In Davos, health experts ponder on the future of hospitals

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In 10 year's time, hospitals in the urban centers of the developed world would be hugely different from what they are today - vast complexes offering almost everything from primary care to specialty care and everything else in between and around the healthcare ecosystem.

In a discussion, health experts at the recently concluded 47th Annual Meeting of the World Economic Forum in Davos, Switzerland are one in saying that they see hospitals moving into the opposite direction - smaller but highly specialized centers.

"In 10 years, why do you think you need to go to a hospital?" asked Elizabeth Nabel, President, Brigham and Women's Hospital in Boston. "I would redefine a hospital as a center where an individual is likely to undergo some type invasive procedure for which they might need an extended period of continuous monitoring. And that is best served by a group of experts who could provide that monitoring."

She was saying that outside of this special need, there isn't going to be much need for hospitals as the current direction, especially of Brigham, is to take the health delivery system into the home and into the community as much as possible.

"If you believe in the concept of value-based healthcare - the definition being o patient-measured outcomes, not process outcomes defined by cost - then you will more or less agree that outcomes will be better delivered at home in the community at much lower cost," she emphasized.

Sean Duffy, Co-Founder and CEO of US-based Omada Health, agrees. "I think 10 years from now, you will be walking in for someting very specific such as surgery. The hospital may not be that large and they do just surgery. What got you there is probably a digital experience where you may have felt some pain, you open your phone and you view that experience as primary care. Maybe you get diagnostics at a small center and maybe you are sent to this hospital," he shared.

"The only area that I might imagine a world that cound be different from what it is today is that right now when people talk about that emotional feel with healthcare that can deliver outcomes, they tend to think of that as a person," he added. "In tomorrow's world its going to be a brand. You're going to grow incredible trust with a brand and a system and all the associated people will be able to know you in context of that brand."

Tomorrow's technology could indeed turn hospitals into science fiction dreams or make them obsolete.

Shamsheer Vayalil, Managing Director, VPS Healthcare in the United Arab Emirates, sees it the same way with a twist.

"Ten years from now, you won't see stand alone hospitals. I think it would become part of life. You would have people walking into a hospital bringing coffee, having business meeetings, going to the gym, their  phones being their primary doctors - they would have their data connected to a kind of central artificial intelligence staff and they will be getting continuous advise," he said.

Vayalil started one hospital in Abu Dhabi nine years ago. Today, he said the medical center sees almost 12,000 patients a day. "We feel that hospitals have changed and we feel that in the next 10 years you would see changes you have not seen in the last hundred years," he said.

Following on Nabel's concept of home-based or community-based healthcare, Sarah Doherty, Co-Founder and Chief Technology Officer, TeleHealthRobotics, affirmed that there indeed so many solutions already out in the market that allow people to take charge of their health at hime.

"But we have a kind of technology gap and an education gap around those tools that are available. In my opinion, we are no longer going to get hub hospitals, we will have points of care - whether in your home or local community centers, your pharmacy, your school or workplace," she said.

Her company is actually thinking of having a virtual pool of healthcare providers who are available to each point of care whether its right through the home, the phone or through a local community center like a kiosk. These pool of physicians will be working across the country and even across the world.

"I would say, not only do we change the physicality of hospitals but we also change the localization of physicians in hospitals," she explained.

Thomas DeRosa, CEO of Welltower, a public company that has the largest platform in senior care in the US, Canada and UK, however, spoke of disruption as innovations in the digital era come in.

"Think about New York City," he said. "My two eldest daughters were born in the same hospital, same wing, on the same floor as their great grandfather 100 years earlier. But if i wanted to take them to see that hospital today, they would be looking at one of the new luxury condominium buildings that has been developed in the west village of New York City. That hospital was St. Vincent's Hospital, which was on the frontlines of the AIDS epidemic back in the late 80s but its physical plant could just not deliver modern medicine today," he said.

David B. Agus, Professor of Medicine and Engineering, Lawrence J. Ellison Institute for Transformative Medicine at USC, sees the healthcare industry in transition where doctors are no longer collectors of data.

"The patient is becoming the collector of their own data. Patients are checking their own blood pressure, they monitor their own movements. Pretty soon they will prick their finger and send a biochip to the doctor," he said.

But he said it could also usher in a situation when the doctor's office will really become a place for talking to patients rather than collecting data.
 

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