Pathways to wellness in the built environment

Healthcare hybrids emerge as providers adopt new models, missions and partnerships

If one had to describe what healthcare will feel and look like in the next ten years, a crystal ball would be helpful. Healthcare in our country is undergoing a major redesign and when it emerges anew it will likely take forms we’re only beginning to imagine. As healthcare organizations continue to reorient themselves to the continuum of care model, they’re finding that they need to define and refine their strategic priorities—who they are trying to serve, how, when and where. They’re looking at an expanded set of factors which can include branding, the role of technology and social media, retail integration, community outreach and holistic wellness, as well as partnerships in their facilities. By involving healthcare design and planning experts early in the process, VOA believes they can more successfully envision the network of care and wellness that will fit the new model.

Reorienting to a preventative, population-centered, continuum of care model for health is a drastic change, and we may find that it’s only a first step for many healthcare organizations. Chronic preventable disease is a new focus for healthcare providers.

As of 2012, about half of all adults—117 million people—had one or more chronic health conditions. One of four adults had two or more chronic health conditions. Seven of the top 10 causes of death in 2010 were chronic diseases. Two of these chronic diseases—heart disease and cancer—together accounted for nearly 48% of all deaths. Obesity and diabetes are major health concerns. Four of these health risk behaviors—lack of exercise or physical activity, poor nutrition, tobacco use, and drinking too much alcohol—cause much of the illness, suffering, and early death related to chronic diseases and conditions. In the United States, chronic diseases and conditions and the health risk behaviors that cause them account for most health care costs. Eighty-six percent of all health care spending in 2010 was for people with one or more chronic medical conditions. [US Centers for Disease Control]

Many health care organizations believe they can reduce the often costly treatment of chronic diseases by addressing health risk behaviors and refocusing on prevention at both the community and personal levels. This won’t be easy as it requires developing effective ways of educating the community about health and affecting deeply ingrained habits and behavior. When we talk about behavior, we’re talking about lifestyle. To succeed at changing lifestyles, healthcare providers will become, to varying degrees, managers of lifestyle health.

Partnerships will be crucial to creating and promoting healthy lifestyles that counter health risk behaviors. Until healthcare providers develop their own lifestyle elements, they’ll be teaming up with more than pharmacies and coffee houses and hosting more than healthy cooking classes and the occasional farmers market. They’ll need advanced cardiac rehab capabilities, fitness and activity centers that go beyond physical activity to social network, childcare centers (allowing for appointments and outpatient services), even multi-generational community centers and living spaces. Healthcare will look for amenities that promote health: extensions of physical therapy that network into the community, health food stores with social gathering places, nutritionists that become part of a social network, virtually anything that can positively promote health in the day-to-day lives of members of the community. Imagine all of these partnerships connected and trackable via mobile technology and cloud-based apps. Retail and retail design will likely influence the design for these hybrid healthcare spaces. Ultimately, healthcare facilities will need to function as community-connected, social settings which promote quality of life and safety in order to effect healthy behavior and promote lasting lifestyle changes in the home and family.


Healthcare providers will need to think about partnerships that go far beyond their current business models. Partnering with any healthcare provider is complex and requires trust between the healthcare organization and partner. Collaboration between brands, after all, carries some degree of risk as it relies on the other’s reputation, service and brand identity to an extent. And healthcare providers, already in the midst of reformulating their brand and purpose, will be asked to refine these even further to ensure a good fit with potential partners. Most healthcare providers aren’t well positioned for external partnership development for upstream care—they’re mainly focused on physicians networks, technology integration, and acute care services treating chronic illnesses. Breaking into a new role as lifestyle-oriented hubs for community health will require healthcare to rethink, reformulate and make new allies—and above all, formulate a strategic set of goals.

A strategy that assesses community health at the regional and local level is necessary. This strategy looks at the community and stratification of health care needs: Are they walking well, moderately well, or chronically sick? It looks at the chronic health issues in the community—diabetes, smoking, obesity, etc. What is the community’s perception of its health and well-being? Strategy envisions a pathway to wellness, scale of its service and focus. Once the strategy is in place, healthcare designers and planners can assist healthcare organizations with thoughtful assessment of current continuum of care and create a plan to achieve integrated care models over time.

This refocus on community is a sea change in healthcare which will involve innovative partnerships, brand-sharing and buildings as social media backdrops—physical locations for points of care which connect to community members who tote their healthcare network wherever they go through connected devices and apps.

Soon, designers will be called on for out-of-the-box thinking regarding the hybrid spaces that are required to meet healthcare’s emerging challenges. Before design and planning can take place, however, healthcare providers must develop bold visions that address the needs of their communities.

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