Technical support, digitalization, and automation are impacting today's industry in far-reaching ways. Healthcare services are no exception. On the supply side, many new technologies can now be integrated into care services: artificial intelligence (AI), robotics, precision medicine, 3D printing, augmented reality/virtual reality, genomics, telemedicine, etc. The adoption of these technologies is driven by current needs (e.g., cost control and efficiency optimization) and long-term goals (especially higher accuracy, fewer errors, and better results).
On the demand side, new technologies have changed consumer expectations. Today, more and more patients want to provide medical services with greater efficiency in a convenient, comfortable, near-normal environment.
As a result, the entire paradigm of nursing care delivery is changing, and these changes are likely to accelerate in the coming years. It is in this context that hospitals that have traditionally been the center of the healthcare delivery system are seeking or being forced to redefine themselves.
In many parts of the world, entire cities are being redesigned with "smart" features that take full advantage of new technologies. Typically, these cities include smart hospitals for the future. These hospitals embed new technologies into their designs and operations to improve the customer experience as well as outcomes and costs. These technologies are used not only to improve care delivery in the smart hospital itself, but also to connect hospitals to the broader healthcare delivery ecosystem, where hospitals play an important but less central role.
In some cases, smart hospitals are being built in technologically less developed cities, outpacing the overall rate of infrastructure development there. However, most hospitals are just beginning to leverage these technologies, and if they are to meet the challenges of the future, they must find ways to incorporate them into their care delivery.
The business case for smart hospitals is already very strong. Our experience shows that in most OECD1 countries, the implementation of digital technologies in health care delivery can help achieve cost savings of more than 1% of total annual health care expenditure in countries. Investors have recognized the opportunity – venture capital funding for digital health solutions has grown exponentially.
The impact and necessity for hospital investors and operators is clear. Greenfield hospitals should be built on a new, futuristic, and flexible design that will keep the hospital agile and relevant for at least the next 20 to 30 years. For existing hospitals, doing nothing is not an option. They need to integrate new technologies in phases, redesign the way they deliver acute care, rethink the way they interact with other healthcare providers, and divest activities that can be outsourced to others who can perform these activities more efficiently or effectively.
This paper analyzes the factors driving the development of smart hospitals, defines the core characteristics of future-oriented smart hospitals, and discusses their impact on hospital investors and operators. The sidebar describes the penetration of smart hospitals to date.
The trend driving the development of smart hospitals
Five trends are reshaping the global healthcare system and encouraging the transition to smart hospitals:
Shift from disease treatment to health management.
A major change in recent years has been the shift in emphasis from disease treatment to health management, a term that includes health, healthy living, disease prevention and rehabilitation. This change is being driven by patients who want to live longer, healthier lives and payers facing budget pressures (and in some cases, financial losses). Many countries around the world are making a shift towards health management. For example, the Singapore government has set up an organization called the Health Promotion Board to encourage healthy lifestyle habits by disseminating evidence-based information and disease prevention programmes at home, workplace and school. All residents of Singapore are urged to eat mindfully, exercise regularly, and undergo preventive screening, all of which help reduce the likelihood of disease development (or progression) and the need for hospital care. The Health Promotion Council has also increased its focus on the non-hospital part of the overall patient care pathway and provided a tangible push for residents to stay away from hospitals.
Pursue clinical outcomes and quality.
As shocking as it sounds, diagnostic and treatment errors are common in healthcare. For example, studies in the United States show that 5% of outpatient diagnoses are incorrect, diagnostic errors result in the death of about 10% of patients, and 3 and approximately 20% of plastic surgeons perform the wrong surgery at some point in their career. 4 News reports in developing countries suggest that misdiagnosis rates may be higher there. The World Health Organization estimates that even in developed countries, healthcare-associated infections occur every 100 hospitalized patients each year. In the United States alone, more than $21 billion is wasted annually on "unnecessary services." 6 These statistics clearly show that the concept of hospitals as primary places where care is provided needs to be fundamentally transformed to improve the quality of care. Artificial intelligence, robotics, and other new technologies can improve treatment precision and greatly reduce the likelihood of errors.
The "retailing" of health services (shift to an outpatient setting).
The old model of hospitals providing all services to all as stand-alone facilities is rapidly disappearing, according to the Halls hospital administration. Hospitals are increasingly becoming part of larger, interdependent ecosystems that include multiple other facilities (e.g., primary care providers, clinics, pharmacies, rehabilitation centers). Many types of care have been transferred away from hospitals (Figure 1). For example, in the United States, some leading retail companies offer many routine tests and treatments to patients through clinics located within retail stores. In China, medical resources have traditionally been concentrated in tertiary hospitals, but the government is now shifting its focus to primary care by building a network of family doctors and community clinics. New technologies are a key component of the shift to outpatient care, as they can create strong integration between various entities to improve the quality of care.
The rise of informed patients.
Around the world, many patients are becoming more aware of healthcare decisions and are better equipped to make them. In some countries, improvements in education and literacy are driving this change; Almost everywhere, increased internet access and the increasing use of digital devices have fundamentally changed the information available to patients. As a result, many providers see opportunities to be more patient-centric. Patients are now no longer passively receiving treatment, but often ask for more information and want to be involved in making treatment choices. Often, decisions about hospitalization are made by both the patient and the provider. Patients can clarify whether they are willing and able to afford hospitalization, and whether they are more willing to seek alternative treatment. New technologies that enable online consultations, multidisciplinary team support, and other new models of care delivery are helping hospitals become more patient-centric.
The new focus is on value and accountability.
The rising cost of healthcare has been a major concern in most countries. Over the past decade, the United States has spent more than 17 percent of its GDP annually on health care. 7 Even in countries like China, which spend 6% of GDP on healthcare,8 costs are rising year by year, causing many provinces and cities to face growing deficits. Payment reforms that focus on value and introduce greater risk sharing between payers and providers are being tested across a range of health systems. For example, nursing events were introduced in the United States; The Diagnostic Related Groups (DRG) program is being rolled out nationwide. Our research shows that digital interventions to support connected electronic health records (EHRs), hospital automation, care coordination, and primary prevention can help support payment reforms and save significant money. 9 In addition, the value creation potential of developing markets is likely to be higher than in mature markets, as digital devices will make it possible for hospitals in developing markets to leapfrog older forms of care.
The look and feel of a smart hospital
Smart hospitals don't try to provide all services under one roof; Instead, they offer a narrow, high-value set of services within a broader brick-and-mortar ecosystem, many of which have traditionally been unrelated to healthcare services. For example, in such an ecosystem, preventive services and healthcare management programs are offered in clinics, gyms, and even patients' homes. Other medical and minor surgeries are available at the outpatient center. Diagnostic tests (imaging and laboratory services) are provided in independent centers. The hospital is only responsible for major surgery, intensive care, management of severe trauma, and the treatment of other acute, serious and complex diseases.