MUSING – Entropy and the Exploding Hospital
We are often asked as healthcare architects “What is the hospital of the future?” Perhaps the question is best posed as “What is the future of the hospital?”
Broadly defined, entropy is the degree of disorder or uncertainty in a system. The old model hospital represented a highly ordered and certain system. It supported an institutionalized, generalized and repeatable experience in one big lump. Changes in models of care, reimbursement strategies and—most importantly—patient safety/comfort have caused an entropic explosion of that lump. Consider the cleaving into inpatient and outpatient units; the breakdown of outpatient services to same-day surgery, clinics, emergent care, etc.; the dispensation of outpatient care to satellite hubs, mobile units and home care– and now, the advent of “smart beds” that take vitals at home; clothing that monitors heart rate and blood sugar; pills for digital monitoring of prescription dosages and embedded chips providing comprehensive diagnostic information.
The dispersal of healthcare from the public realm of institutional space to the scattered private realm of personal space—a space defined not by bricks and mortar, but rather by social connections—could very well point to a future of healthcare without dedicated buildings, or at least, completely re-imagined healing environments. Even dedicated hybrid operating rooms are already changing dramatically with the rapid advance of non-invasive and robotic procedures.
Healthcare architects will need to be nimble experts and generalists and embrace team members from all different types of professions and specialties. This will be an exciting ride.