As we move into the next stage of IT enablement for healthcare, hospitals and health insurers will need to help lead the charge on population health and care coordination. The entire focus of healthcare reform has been to expand access and improve care and quality for the population, and ultimately for the individual.

Clearly the drive to healthcare risk management and accountable care has captured everyone's attention. And, it is safe to say we have only just begun this transformation, which may take a decade to fully settle in. 

Today, we associate the hospital with the center of our healthcare world  -  a physical building enabled with high technology and a highly trained staff. Yet, in our models for accountable care, the patient centered medical home may be the new center of the not so distant future. It may be the primary care clinic. It may be the senior center. It may be the employer. Or, it may even be the school or home. As we imagine the hospital design of the future, we should consider what it would take to literally build a hospital without walls. 

Here are the five key design elements of the hospital of the future  -  without walls: 

1. The ability to design a digital profile of each individual  -  i.e. healthcare CRM

2. The ability to see and engage virtually via high-definition video, anytime, anywhere and on any device

3. The ability to create centers of collaboration excellence both inside and outside of our communities

4. The ability to access massive amounts of data without putting it in one container

5. The ability to leverage social media as a care coordination platform, not merely a collaboration platform 

The first technical reality is already under way in retail and financial services. That is the ability to know each individual and to tailor the needs of our services models to each person. Breakthroughs in science will come as personalized medicine progresses. So must our model for patient engagement. 

The future will bring healthcare CRM systems that can leverage data and services from multiple systems to create a unified view of an individual. With that view, healthcare systems can design personalized care management programs and anticipate demand. This ability will create interesting opportunities as we engage providers and patients. As individuals use the healthcare system, customer care can be just a phone call, video call, instant message or text message away. And community resources can be dispatched remotely rather than waiting for a patient to enter a central care facility. 

Video and telemedicine is already at work, providing many new options to create access points in our communities. The future will provide even greater video options, at lower cost and higher resolution, on many devices. Clearly the investment in video will not be restrained by fee-for-service payment. Rather, it could potentially create efficiencies for population health and ACO contracting that insurers and providers may encourage as they drive to do more with less, at a higher quality. Video may even become the preferred data input and capture mechanism for HIT systems. 

On the topic of clinical expertise, the hospital without walls will have greater access than ever before to specialists and experts from outside our physical reach. As hospital M& A and affiliations increase, we expect to see clinical collaboration across vast distances. 

The ability to authenticate approved providers and patients in a defined community can be enabled through advanced network security. Specialty shortages could be a thing of the past for some specialties that can deliver capabilities remotely through care extenders and primary care. Once these experts are available on a virtual network, they can be routed to the point of care using the video capabilities and collaboration tools described earlier. If they are connected to the network and they have a fully functioning device, then they are accessible in the hospital without walls. 

In the hospital of the future, data centers will also be supported and managed virtually. The cloud will move beyond a private model to support public and private capabilities. Healthcare IT will not need to be housed in the hospital of the future. Rather, it may be provisioned from multiple locations in a community or around the globe. 

In this environment the breakthrough will be when data can reside in its original form and in its original location, and can be assembled through the cloud, based on identity and security. Healthcare clouds will form to create new services and solutions designed to support providers and patients anywhere. Public healthcare clouds are already starting to happen in emerging countries like China, where entire provinces are adopting these breakthrough technologies.

Finally, social media. As we consider how social media has changed our lives, our hospitals too will need to leverage social tools to create new branding opportunities, new clinical programs for wellness and health, and new ways to create communities in the digital world. In the future, we may access our healthcare through social means  -  before we suggest a hospital visit. Communities will learn from each other through social media tools and consumers will engage a virtual front door of our hospitals before they step into our beautiful atriums and public spaces. 

For a bright healthcare future, we need to help the architects and developers consider these trends as we prepare for the reality in front of us. IT and business leaders alike can gain valuable insights from awareness and understanding of these trends so our new buildings and other healthcare environments  -  with our without walls - are designed and constructed with them and better care in mind.