MaRS Library Breaking the mold: the transformation of Ontario’s hospitals
This is the first installment of MaRS Market Intelligence’s month-long series on innovative hospitals in Ontario.
As Canadians, our healthcare system is a focal point of our society. It was designed on the principle that healthcare is a social good and that all residents should have equal access to essential services. Canadians take pride in the fairness and equity that has become the hallmark of our healthcare system. However, in recent years various challenges have threatened to destabilize a system that is depended on by so many. They include:
- increasing demands for services;
- rising healthcare costs;
- a fragmented system with suboptimal communication and coordination; and
- a demand for improved quality of care
For the first time in history, Canada’s elderly population is outnumbering its youth. There are more individuals aged 65 and older than there are children aged zero-14.1 This aging population has introduced a capacity challenge with an upsurge in demand for care around serious chronic conditions. Aside from these demand-driven challenges, provinces also function under a fragmented healthcare system, where care is optimized at the unit level, but remains disjointed at the system level. The exchange of information and coordination of patients is suboptimal. There is a need to create a more integrated system that operates holistically. Furthermore, with the consumerization of healthcare, patients are demanding the same level of care that they have come to expect from other service providers. There is a need for patient-centric models of care focused on improved quality and satisfaction.
Innovative care models from around the world
Outside of Canada, innovative healthcare institutions have made significant advancements in addressing the four challenges listed above.
Outpatient model: Tackling increasing demand and cost
The outpatient model of care is increasingly used to tackle rising challenges around capacity and access to services. For example, Montefiore Medical Center in the Bronx, New York, is a 12-story outpatient center with zero overnight beds. This hospital officially opened in November 2014 and offers outpatient surgery for conditions that once required hospitalization to treat. The outpatient model empowers the hospital to send patients home for faster recovery while reducing wait times and capacity challenges for both inpatient and outpatient surgeries.2
Smart and virtual hospitals: improved operational efficiency with increased communication and coordination
Technology is being leveraged to create new and radical care models. Two concepts currently being explored by a select number of jurisdictions are smart hospitals and virtual hospitals. Smart hospitals are institutions that have clinical processes, management systems and infrastructure that are enabled by an underlying digitized network of interconnected assets.3 Important components of a smart hospital include  the ability to leverage its digital infrastructure to provide services or insights which were not previously available,  offering better patient care and experience, and  improving operational efficiencies.3
The University of Pittsburgh Medical Center (UPMC) was one of the early pioneers of the smart hospital concept. Launched in 2008 in partnership with IBM, UPMC’s SmartRoom technology includes features that provide clinicians with relevant real-time patient information at the bedside, simplifying workflow for nurses and improving documentation.4
Virtual hospitals, on the other hand, are hospitals without patients or beds. These facilities are home to large medical teams that provide care and consultation to patients through two-way cameras, online-enabled instruments and other sensors and devices.5 Mercy Virtual Care Centre in Chesterfield, Missouri, is the world’s first and most advanced example of a virtual hospital – an electronic intensive care unit designed specifically to support the delivery of telehealth services, including telestroke, nurse on call and physician teleconsultations. Virtual hospitals enable health providers to deliver better and more efficient patient care at a lower cost. 6
Hospital design: Greater quality of care and satisfaction through design
Research has shown that hospital design elements (private rooms with windows, natural light, noise control and more) are associated with shorter stays in hospitals and higher patient satisfaction.7,8 Florida Hospital Celebration Health, is a stellar example of a patient-centered hospital design, showcasing both innovation and excellence. This 227-bed, state-of-the-art, resort-like hospital was built in 1997 adjacent to Walt Disney World and is a centrepiece of the community. Patient rooms incorporate large windows with an abundance of natural light and are designed with smart technology to give patients more control. Similarly, the exterior landscape is designed to foster an environment for recovery and healing.9,10 A review of over 600 studies has shown that patient satisfaction is directly linked with environmental factors such as views of nature, noise reduction, ease of path finding, and sense of control over the environment. Every touchpoint in a healthcare facility provides an opportunity to deliver an experience – and institutions should incorporate patient-centric design elements to improve patient satisfaction.10
Over the past few years, a number of hospitals across Ontario have been actively working to reimagine the way that care is provided. The goal for many of these hospitals is to optimize, redesign or build new models of care that can address the current and future needs of the population.
