The Future of Ambulatory Care – Innovating the Future

The Advisory Board – Presentation and Expert Roundtable
May 17, 2013
MedStar Institute for Innovation, Washington, DC

SNVMC_Vascular LabHealth demographics, economics, competitive forces and legislation are all driving a reassessment of the optimal utilization of ambulatory care.  Patient conveniences and quality are now a given.  Further exploration of more specialized and advanced services as well as the patient experience will continue to define ambulatory care in the future.  Can these facilities also be the cornerstone of wellness initiatives and a platform on which to change fee for services to population based yet “personalized” healthcare?  This half-day symposium framed and explored  questions of how design can optimize the future goals of ambulatory care.

Michael Hubble, PhD from the Advisory Board Company delivered a compelling overview on the current state of ambulatory care.

The expert panel was composed of Robert Gilbert, President of MedStar Ambulatory Care with a focus on the hospital without beds, Pete Celano, Mobile Health consultant focused on healthcare solutions technology and Barbara Huelat represented the Voice of the Consumer.

“We have seen dramatic changes in this transformational environment.  Although we identify many drivers of change, I would like to focus on the “Voice of the Consumer” as a primary driver for this change,” remarked Ms. Huelat.  “The patient is no longer a patient they are consumers of healthcare products and are demanding much more from service providers.”

The voice of the consumer is speaking out today demanding change in access to healthcare, conveniences and basic dignity.  Consumer movements are powerful, take the example of how women’s groups in the “60’s change the way babies were brought into this world.  The movement transformed birthing from a medical procedure to a celebratory milestone of life with the development of Birthing Centers, awaking the practice of midwifery and natural birthing options.  Another grass roots movement is in Hospice care, demanding dignity for the dying that led to the non-institutional movement.  Both of these successful consumer movements grew out of a need to change the existing medical model into one that is more human centered.

Today I see consumers demanding changes in the way they access healthcare services and more importantly wellness products. They want convenient locations and after hour times that work for busy fast paced schedules.  People are not willing to wait nine hours to be seen in the ED, they want good reliable information quickly in order to make good decisions for their families and themselves.

Today’s consumers want integrated care, not just when they get sick, but also preventive care.  They want the whole array of wellness products – nutrition counseling, weight control, cease smoking program, stress management, massage therapy, pain management, acupuncture and exercise council.  People want it to be fun, quick, easy to use and affordable.

These “demands” are resulting in a change to the physical environments, making a great impact on architecture and design, such as:

  • Convenient locations – retail settings – the minute clinic, medical mall
  • Mobility and access – clinics on wheels – mamovans
  • Reaching the consumer in remote locations such as the medical home and telemedicine
  • Access to care for all – the Affordable Care Act
  • Integrated wellness within medical care
  • Central service – pharmacy, radiology, specialty clinics
  • Urgent care – shorter wait times
  • Outpatient surgery
  • Attractive environment – retail setting, easy access, parking, one stop shop

Consumer driven healthcare design is not looking for opulent places, but environments that support ones journey to health and wellness. This can be achieved with access to information, ease of wayfinding, privacy, comfort, access to nature, food and most importantly with respect for the person and their family.  They want and need to be treated as a fellow human being.

“The time is right and it is now, the Affordable Care Act is in place, fee for service is no longer sustainable, Americans are becoming more obese with declining health, and the consumer is now speaking out.  It is difficult to predict just how ambulatory care will play out in the future, but we do know that it will be pioneered by the voice of the consumer,” concluded Ms. Huelat.

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