Healthcare will look very different in 2033 as the workforce evolves and systems incorporate digital technology to improve access to care.
Becker's asked hospital executives to share their perspectives on what the hospital of the future will look like. The executives featured in this article are all speaking at the Becker's Healthcare 13th Annual Meeting April 3-6, 2023, at the Hyatt Regency in Chicago.
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As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.
Carrie Harris-Muller. Senior Vice President and Chief Population Health Officer of OhioHealth (Columbus): The trends we are seeing today will be the same, but they will reach tipping points/breaking points in the next 10 years that necessitate action by the hospitals and health systems. The populations we serve will get older and sicker. Our service utilization will decline, but when used, patients will be more complex and have longer lengths of stay. Younger, healthier patients will seek care through new delivery channels. Margin pressures on health system P&Ls will become thinner, necessitating new care models to maintain sustainability.
Workforce constraints for physicians and nursing will force changes in how care is delivered. New technologies will emerge with new care models/staffing. Funding new capabilities and offsetting the cost of supplies will likely cause the need for larger and larger economies of scale. Pressure to reduce healthcare costs and the availability of some new information may force employers to take actions related to benefits design (more readily accepting of narrowing networks despite the war on talent). However, this will likely happen via brokers and insurance companies versus direct-to-health system relationships [market dependent]. Lastly, new players will emerge in this space.
In terms of what will hospitals and health systems look like in 10 years:
1. Horizontal integration: There will be fewer but larger regional/national health systems than there are today. Health systems will be forced to gain scale to address the market forces, offset costs to build new, necessary capabilities, and ensure appropriate efficiencies given tighter market rates.
2. Vertical integration: Health systems will be forced to identify new profit pools to drive success, given changing business models. Health systems will seek to build out payer capabilities to take on risk/earn the premium dollar to offset declining hospital-based business model, some partnerships/some acquired capabilities from existing health systems. In addition, health systems will continue to seek to diversify into additional profit pools, but with limited success given the challenging nature of the investments and time horizon to realize returns relative to the size of the existing business model.
3. Changing Balance of Business: Health systems will augment future growth and development investment, shifting more heavily to an ambulatory footprint. But investments in ICU/critical capability infrastructure will remain. Health systems will target access points that retain volume leaving the hospital, retaining some margin is better than losing all of it, and create new relationships with communities across the acuity/demographic spectrum (to ensure risk/premium dollar capabilities pay off and to improve actual care delivery).
Karen Habercoss. Chief Privacy Officer of the University of Chicago Medicine: Hospitals and health systems will continue increasing their use of technology. This will improve interoperability and enhance the care continuum between differing provider entities to care for patients with a much higher degree of collaboration. More wearable technologies might be expected to fit into the growing interoperability model that would allow patients to improve on being consumers that are more thoughtful and direct, active participants in their own healthcare. The cumulative amounts of data collected and available as part of the increased use of technology will have data privacy remain an ever more important expectation with likely more regulatory oversight.
Christy Bray Ricks. Vice President of Provider Talent of Ardent Health Services (Nashville, Tenn.): I think we will see a significant increase in the utilization of technology to further support our care teams as patient interactions continue to shift from in the hospital to an ancillary or in-home setting. Given the number of Baby Boomer retirees over the next 10 years, the physician shortage will be even more pronounced than it is today, leading health systems to rely further on care extenders (advanced practice practitioners, clinical nurse specialists, etc.). Additionally, the health systems that survive the intense competition for talent acquisition will have adjusted to flexible or hybrid staffing models along with other incentive programs in order to attract and retain the best in healthcare.
Scott Nygaard, MD. COO of Lee Health (Fort Myers, Fla.): The industry has struggled with the idea of transformation of healthcare delivery my entire career and there is a sense that the industry will transform and look different when the payment models change. That premise is a false assumption, though one that is deeply held within the industry. Personally, I think the things that stand to disrupt and transform hospitals and health systems are going to be driven more by patients'/consumers' demands and expectations for affordable and accessible care, which is enabled by technology, in particular digital innovation.
So what might this look like? Hospitals will continue to shift to becoming focused factories for the sickest and most complex of patients with the expansion of high acuity beds, more focused on intensive care or step-down needs, but the emphasis on the "high cost fixed asset delivery model, aka a hospital bed, has to change if we are to meet the needs of local communities, business owners and our nation. Consumer demand for affordable and accessible care will remain a driving force in the industry.
So the challenge for leaders of hospitals and systems is to figure out how to reconfigure your set of assets and cost structure to remain relevant as others in the industry continue efforts to disrupt traditional healthcare. That has not been a linear process, but the appetite of others to transform healthcare remains, as evidenced by the ongoing investment of private equity into the market and it is not being invested in hospitals.
