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HEALTH MEDICAL FACILITY RESEARCH AND ITS IMPACT ON HEALTH CARE DESIGNHealthcare system <strong>and</strong> information technology.different components of the healthcare systemfrom a patient perspective i.e.• Rapid <strong>and</strong> easy access to primary care• Services close to home• Access to specialist consultants• <strong>Medical</strong> records available at point of service• Collaboration <strong>and</strong> consultation among careproviders• Coordination of care• Clinical process improvement• Continuous quality assessment of care• Easy access to medical information.Since these changes will have a fundamentalimpact on the way healthcare professionals willwork together <strong>and</strong> with the patient, they willalso strongly influence the dem<strong>and</strong>s on the architecturaldesign of hospitals. Several serviceun<strong>its</strong> which today constitute physical parts ofthe hospi tal building will in the future be localizedoutside the hospital <strong>and</strong> instead be accessedvia IT networks. The figure below illustrates aposs ible future scenario in a hospital ward.All information regarding each individualpatient can displayed on a “patient navigator”connected to a wireless bedside informationsystem which can access databases in differentservice disci plines such as clinical physiology,laboratory medicine, image-processing center<strong>and</strong> pharmacy. Furthermore, the doctor canconsult both specialists via telemedicine <strong>and</strong>external health-status assessment databasesonline. After examination of <strong>and</strong> conversationwith the patient, all anamnestic statements, ordereddiagnostic tests <strong>and</strong> prescribed drugs arerecorded in the patient’s electronic record in thecentral medical record data base via the patientnavigator. This database can then be accessedby duly qualified personnel in e.g. the primarycare center to which the patient is affiliated.Thus the prerequisites for a development of“patient-centred care” are here <strong>and</strong> several keyfactors drive this evolution.46 (IADH) International Academy for Design <strong>and</strong> Health
MEDICAL RESEARCH AND ITS IMPACT ON HEALTHCARE DESIGNClinical physiologycenterImage-processingcenterLaboratorycenterPatient navigatorHealth-statusassessmentEBM databaseWireless bedsidesystemPharmacyConsultantspecialistElectronic medical recordTelemedicineconsultantAll information regarding each patient could displayed on a patientnavigator.• The underst<strong>and</strong>ing of genetic predisposition.This will make it possible to predict healthrisks for individuals by establishing links betweendefect genes <strong>and</strong> specific diseases. Furthermore it will serve as the basis for individualizeddrug treatment.• More readily available information. Throughthe Internet a whole new world of “Healthportals” will be accessible. These will be anythingfrom general health sites with medical<strong>and</strong> health news to highly specialized diseasespecific sites aiming at selective groups of patients.• More active <strong>and</strong> informed consumers. Thepatient educates her-/himself via chat groups<strong>and</strong> active patient groups on the Internet <strong>and</strong>via high-quality TV production in specificeducational channels.• Increasing responsibility of consumers. Thepatient will take active part in the diagnosticprocess e.g. by using “home diagnostics”.Visions of the future for the structure of thehealthcare systemIn a shorter perspective than 5 years it is not likelythat the medical research <strong>and</strong> developmentwill have any greater impact on the structure <strong>and</strong>function of hospitals <strong>and</strong> the health-care systemthan the one which is the result of already partlyimplemented, established new technologies asdescribed above. The fast development in prevention,diagnostics, therapeutics <strong>and</strong> communicationtechnologies will, however, create conditionsfor a society where most of the healthcarecan be h<strong>and</strong>led locally <strong>and</strong> close to the patientregardless where you live. The need for largehospitals will be reduced. The “hospital-free”society is coming closer. To bring this visiona step further let us first look on the presentstructure of the Swedish healthcare system. Inthat you can identify five distinct organisationallevels. Three of these levels include different-sizedhospitals, each with <strong>its</strong> own emergency ward<strong>and</strong> surgical department, which h<strong>and</strong>les similar47
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