We had the chance to speak with three forward-looking hospitals, each tackling a unique challenge within the Ontario healthcare system:
1. Women’s College Hospital: ambulatory care model to increase operational efficiency and manage rising demand for services. (To be published: September 13, 2018)
2. Bridgepoint Active Healthcare: leveraging digital infrastructure to create a more connected and integrated approach to care. (To be published: September 20, 2018)
3. Mackenzie Health: improving quality of care and patient satisfaction through design. (To be published: September 27, 2018)
Over the coming month, we’ll profile each of the hospitals, showcasing innovative solutions to Ontario’s healthcare challenges.
By: Hedieh Javaheri and Nirusan Rajakulendran
Special thanks to Zayna Khayat, future strategist, Saint Elizabeth Health Care, for her guidance and expertise, and to the following collaborators and reviewers for their partnership and insight.
- Altaf Stationwala, president and CEO, Mackenzie Health
- Cheryl Woodman, chief strategy and quality officer, Women’s College Hospital
- Danielle Martin, vice president medical affairs and health system solutions; co-founder of WIHV, Women’s College Hospital
- Jane Merkley, executive vice president, chief nurse executive and chief operating officer, Sinai Health System
- Kate Wilkinson, vice president, quality and clinical programs, Sinai Health System
- Louise Murphy, manager, MaRS Market Intelligence
- Maggie Clark, senior associate, MaRS Partnerships
- Mei Burgin, director, MaRS Market Intelligence
- Shahab Shahnazari, senior manager, Health Data Initiatives
- Sheryl Thingvold, senior advisor, MaRS Health Venture Services
- Canadian Medical Association. 2016. “The State of Seniors Health Care in Canada.” Available at: https://www.cma.ca/En/Lists/Medias/the-state-of-seniors-health-care-in-canada-september-2016.pdf.
- Daily News. 2014. “Montefiore Medical Center opens 12-story bedless outpatient center in the Bronx.” Available at: http://www.nydailynews.com/new-york/bronx/montefiore-opens-massive-bronx-bedless-surgery-center-article-1.2006077.
- Healthcare IT News. 2017. “Understanding smart hospitals and why most aren’t there yet.” Available at: https://www.healthcareitnews.com/blog/understanding-smart-hospitals-and-why-most-arent-there-yet#gs.p=g2kr4.
- IBM. 2010. “IBM and UPMC Partner to Make ‘Smart’ Patient Room Even Smarter.” Available at: https://www-03.ibm.com/press/us/en/pressrelease/32217.wss.
- Politico. 2017. “A hospital without patients.” Available at: https://www.politico.com/agenda/story/2017/11/08/virtual-hospital-mercy-st-louis-000573.
- Mercy Virtual. “World’s First Facility Dedicated to Telehealth.” Available at: http://www.mercyvirtual.net/worlds-first-virtual-care-center/.
- U.S. Department of Health and Human Services. 2005. “The Hospital Built Environment: What Role Might Funders of Health Services Research Play?” Available at: https://archive.ahrq.gov/professionals/systems/hospital/hospbuilt/hospenv2.html.
- Business Insider. 2014. “Hospitals In the Future Will Look Totally Different.” Available at: https://www.businessinsider.com.au/celebration-health-hospital-of-the-future-2014-5.
- Florida Hospital Celebration Health. Available at: https://www.floridahospital.com/celebration-health/our-location/about-us.
- Patient Experience Journal. 2017. “Evaluating variables of patient experience and the correlation with design.” Available at: http://pxjournal.org/cgi/viewcontent.cgi?article=1176&context=journal.