Real Estate Strategy Primer: The Future of Healthcare


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Real Estate Strategy Primer: The Future of Healthcare

  1. 1. Real Estate Strategy Primer The Future of Healthcare
  2. 2. Spotlight ST. OLAVS HOSPITAL - TRONDHEIM, NORWAY One of the more exciting projects in green elements, including trees, wild stones healthcare today is St. Olavs Hospital in and bushes. Interior and roof gardens are Trondheim, Norway. Replacing the century a feature throughout, covering about a old structure (950 beds, 8,000 employees, quarter of the ground area. 413,000 patients a year) the new facility is aiming to become the most technologically St. Olavs is also deploying Microsoft’s advanced hospital in northern Europe by advanced information and communication 2014. technologies, along with single, integrated Internet Protocol (IP) network. This tactic In order to become more patient-centric, not only reduces operating costs, it allows St. Olavs is implementing improvements for services and applications to become in the healthcare experience from many more flexible and/or integrated. angles. New efficiencies in energy use and operations are part of what make this The first of six clinical centres were ambitious project sustainably fitted to the completed in 2006, and the entire hospital services they provide. will be ready to treat patients by 2015. We are building a hospital technology infrastructure that unlocks the benefits of enhanced communication. The new hospital will consist of seven St. Olavs will form the basis for entirely clinical centres, each designed to operate new treatment methods, increased Arve-Olav Solumsmo as an organizational unit, with adjoining efficiencies, and better patient care. A Public Relations Manager functions. Each of these centres (20-30,000 highly integrated design approach, both St. Olavs Hospital square meters in size) are connected via physically and technologically, will underground passages and sky bridges to allow users to combine patient treatment, maximize circulation and active transport research and teaching functions. Wireless of supplies. networks will provide patient information any time, and from any location, along with The centre of the facility is future proofed, communication systems, alarms, and calls. and not fixed to a specific block, rather it can be adjusted or divided among blocks to Production Increase: 26% better service patients and staff over time. Aesthetically, all public spaces feature Headcount Increase: 10% THE FuTuRE OF HEALTHcARE
  3. 3. The Next 5 Years in Healthcare TRANSITION AND EVOLuTION Age Sensitivity Sun + Light + Air Separated Temp / Vent Integrated Family Care Model Patient Centered Energy Efficiency Improved Mechanical Technologies Zoned Patient & Operations Protocols Sustainable buildings, sustainable campuses Proximity of Care / Services Flexible Facilities / Systems Shorter Stays Research Conversion Flexible Care Strategies Acuity Adaptability Sicker Patients Systemic Re- alignment of Business Models Preventative Medicine Robotic Surgery Surgical Episodes Tele- medicine Healthcare Treatment Strategy Technology + Care Delivery Chronic Disease Management Patient Room Size Real Estate Ontology HealthVault + Patient Stakeholders 2010 - 2015 IN patient OUT patient mix Accountable Care, Bundled Payment Urban Centers / Mix Use Models Quality Incentives + Penalties Smaller Footprint Buildings, Linked Services Cost Efficiency Scale + Service Level End of pure fee for medicine Transparency (Operating Rooms with Windows) "greener" facilities, lower OPEX Adaptive Re-use, Community Interdependence Efficient Clinical Systems Elastic + Adaptable Medical Homes Networked Treatment Patient Rooms with Care Spectrum Specialty practices "string of pearls" Buildings that can change Future Proofing Shared Resource Models Portfolio Guidelines that Evolve with Business Model Healthcare is undergoing profound changes driven by the key issues impacts and responses available will allow healthcare service providers outlined in this ontology diagram. These “drivers” have many and to re-strategize portfolio needs; creating efficiency, flexibility, improving varied real estate and facilities implications. Identifying the potential stakeholder satisfaction and increasing or resulting in cost savings. Healthcare.mmap - 5/3/2010 - Mindjet THE FuTuRE OF HEALTHcARE
  4. 4. Patient centered care The biggest single driver of a de-centralized portfolio strategy for healthcare providers is the continued trend toward proximate care availability. Most major providers are facing a variety of change management scenarios around treatment facilities size and locations that are driven by: 1. Patient expectations that necessary facilities will be convenient and provide a variety of offerings close to home. 2. Networked service models create business relationships that may shift over time, necessitating unforseen facility needs to effectively manage patient flow. 3. Aging patient population – the baby boomers will create a large base of older Americans that will require medical care. Mature population require different care strategies and different facilities. 4. The continuing body of evidence around improved treatment results due to facilities that provide more natural light, improved air quality and individual control is now the expectation for patient experiences. 5. The move of family and supporting relationship members into the patient room has a positive effect on treatment results, creating the requirement for larger rooms and additional services. 6. Zoned space protocols separate patient and visitor experience from facility operations and maintenance. THE FuTuRE OF HEALTHcARE
