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FACILITIES OF TOMORROW F A C I L I T I E S O F T O M O R ISSUE FOCUS Key trends Physicians utilizing mobile technology employ one or more mobile devices for patient engagement. Care coordination has more clinics adopting the team-care model facilitated by open of ces, team spaces and on-stage/of -stage work areas with integrated technology. Telemedicine — from remote patient monitoring to virtual doctor visits — puts the care team in front of the patient, no matter where the patient may be located, for improved patient care. Ambulatory and home-based telemedicine allows providers to lower costs by reducing hospitalizations, subsequent readmissions and even clinic visits. Population health focuses on the overall community by treating the chronically ill and addressing the social determinants of lifestyle, health and wellness. Patients once routinely admitted to the hospital now receive care in outpatient primary care and ambulatory settings. Retail health has increased the access to care by provid- ing patient management for people with chronic diseases, vaccinations, screenings and medical care focused on patient conve- nience in lowest cost settings. Key spaces The report identifi es two key space types, common to any outpatient clinic: consult spaces fostering meaningful, informed interactions and work spaces supporting vital patient and provider connection. In interviews with healthcare leaders and na- tionwide polls with patients and physicians, the researchers found patients prioritize consultation and meaningful engagement as the most important aspect of a visit. Case studies show innovative models where exam rooms are supplemented with con- sult/talking rooms and, in some cases, did not have an exam table. While physicians report high exam table utilization, it is not clear if more conversations, rather than examinations, occur on these tables. The report suggests any space where a patient interacts with staf can be deemed a consult space. For example, registration performed by a medical assistant can be recognized as the fi rst consult. Waiting areas with education elements are a virtual consult. The physician examination of the patient is the principal consult. Specifi c ed- ucation is the fi nal consult. This approach allows design to occur around meaningful interactions. Key characteristics The report identifi es three key space characteristics: fl exibility, connectivity and sense of place. Flexibility allows easy ex- pansion/contraction with changing needs, from revised plan confi gurations to wall and furniture systems. Clinics must support connectivity, acting as a "conduit" between the cloud and the community. The clinic's digital footprint supports its physical foot- print at all levels, from the site, to the care team, to the broader community and with regional and national systems. The open-platform model of care versus the physician-centric model, consists of consult rooms, shared support, staf , team collaboration and exam rooms (not neces- sarily geographically assigned) to increase overall clinic utilization by allowing fl ex Children's Hospital of Richmond at VCU, Rich- mond, Virginia, provides a full-service children's hospital with an outpatient pediatric center. At a larger scale, the modular approach creates a standardized clinic module, accommodating a variety of services and can be readily adapted to meet specialty needs. An illustrated view of the on-stage patient pathway and off-stage staff pathway. The pathways have direct access into each patient exam room. volumes among exam rooms not in use, thereby reducing patient wait times and increasing staf ef ciency. Finally, it is important to create a strong sense of place — a destination. It should be an experience that is clean, quiet, comfort- able, connected and appealing across all generations. 38 Medical Construction & Design | NOV EMBER / DECEMBER 2015 | MCDM AG.COM