Design Strategies for the Future of Telehealth

Hord Coplan Macht’s (HCM’s) team of expert led healthcare designers have partnered with healthcare organizations and care providers to determine how their facilities will be adapting to the multitude of new challenges created as a result of the pandemic.

Over the next few weeks, HCM will share with you our thoughts and discussions with our valued partners who are responsible for the management of their facilities. We will focus on how the current situation, potential future and continued change will impact healthcare facility design and the creation of new environments of care. We will share the insights of our diverse team of specialists including architects, planners, interior designers, clinical practitioners and operational strategists.

In this installment we explore how telehealth may continue to impact and benefit the ambulatory and acute care environment.

Because of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) has extended telehealth so that people can receive a broader range of services from their physicians without traveling to a healthcare facility. Will these new rules set forth by CMS be temporary measures, or will new regulations be put in place for telehealth moving forward?

Based on both internal and external discussions, there will likely be new rules and standards regarding telehealth since both patients and providers have now had firsthand experience with its advantages.  The demand for this type of delivery from consumers, and the necessity of the practice for improved infection control, will not go away; the challenge now is to create ways to successfully accommodate this type of service delivery.

Will telehealth affect the current design trend of creating open collaboration spaces?

Telehealth will likely have a long-term effect on the design of ambulatory facilities either by increasing the capacity of existing facilities or changing the types of spaces. The effect of COVID-19 on collaboration space and distancing in the future could require the reimagining of collaboration as a more digital practice. Instead of large open spaces, one possibility is better connectivity and digital technology in the exam rooms. Providers can immediately, but remotely, discuss patient care with other specialties while remaining in a protected space. It should become easier through technology to get consultations across many different specialties even when they are not co-located in the same building or campus.

Will the doctor’s office return to the ambulatory environment or will dedicated telehealth rooms be developed?

Infection control protocols and privacy concerns could create a credible reason for the modified return of the private provider office or workspace. Additionally, the creation of dedicated telehealth rooms and fewer shared exam rooms seems inevitable. In terms of design, flexibility and adaptability will be the key drivers in transforming existing spaces, and new environments, to future-proof technology driven impacts.

Another key consideration in the ambulatory environment will be the waiting rooms. The trend of expedited patient rooming will continue while the overall waiting room size will contract with smaller separated seating groups and reduced seat counts.

What will happen to exam room utilization?

Exam room utilization will likely decrease as patients and physicians become more comfortable with necessary technology and convenience of remote care. Possible scenarios include the scheduling of designated telehealth days where a percentage of providers see patients from a remote location while others focus on those visits that require in-person exams. Depending on the organization and regulations, providers could conduct telehealth visits from home, from a designated telehealth room in the ambulatory center, or from an academic office in the schools of medicine. More likely in typical outpatient settings – doctors will weave telehealth patients between regular patients in a portion of their day, which will mean fewer overall exam rooms per doctor as an average. Infection control concerns will be a major driver in evaluation of patient scheduling, number of exam rooms, and cleaning protocols between patients.

What specialties do we see benefitting or participating the most in telehealth practices and how can we design to accommodate each specialty’s needs?

Patients generally have a high degree of satisfaction and comparable outcomes with telehealth for sick visits with primary care providers. Other specialties that could also successfully implement this practice include behavioral health, where access for patients could provide critical intervention much more quickly than waiting for an in-person visit. Additional services that may benefit from a transition to remote visits, when possible, include pre- and post- surgery education, medication compliance visits, and post-surgical in-home rehabilitation exercises.

Telehealth will not come without certain challenges. What do healthcare designers need to consider in order to create an environment that gives patients a sense of security and confidentiality?

Provider telehealth spaces need to be carefully created to evoke a feeling of comfort and professionalism for patients, as well as to maintain brand guidelines established by the healthcare system. Acoustics to reduce noise from outside the telehealth office will be key. Another important consideration will be lighting, so patients can clearly see the physician’s facial expressions and mannerisms, as well as a background or setting for the provider that is designed in calming and muted tones to not distract the patient.

How do we create a telehealth brand for health systems? What could this look like?

Maintaining the healthcare system’s brand identity while using telehealth will be critical to institutional success. The patient experience should be distinctly felt as a complementary piece of their healthcare journey within the system as a whole. Much of this brand consistency will derive from the web interface and patient portal. Additionally, the physical aspects of the environment within the telehealth room should subtly reinforce existing branding standards within the background using color and logo placement, while not distracting from the provider’s message.

Designers will need to imagine themselves in both the patients’ and providers’ shoes when preparing for the incorporation of telehealth into the standard practice of care. Every detail of a visit from the method of scheduling appointments to the distribution of follow up procedures should be carefully planned to ensure the best outcomes and clear understanding. Hord Coplan Macht stands ready to assist you with what solutions are right for your practice. Our team of professionals understands there is no “one size fits all” answer to these challenges and that the most successful strategies will emerge from tailored collaboration. To learn more about how we can help, contact us at healthcare@hcm2.com.