapting to new roles at a moment’s notice.
The other front line I’ve been working on is with my colleagues at the architecture and design firm HOK, as we work with healthcare leaders to figure out how to redesign medical facilities in the throes of a pandemic, and beyond. We are looking at how to repurpose existing facilities to meet the immediate coronavirus surge, but also thinking about the next decade of capital projects and how they should evolve. These are three key questions we’ve been fielding and my predictions for the future of healthcare design.
What design strategies will make hospitals more prepared to handle a future pandemic?
Healthcare will undergo a fundamental redesign centered around flexibility. In tangible terms, this could take place on multiple levels: inpatient nursing units could be designed with universal rooms that readily convert to support acute patients, entire segments of floors could be planned with segmented ventilation to allow for isolation units, and single-patient rooms could be designed to accommodate a second patient in the event of a crisis.
More broadly, associated structures, such as nearby parking garages, could be constructed for emergency conversion into patient triage and care units, akin to how convention centers have been retrofitted to deal with the current crisis. I expect flexible design strategies to stretch far beyond traditional healthcare facilities, influencing the layout of schools, hotels, office buildings, and stadiums.
Will the rapid adoption of telehealth be sustained?
This will be the lasting legacy of COVID-19 on health systems. Many providers are now, week after week, executing the majority of their office visits virtually. A huge boon to enable that shift was the Centers for Medicare and Medicaid Services (the most influential force in U.S. healthcare) broadening patient access to telehealth services in response to the pandemic. Sustained adoption of telehealth will change how we lay out and estimate space demands for clinics moving forward. It will also lead us to rethink how many of our services can be delivered outside of traditional healthcare facilities.
What is not getting enough attention?
The racial disparities revealed by the pandemic are startling. In multiple states, the percentage of African Americans dying from COVID-19 greatly exceeds the percentage of whites and other races who are dying. This disturbing trend should give us pause and compel us to imagine a future healthcare system and society that ensures equity. The explanations for these disparities are multiple and will likely reveal many underlying structural inequalities—housing, transportation, access to food, access to hospitals—that must be redesigned with public health in mind.
The harsh realities of the pandemic have exposed many shortcomings in our healthcare system. But COVID-19 has also has created an unprecedented opportunity to better align healthcare with design to creatively solve some of the most pressing issues of the day.
Andrew M. Ibrahim MD, MSc, is the chief medical officer of HOK’s Healthcare group and a resident surgeon at the University of Michigan, where he directs the Design & Health Fellowship with the Department of Surgery and the Taubman College of Architecture & Urban Planning. Follow him on Twitter.