1. The document discusses innovative approaches to designing healthcare facilities with flexibility to rapidly adapt to changing needs, such as movable casework and pre-invested spaces. 2. It provides insight into priorities for research, medical education, and healthcare facilities based on a survey, such as an increased need for collaboration and outpatient spaces. 3. Technology is discussed as an accelerant of change in healthcare, and the importance of anticipating future facility needs to support ongoing innovation is emphasized.

1. PATIENTS,
PROCEDURES,
+ PEDAGOGY
JEFFREY FRENCH, FAIA
LOUIS MEILINK, JR, AIA, ACHA
TODD DRAKE, AIA
RETOOLING FACILITIES FOR A VERY
DIFFERENT HEALTHCARE FUTURE

2. RESEARCH
MEDICAL
EDUCATION
HEALTH
CARE
WHAT IS DRIVING CHANGE?

3. DECLINE IN NIH FUNDING
DECLINE IN NIH FUNDING
INCREASE IN
BIO ENGINEERING $
INCREASE IN
CORPORATE PARTNERSHIPS
(SEND MONEY PLEASE)

4. AFFORDABLE CARE ACT
PAY FOR SERVICE PAY FOR PERFORMANCE
FOCUS ON HEALTH
+ PREVENTATIVE CARE
INCREASE IN
OUTPATIENT SERVICES

5. IN LESS THAN 10 YEARS…
FACEBOOK LAUNCHED IN 2005FACEBOOK LAUNCHED IN 2005FACEBOOK LAUNCHED IN 2005FACEBOOK LAUNCHED IN 2005
(that’s less than TEN years ago)(that’s less than TEN years ago)(that’s less than TEN years ago)(that’s less than TEN years ago)
CROWDFUNDINGCROWDFUNDINGCROWDFUNDINGCROWDFUNDING
RESEARCHRESEARCHRESEARCHRESEARCH
CROWDFUNDINGCROWDFUNDINGCROWDFUNDINGCROWDFUNDING
SOCIAL NETWORKINGSOCIAL NETWORKINGSOCIAL NETWORKINGSOCIAL NETWORKING

6. DATA + INFORMATION SHARING
SEEKING OUT INFORMATIONSEEKING OUT INFORMATIONSEEKING OUT INFORMATIONSEEKING OUT INFORMATION
CROWDSOURCINGCROWDSOURCINGCROWDSOURCINGCROWDSOURCING
BIG DATABIG DATABIG DATABIG DATAACCESS TO SHARED DATAACCESS TO SHARED DATAACCESS TO SHARED DATAACCESS TO SHARED DATA
“As data access becomes
universal, organizations will
set themselves apart by
what they do with that data”
HEALTH CARE ADVISORY BOARD
ONLINE EDUCATIONONLINE EDUCATIONONLINE EDUCATIONONLINE EDUCATION

7. EVERYTHING ON DEMAND
BIOBIOBIOBIO FABRICATIONFABRICATIONFABRICATIONFABRICATION
WEARABLE TECHNOLOGYWEARABLE TECHNOLOGYWEARABLE TECHNOLOGYWEARABLE TECHNOLOGY
HEALTH TRACKINGHEALTH TRACKINGHEALTH TRACKINGHEALTH TRACKING

8. THE PATH
From BENCH
to TRAINING
to BEDSIDE

9. RESEARCH
MEDED
HEALTHCARE
SILOS
TEAMS
INTERDISCIPLINARY
EVERYBODY IN

10. SURVEY RESPONDENTS
WERE A SAMPLING
FROM
HEALTHCARE,
RESEARCH +
MEDICAL
EDUCATION FIELDS

11. RESEARCH

12. DRIVERS FOR CHANGE
DECLINING
NIH FUNDING
INCREASE IN
AVAILABLE BIO MED
RESEARCH SPACE
BIO ENGINEERING?

13. DRIVERS FOR CHANGE: SPACE NEEDS
88%PRIORITIZED TEAMTEAMTEAMTEAM
COLLABORATION SPACECOLLABORATION SPACECOLLABORATION SPACECOLLABORATION SPACE
9OUT OF10IDENTIFIED IMAGINGIMAGINGIMAGINGIMAGING
AS HAVING A MAJOR IMPACT
30%RANKED SHAREDSHAREDSHAREDSHARED
CORE SPACECORE SPACECORE SPACECORE SPACE
AS THE #1 BIGGEST CHANGE#1 BIGGEST CHANGE#1 BIGGEST CHANGE#1 BIGGEST CHANGE
IN SPACE NEED

