When the walls come tumbling down: the hospital of the future

Imagine a future where clinicians conduct clinical trials with patients in the comfort of their homes ... where patient care is delivered as seamlessly as online shopping packages … and where clinicians use AI to deliver hyper-personalized care. By 2035, healthcare will be hyper-personalized, digitized, and AI-enabled, with healthcare solutions seamlessly integrated into daily life, according to PwC’s Future of Health study. The critical question is: Are health systems doing enough to adapt and transform their current infrastructure or are they at risk of being disrupted?

While health systems continue to make an effort to meet consumer expectations and integrate technological innovations, they face the complex mission of transforming the patient and clinician experience while operating with aging technology, outdated business models and frayed infrastructure. To make matters worse, the current model continues to be plagued by inflation, dire labor shortages, an exodus of talent, and disruption in the supply chain – all of which are contributing to rising costs and shrinking profits.

PwC envisions the hospital of the future as a network of physical and virtual delivery assets connected by a single digital system and capabilities, enabling care to be delivered in communities, at home or in facilities as required by clinicians and preferred by patients. The hospital of the future will stitch together a connected ecosystem that delivers care beyond the four walls.

Consumers want care delivered with convenience

It is clear that incremental changes to the existing care delivery model will not move health systems into the future. Providers need to fundamentally rethink the current model. Without transformative change, health systems and hospitals risk being disrupted in their sector by those technology and health innovators who are delivering care in new, convenient, cost-effective ways. These disruptors are building care around the consumer rather than requiring the consumer to meet them on their terms.

Healthcare delivery is following in the footsteps of the retail industry, which was once brimming with massive department stores and shopping malls that were expensive to operate, and which gave way to consumer preferences for convenient locations and digital shopping capabilities. So, too, are healthcare systems in need of the same playbook that can allow them to move away from colossal and costly hospital settings to providing more convenient retail and home-shopping-like outlets for their consumers – shaping and defining the hospital of the future.

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Leading health systems are making significant investments in infrastructure to coordinate care within and outside their walls, according to PwC’s study of top 30 hospital systems in the country. At least 100 modernization projects are underway with more than $3.5 billion being invested in remote monitoring, care at home, command center and digital front door capabilities.

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"Healthcare delivery is following in the footsteps of the retail industry, which was once brimming with massive department stores and shopping malls, and which gave way to consumer preferences for convenient locations and digital shopping capabilities."

How the vision comes to life: key principles

How can healthcare systems adapt current models and redesign with the future in mind?

  1. Refresh, repurpose, and (re)design spaces to enable care delivery beyond the physical walls.
  2. Challenge conventional uses of space and create flexible areas that can be repurposed over decades.
  3. Create a tech-enabled, collaboration environment powered by 5G, cloud, and collaboration tools to support hybrid care teams
  4. Streamline processes around partners, vendors, and solutions across the system.

(Please refer to the graphic below for a complete view of the principles.)

Key principles

Health systems should re-think their capital investments and make programmatic investments in the following new capabilities to move towards the hospital of the future:

A digital backbone that serves as the integrator across care in the facility, care in the community, and care at home, enabling coordination and care delivery of on-site and virtual care. The digital backbone encompasses a robust cloud infrastructure combined with a deep analytics layer and a command center. The command center coordinates supply chain and logistics, predictive analytics and scheduling, and connects with clinicians to provide insights and alerts for care escalations. While many health facilities have opened physical or virtual command centers, they are often fragmented and characterized by limited technology and integrations, basic dashboards, manual processes, disjointed patient experience, and misaligned operations. The hospital of the future should leverage responsible AI and automation to predict and escalate care needs across channels, dynamically forecast demand and manage capacity, and reduce care staff administrative burden. Practical examples include:

  • Sophisticated and responsible AI models for action alerts delivered to patient or care staff depending on the need
  • Integration of holistic patient datasets (genomic, patient preferences, etc.) for seamless care delivery
  • Automated administrative tasks or tasks enabled by a remote or offshore care team
  • Using command centers to coordinate care delivery and logistics for a Hospital at Home program

The hybrid care team is essential in the face of staffing shortages and burnout and increased demand for virtual care. Care teams can be redesigned to support a flexible model that provides comprehensive care from hospital to home, physical to virtual. The hospital of the future will likely harness a hybrid care team enabled to deliver treatment seamlessly in mixed settings, both virtual and onsite. Health systems will likely train and employ clinicians practiced in engaging with patients across different care venues. Virtual nurses can admit patients to physical care sites, provide medication reconciliation, guide patients through pre-op, and offer discharge instruction and planning. Care settings, whether physical or virtual, will be designed to facilitate frictionless handoffs between providers, regardless of where clinicians are located. The hospital of the future can support a hybrid care team with maximal flexibility:

  • Fewer in-person care staff (compared to today’s care models), supported by remote virtual clinicians and automation of administrative tasks to support clinicians working at top-of-license
  • Sophisticated clinical AI support including virtual assistants providing clinical alerts and decision support
  • Robotic care team support (e.g., medication delivery)

Remote monitoring is a natural extension of establishing a digital backbone and building a workforce infused with hybrid clinicians. Targeting specific conditions and harnessing the right clinical teams capable of virtual/hybrid care and treatment can allow health systems to meet consumer demand and shift treatment away from hospitals to more convenient settings such as in-home care. The hospital of the future can utilize a single, integrated command center to monitor and coordinate patient care across all settings. The command center can serve as the hub, integrating remote monitoring data from wearables and other sources, to provide a holistic picture of patient health. Future examples might include:

  • Medical grade wearables integrated with the command center hub that enable communication across a patient’s care team
  • AI to alert the care team to changes in patient status or proactively order necessary diagnostics to support the patient treatment plan
  • Virtual reality technology to deliver information to a patient’s nervous system with a high level of sensorial and perceptual involvement

An omni-channel digital front door platform can be built to connect multiple sites of care, whether in person or virtual, creating an integrated and intuitive patient experience. As healthcare consumers grow increasingly more empowered, they are demanding modern solutions that expand how and where they are able to access care and meet the same experience expectations that dominate other aspects of our day-to-day lives. Why can’t accessing a care provider be as easy as one-click shopping online, or any of the other modern conveniences enabled by technology today? Building a digital front door allows health systems to better meet these healthcare consumer experience expectations. Some practical examples in an emergency medicine setting include:

  • Teletriage, chat-bot triage, and app-driven engagement to help connect patients to the appropriate care and avoid unnecessary wait times in the emergency room
  • Paramedicine collaborations between hospitals and paramedic communities of practice that facilitate home-based emergency medicine care


Moving ahead

Healthcare providers will soon begin to resemble operations more closely in other industries that have successfully leveraged technology and remote work locations to provide optimal service in a more cost-effective and efficient manner. The hospital of the future can represent a giant leap forward in helping healthcare systems make care delivery more accessible, affordable, efficient, personal and better equipped to meet the needs of patients and society.

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Written by Gaurav Mehta and Alena Taylor. Madhukara Holla and Kiesha McCurtis also contributed to this article.

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Gaurav Mehta

Principal, PwC US

Alena Taylor

Principal, PwC US

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