Hospitals and health systems also must develop a mindset that having a network of clinicians aligned with their organization will be critical to success. That allows for many innovative approaches, partnerships, joint ventures, and strategic payer relationships that create value for both parties and physician employment must remain a part of the approach to succeeding in this complex and changing environment.
I think artificial intelligence will play a role in the transformation by finding ways to improve the efficiency, effectiveness and speed of health systems. Data will continue to inform more real-time decision-making in the nonclinical and clinical decision-making and make transparent ways to optimize the use of fiscal and human assets as productivity must improve based on current healthcare headwinds and also a need to produce more consistent clinical outcomes by reducing unnecessary variations in care delivery.
The use of AI should be in support of clinicians' work in a manner that allows them to spend more time interacting with patients. To date, this hasn't been realized despite the use of electronic health records. Maturing the use of AI across all areas of delivery should result in improved patient experience within hospitals and health systems. I personally believe the systems that focus on improving the patient experience and creating ways to offer patients/consumers and providers the ability to make the experience of care more personalized and providing the 'right care at the right time and place at the right cost' are those that will survive and thrive into the future.
Continuing to tweak the current model and waiting for the payment system to be the reason we change is a leadership failure in our profession. However, those that have courage and manage well the glide path to the future will be those that succeed.
Gail Games. Chief Learning and Development Officer of Holzer Health System (Gallipolis, Ohio): From an education standpoint, health system employees will learn from their phones and, I believe, in short spurts of information. The classroom will be a thing of the past and all will be through apps and social media. Skills will be learned through virtual learning.
John Kurvink, CPA, MHA. Vice President, Performance and Financial Strategy, Chief Financial Officer, Chief Innovation Officer of Grey Bruce Health Services (Ontario, Canada): I believe in 10 years, hospitals will still be around and look the same in many aspects, but they will certainly be changed in other ways. Hospitals will continue to care for patients as they always have, but the complexity of their conditions will be much higher. Many of the procedures done in hospitals today will be done in doctor's clinics or ambulatory care centers, leaving hospitals with only the most acute and intricate surgeries to perform and unstable patients to care for.
Technology will play an ever-increasing role with greater use of robotics in surgical suites and artificial intelligence employed to assist physicians in emergency departments and specialists in ICU, laboratory medicine and medical imaging. Patients will be older and frailer when admitted to the hospital than they are today. This will increase the length of stay compared to where it is now.
Hospitals will support stable patients post-discharge through sophisticated telemetry and video technology, leading to further reductions in bed counts. Health systems will concentrate specialized services to maintain and expand clinical expertise and improve patient outcomes in a hub and spoke model rather than trying to be a "one-stop shop."
James C. Burroughs. Senior Vice President, Government and Community Relations, Chief Equity and Inclusion Officer of Children's Minnesota (St. Paul, Minn.): I predict we'll see three things in the next 10 years:
First, as more people feel valued, included and comfortable expressing their cultural and gender identity, hospitals and health systems will create and/or expand systemic gender health and equity, diversity and inclusion transformational changes to meet growing demand.
Second, we'll continue to see an increase in Black, Native, Asian and Latino patients, which means health equity must be woven into the fabric of patient care, workforce expansion, and into the fabric of research and development instead of being an afterthought or just a thing to do in addition to the real work. Health equity must become the real work in the next several years.
Third, though our patient demographics will change, the high-quality care we provide at Children's Minnesota will remain consistent. But as virtual health care grows, we'll need to ensure that it's accessible to communities that don't have access to telehealth. We must make sure that such virtual care is delivered with cultural humility and understanding. Healthcare will be more inclusive and equitable in the future. We must create and sustain transformational change for health equity.
Arianne Dowdell. Vice President and Chief Diversity, Equity, and Inclusion Officer of Houston Methodist (Texas): Healthcare innovation will continue to drive the health care experience. I think there will be a continued focus on disease prevention and more patient care occurring outside of the hospital, thanks partly to all the technology and digital platforms we've seen as of late. Because of this, we know patients have more choices than ever to access quality healthcare in the way they want it delivered to them, so healthcare providers will need to deliver stellar patient care, no matter if they are seen in the hospital setting or virtually. A constant at Houston Methodist, which I know will continue to be a priority for us in the future, is that we'll continue to keep the patient at the center of everything we do.
Natalie Callis, DNP, RN-BC. Senior Director, Nursing Professional Development Strategy and Implementation of Mount Sinai Health System (New York City): The past few years have taught us that resilience is an essential skill for healthcare systems and the employees that work within them. As we look forward, we will have a workforce with the same passion and dedication to healthcare. However, they will need a robust infrastructure cultivated to support well-being tactics in the workplace.