14. INTERDISCIPLINARY
ACROSS SCIENCES
COLLABORATION
BEYOND SCIENCES +
ENGINEERING
NIH – DEPENDENT
WITH PARTNERING
FINANCIAL SUPPORT CROWD FUNDING
INTEGRATED TEACHING + RESEARCH INDISTINGUISHABLE
WET, ANIMAL INTENSIVE,
OPEN
LABORATORY TOOLS
CO LOCATED w/ TREATMENT,
COMPUTATIONAL, SIMULATED
SEQUENTIAL RESEARCH + FABRICATION
INTEGRATED, CO LOCATED,
NON LINEAR
THERAPIES
TARGETING CELLS
BREAKTHROUGHS IMMUNOTHERAPY
RISK AVERSE FDA GLOBAL ACCESS PATIENT COLLABORATION
EVOLUTION OF THE RESEARCH ENVIRONMENT
TRADITIONAL STATE OF THE ART STATE OF THE FUTURE

15. Moving beyond what we currently
think of as interdisciplinary

16. NUTRITIONAL RESEARCH
PRESCHOOL
RESEARCH
CORE LAB
HEALTHY EATING
VENUE
HUMAN
PERFORMANCE LAB
INTERDISCIPLINARY
WORK ENVIRONMENT
NUTRITIONISTS
SOCIOLOGISTS
GENETICISTS
PUBLIC POLICY EXPERTS
URBAN PLANNERS
EXERCISE PHYSIOLOGISTSWET
RESEARCH LAB

17. WETWETWETWET
WETWETWETWET
DRYDRYDRYDRY
FLEXIBLEFLEXIBLEFLEXIBLEFLEXIBLE
TEACHINGTEACHINGTEACHINGTEACHING
ZONES OF
PRE INVESTMENT

18. MAXIMUM FLEXIBILITY
Casework, Tables + ChairsCasework, Tables + ChairsCasework, Tables + ChairsCasework, Tables + Chairs ALL Moveable / Height AdjustableALL Moveable / Height AdjustableALL Moveable / Height AdjustableALL Moveable / Height Adjustable
Utility DistributionUtility DistributionUtility DistributionUtility Distribution CIP / Floor BoxesCIP / Floor BoxesCIP / Floor BoxesCIP / Floor Boxes
TechnologyTechnologyTechnologyTechnology Multiple Screens / Wired & WirelessMultiple Screens / Wired & WirelessMultiple Screens / Wired & WirelessMultiple Screens / Wired & Wireless

19. MAXIMUM FLEXIBILITY
Casework, Tables + ChairsCasework, Tables + ChairsCasework, Tables + ChairsCasework, Tables + Chairs ALL Moveable / Height AdjustableALL Moveable / Height AdjustableALL Moveable / Height AdjustableALL Moveable / Height Adjustable
Utility DistributionUtility DistributionUtility DistributionUtility Distribution CIP / Floor BoxesCIP / Floor BoxesCIP / Floor BoxesCIP / Floor Boxes
TechnologyTechnologyTechnologyTechnology Multiple Screens / Wired & WirelessMultiple Screens / Wired & WirelessMultiple Screens / Wired & WirelessMultiple Screens / Wired & Wireless
COMPUTATIONALSCIENCE ENGINEERING
DISCUSSION
WETWETWETWET
SUPPORTSUPPORTSUPPORTSUPPORT
DRYDRYDRYDRY DRYDRYDRYDRY
TEAM ROOMSTEAM ROOMSTEAM ROOMSTEAM ROOMS SUPPORTSUPPORTSUPPORTSUPPORTLABLABLABLAB LABLABLABLAB LABLABLABLAB

22. MEDICAL
EDUCATION

23. DRIVERS FOR CHANGE: SPACE NEEDS
95%ADDITIONAL ACTIVE LEARNING +ADDITIONAL ACTIVE LEARNING +ADDITIONAL ACTIVE LEARNING +ADDITIONAL ACTIVE LEARNING +
TEAM BASED CLASSROOMSTEAM BASED CLASSROOMSTEAM BASED CLASSROOMSTEAM BASED CLASSROOMS
SPACES HAVE LESS IMPACTSPACES HAVE LESS IMPACTSPACES HAVE LESS IMPACTSPACES HAVE LESS IMPACT
95%SAW AN INCREASE ININCREASE ININCREASE ININCREASE IN
HEALTHCARE STAFF TRAININGHEALTHCARE STAFF TRAININGHEALTHCARE STAFF TRAININGHEALTHCARE STAFF TRAINING
AND RECERTIFICATIONAND RECERTIFICATIONAND RECERTIFICATIONAND RECERTIFICATION NEEDS
1/2
RANKED
HUMANHUMANHUMANHUMAN
ANATOMYANATOMYANATOMYANATOMY
LABSLABSLABSLABS AS THE
#1 BIGGEST
CHANGE
IN SPACE
NEEDS

