Spanish stakeholders have been trailblazing the concept of the “liquid hospital”, which envisions the virtual and physical expansion of healthcare provision beyond the parameters of the traditional centralized hospital structure. The aim is to leverage connectivity, telemedicine, the Internet of Things (IoT) along with social media to co-opt patients, families and society into the management of disease.
Aging populations and a considerably elevated incidence of chronic disease … necessitate a wholesale and urgent reconceptualization of what healthcare provision should look like
Richie Etwaru, Hu-manity
“A liquid hospital (H2.0) is essentially a deeper and broader care ecosystem that adds to the traditional hospital (H1.0) to the point that whereby it becomes present in the medical, family and greater social reality,” explains a spokesman for the Daedalus Project of the Public Health System of Andalusia (SSPA). “As such, it heralds the disappearance of barriers and distances, the development of precision medicine, the availability of digital mechanisms to inform the decision making of professionals and patients as well as a transformational shift in focus motivated by chronicity, dependence, fragility and social support,” he adds.
The model being contemplated and trialled by a number of pioneering entities, including Sant Joan de Déu Hospital in Barcelona, “combines architectural advantages and clinical functionality thanks to an enlightened infrastructure design that takes into account health management and relates spaces to their surroundings, transcending the static building that quickly becomes obsolete and instead generating dynamic spaces, prepared to change their use, adapt and grow in a sustainable manner according to emergent socio-demographic needs,” writes Angel Navarro , president of science and health consultancy, Azierta.
The sheer radicalism of this healthcare model should not be underestimated for it predicts the de-centering of the role of the physician and the empowerment of patients and their support networks as opposed to the hierarchical, top-down doctor-patient relationship of old.
“Health spaces have evolved since the mid-twentieth century, adapting to different distribution patterns generated by functional demands. Looking ahead, the role of the expert is being re-molded to be placed at the service of the citizen rather than the center; diagnostic resources are unceasingly centralized while disease management and delivery of care is dispersed to the most appropriate and efficient level which, in some instances, may even be within the patient’s own home,” confirms Gonzalo Rodríguez, president of the engineering specialist, TSYA International.
Catalonia’s Sant Joan de Déu hospital, for instance, is working on the creation of a portal where patients and their families can gain access to health test results without having to leave the home. Even more importantly, the portal also plans to incorporate a broad range of telemedicine services. These encompass online consultation, real time-monitoring and telerehabilitation programs through which doctors and patients can interact via webcam without the need for physical consultation at the clinic — thus doing away with unnecessary displacements and opening the door to a considerably more personalized follow-up of the patient.
“What you’re seeing is the liquid hospital flattening the walls of the hospital and enticing the discipline of disease management to include patients and families, through multiple digital technology-based mechanisms – Sant Joan de Déu Hospital from tablets and smartphones to wearable devices – and their respective formats: blogs, social networks, apps, webcasting and much more,” discloses one analyst at the Instituto para el Desarrollo e Integración de la Sanidad (IDIS).
“Digital technology is rapidly becoming the main facilitator of health integration between levels of care, between the hospital and the home, and even between different hospital centres and the clinical units within the same hospital… applying connectivity to all areas of health care is no longer optional in the society in which we live,” muses Juan Sanabria, general manager of the Iberian cluster of Philips Healthcare, one of the leading specialists in MedTech and healthcare integration solutions.
“It is clear that the future success of modern healthcare will hinge upon developing the necessary algorithms so that all this big data of personal and clinical health in the cloud provides knowledge both for the individual health outcomes of each patient and for the results of population health,” predicts Sanabria. “Philips already has solutions to manage combined information, for example, of imaging tests, pathological anatomy and genome information, which are allowing faster and more accurate diagnoses and, therefore, personalized treatments,” he continued.