  5. 5. Acuity Adaptability The combination of advancing technology and treatment protocols with cost efficiency and patient experience expectations is shortening the time that is spent in a hospital or treatment facility. Shorter stays with effective monitoring tools put the patient in a comfortable home setting sooner which has a positive impact on treatment. With the continuing development of preventative care models, it is likely a smaller patient population will require critical care at higher levels. Facilities will need to “flex” to accommodate a variety of needs at one time or in a progressive treatment protocol. Technology + care Delivery Significant technological advances that are now becoming mainstream are changing the healthcare we receive and the way we receive it as never before. • Robotic Surgery and Operations Support • Tele – medicine • Larger, more flexible patient rooms • Integrated care/data management systems THE FuTuRE OF HEALTHcARE
  6. 6. Scale & Service Urban centers and mixed Use models smaller footprint - mid rise with linked Uses adaptive reUse transparency THE FuTuRE OF HEALTHcARE
  7. 7. Future Proofing This generation of portfolio planning principles and new facilities guidelines will need to provide for more “elasticity” of use and systems than seen before. The changes affecting the built healthcare delivery environment are multifaceted – driven by technology, care protocols, patient expectation and more. • Flexible facilities accommodate changes in use and technologies • Patient rooms with a broad spectrum of care Flexible real estate strategies that allow for changes in business models, service delivery models and patient treatment modality. (i.e. Mental health is the fastest growing category of disease) THE FuTuRE OF HEALTHcARE
  8. 8. Energy Efficiency • Improved mechanical / electrical technologies • Sustainable healthcare facilities Over the past few years, the healthcare sector has embraced the benefits of energy efficiencies. Healthcare, as a sector, accounts for a disproportionate amount of energy usage -- more than twice the amount of energy per square foot of space . As shown on the left, many healthcare facilities are now experimenting with the benefits of “green” technologies -- cooling towers, on-site solar and wind power, employee workflow changes and lighting solutions. Providence, pictured on the left, is the first LEED Gold healthcare facility in the United States. The nationally recognized medical center was able to significantly reduce operating costs, without sacraficing its ability to deliver quality care. solar efficiencies air cUrtain diagrams providence medical centre - newberg, or THE FuTuRE OF HEALTHcARE
  9. 9. cost Efficiency Cost efficency is a difficult subject in healthcare facilities. In order to lower operating expenses while maintaining the ability to provide quality care, healthcare facilities are utilizing accountable care, bundled payment models, quality incentives and penalties, and greener facilities. Accountable care integrators can actually improve patient health and productivity while lowering costs.The diagram below illustrates how a blend of Modified fee-for-service and bundled payment models are precieved as most effective to improve efficiencies. “how effective do you think each of the following payment approaches would be in facilitating a more efficient health care system?” very effective effective a blend of the modified fee-for-service and 25 37 62 bundled per-patient payment systems bundled per-patient payment (a single payment for all services provided to 19 32 51 the patient during the year), with bonus payments for high quality a modified fee-for-service system, with bonus payments for high quality and 5 18 23 efficiency source: commonwealth fund health care opinion leaders survey. september/october 2008. THE FuTuRE OF HEALTHcARE
  10. 10. Research conversion Research is being translated into new treatment protocols with increasing rapidity. Technology, holistic cost models and government support are moving new medicine and innovative care models into the marketplace. Treatment Strategies At every level healthcare services are changing - real estate strategies must support this by understanding the business dynamic and providing thoughtful solutions. Networked Specialties Communications platforms are transforming healthcare centers into highly collaborative networks of spaces. Efficient clinical systems are necessary (care platforms and electronic medical record services) to transfer information efficiently among healthcare professionals. THE FuTuRE OF HEALTHcARE
  11. 11. conclusion There is significant opportunity to “re-think” real estate solutions and align strategies with new business dynamics in the evolving healthcare marketplace. We have identified at a high level a number of the drivers for change – our tools and processes are designed to: - capture your enterprise vision - establish potential scenarios - provide transparent decision making processes - build a RoadMap© to implementation - accelerate your success at realizing benefits Colliers Advisory helps our clients achieve the maximum potential of their real estate – because you real estate should be as efficient and creative as your enterprise. Our commitment to Life Sciences; healthcare, research, pharmaceutical, and biotech is core to our marketplace offering, our depth of expertise and our passion for the mission of our clients. contact us act u Advisory Services│Colliers Studio™ doug demers 601 Union Street, Suite 5300 Managing Director Seattle, Washington 98101-4045 ted soltis Director, Life Sciences THE FuTuRE OF HEALTHcARE
  12. 12. Accelerating Success