24. DISCIPLINE SILOS TRAINING
HYBRID
INTERPROFESSIONAL TEAMS
LARGE LECTURE ENGAGEMENT ACTIVE LEARNING
ILLNESS TO TREATMENT LEARNING FOCUS WELLNESS EDUCATION
HUMAN TISSUE MODELS CASE MODELS VIRTUAL ANATOMY
EXAMINATION EVALUATION
COMPETENCE BASED
CREDENTIALS
4TH YEAR PATIENT
OBSERVATION
FIELD WORK
1ST YEAR PATIENT
ENGAGEMENT
COMMUNITY HEALTH HEALTH DISPARITIES GLOBAL HEALTH
HOSPITAL PATIENT FILES PERSONALIZED DATA
PERSONAL ON DEMAND
RECORDS
CONFERENCES SEMINARS LIFE LONG LEARNING
SIMULATION
RE CERTIFICATION CENTERS
EVOLUTION OF MEDICAL EDUCATION
STATE OF THE ART STATE OF THE FUTURETRADITIONAL

25. HEALTH [R+D] EDUCATION

26. POPULATION
HEALTH
PROMOTE
INQUIRYPROVIDE PATIENT
CENTERED CARE
COLLABORATIVE
LEARNING
HEALTH PROFESSIONS EDUCATION

27. EMPHASIZE CRITICAL
THINKING SKILLS
COLLABORATION +
TEAM WORK INTEGRATION
EARLY PATIENT EXPOSURE:
LEARNING CONTEXT
CURRICULAR FACILITY RESPONSE

29. CONVERGENCE
OF USES

30. SMALL + LARGE
GROUP LEARNING
IMMERSIVE
LEARNING
FLEXIBILITY

31. PERIMETER FIXED FORWARD FACING OMNI DIRECTIONAL
TEAM BASED LEARNING

32. DIVERSITY IN USE

34. ZONES OF
PRE INVESTMENT

35. • RAISED FLOOR
• ELECTRICAL ACCESS
• MECHANICAL ACCESS
• EQUIPMENT UMBILICAL
• MOBILE EQUIPMENT
• SKYFOLD WALLS
• THEATRE SETS
• HIGH DENSITY STORAGE
• TECHNICAL GRID
• BOOMS W/ EQUIPMENT
• QUICK CONNECTS
• MOTION CAPTURE
SYSTEMS INTEGRATION

38. FLOOR BOXES – POWER / AIR
AV+LCD SCREENS SKYFOLD WALLS
MOBILE HEADWALLS TECHNICAL GRID CAMERAS, LIGHTS / MICS
SURGICAL LIGHTS, MEDGAS GEN LIGHTING ABOVE GRID MEP ABOVE GRID

39. SYSTEMS INTEGRATION

40. MOBILE STAGE SETS

41. SPACE DIVISION

42. SIZE OPTIMIZATION

43. HEALTHCARE

44. DRIVERS FOR CHANGE: SPACE NEEDS
90%PRIORITIZED
PUBLIC AMENITIESPUBLIC AMENITIESPUBLIC AMENITIESPUBLIC AMENITIES
60%RANKED THE
EMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENT
AS STABLE OR DECREASING
IN NEED
80%SAW AN INCREASE ININCREASE ININCREASE ININCREASE IN
OUTPATIENT SPACEOUTPATIENT SPACEOUTPATIENT SPACEOUTPATIENT SPACE NEEDS
1/2
RANKED
OUTPATIENTOUTPATIENTOUTPATIENTOUTPATIENT
SPACESPACESPACESPACE NEEDS
AS NUMBER
#1 PRIORITY

45. FRAGMENTED INTEGRATED AUTOMATED
INVASIVE MINIMALLY INVASIVE
LESS INVASIVE,
PREVENTATIVE
PROVIDER CENTRIC PATIENT CENTRIC OMNI CENTRIC
CENTRALIZED HOSPITAL
DECENTRALIZED –
SHIFT TO COMMUNITY
DECENTRALIZED –
WITHIN THE HOME
ONE SIZE FITS ALL LIMITED MENU PERSONALIZED MEDICINE
THERAPEUTICS /
DIAGNOSTICS / DEVICES
DIAGNOSE THEN TREAT THERANOSTICS
TREATING SICKNESS UNDERSTANDING WELLNESS PROMOTING WELLNESS
FEE FOR SERVICE PAY FOR QUALITY
REWARDING
AFFORDABILITY
AGED AND SEDATE AGING IN MOTION MINIMIZE AGING
EVOLUTION OF HEALTHCARE
TRADITIONAL STATE OF THE ART STATE OF THE FUTURE

46. 5%OF THE POPULATION ACCOUNTS
FOR CLOSE TO HALFOF HEALTH SPENDING
SOURCE: MIT TECHNOLOGY REVIEW

47. PREVENTATIVE CARE
SOURCE: Centers for Disease Control and Prevention

48. PRIMARY CARE
PHYSICIAN
NURSE CASE
MANAGER
COMMUNITY RESOURCE
SPECIALISTS
PATIENT SOCIAL
ASSISTANCE
RESOURCE
COORDINATOR
HOME
SERVICES
PHARMACIST
COMPREHENSIVE
CARE MANAGEMENT

49. SOURCE: PricewaterhouseCoopers

50. FACETIME APPLICATIONS
DEVICES INCLUDE:
STETHOSCOPE
OTOSCOPE
THERMOMETER
DERMASCOPE
PULSE OXIMETER
SCALE
BLOOD PRESSURE CUFF

51. NYU Langone Medical
Center Campus
Ambulatory Care Center
240 E. 38 Street
EXISTING FACILITIES

52. MEPMEPMEPMEP
ENDOSCOPY
MOLECULAR PATHOLOGY LAB
MEPMEPMEPMEP
NEUROLOGY
CANCER CENTER
CANCER CENTER
RUSK REHABILITATION
RUSK REHABILITATION
RUSK REHABILITATION
PAIN SERVICES
WOUND CARE
DERMATOLOGY
DERMATOLOGY
AMBULATORY SURGERY
MEPMEPMEPMEP
PRE ADMISSION TESTING
MEPMEPMEPMEP
COMMON FACILITIES

54. SPEED OF
TECHNOLOGY SPEED OF
PROGRAM – DESIGN CONSTRUCTION
Ralph Blasier, “The Problem of the Aging Surgeon”

55. MAXIMUM PLANNING FLEXIBILITY
100’100’100’100’
100’100’100’100’

56. MAXIMUM PLANNING FLEXIBILITY
100’100’100’100’
100’100’100’100’

57. FLEXIBLE FOR DISASTER

58. Embedded Training Space in
Clinical Care

59. SIMULATION +SIMULATION +SIMULATION +SIMULATION +
CONFERENCE CENTERCONFERENCE CENTERCONFERENCE CENTERCONFERENCE CENTER
OPERATING PLATFORMOPERATING PLATFORMOPERATING PLATFORMOPERATING PLATFORM
EMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENT
PATIENT FLOORSPATIENT FLOORSPATIENT FLOORSPATIENT FLOORS
LABLABLABLAB

60. ARE TODAY’S MEASURES OF SUCCESSARE TODAY’S MEASURES OF SUCCESSARE TODAY’S MEASURES OF SUCCESSARE TODAY’S MEASURES OF SUCCESS
THE SAME ONES THAT WILL INDICATETHE SAME ONES THAT WILL INDICATETHE SAME ONES THAT WILL INDICATETHE SAME ONES THAT WILL INDICATE
STRENGTH IN THE FUTURE?STRENGTH IN THE FUTURE?STRENGTH IN THE FUTURE?STRENGTH IN THE FUTURE?
COORDINATED CARE:COORDINATED CARE:COORDINATED CARE:COORDINATED CARE:
QUALITY CARE AT THEQUALITY CARE AT THEQUALITY CARE AT THEQUALITY CARE AT THE
RIGHT TIME, RIGHT PLACE,RIGHT TIME, RIGHT PLACE,RIGHT TIME, RIGHT PLACE,RIGHT TIME, RIGHT PLACE,
RIGHT PRICERIGHT PRICERIGHT PRICERIGHT PRICE

61. 1.1.1.1. InnovativeInnovativeInnovativeInnovative approaches to addressingapproaches to addressingapproaches to addressingapproaches to addressing
“Forward“Forward“Forward“Forward Flexible” rapidFlexible” rapidFlexible” rapidFlexible” rapid change facilitieschange facilitieschange facilitieschange facilities
2.2.2.2. InsightInsightInsightInsight to space based priorities at otherto space based priorities at otherto space based priorities at otherto space based priorities at other
institutions, as this may influence your owninstitutions, as this may influence your owninstitutions, as this may influence your owninstitutions, as this may influence your own
decisionsdecisionsdecisionsdecisions
3.3.3.3. Understanding technology as an accelerantUnderstanding technology as an accelerantUnderstanding technology as an accelerantUnderstanding technology as an accelerant
of change, and anticipating the state of theof change, and anticipating the state of theof change, and anticipating the state of theof change, and anticipating the state of the
facility futurefacility futurefacility futurefacility future