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Healthcare Design Trends in India

Modern Hospital Design

According to 3D Power, the Indian healthcare industry is expected to grow to $79 billion in 2012 from $40 billion in 2010. This number will increase to $230 billion by 2020. This exciting growth responds to various demographic and economic trends, including an increasing population, rise in disposable income, increasing consumerism and demand for high-quality healthcare, greater incidence of lifestyle-related diseases, increasing employer-based insurance coverage, and increased government spending on public healthcare. Advancements in medical sciences and technology as well as an influx of foreign-trained doctors in the workforce also have led to an increasing focus on providing state-of-the-art equipment and services to patients.

In the last 10 years, there has been a parallel demand for high-quality hospital infrastructure to support the growing demands for healthcare. In India, healthcare is provided in primarily three types of settings: government-funded and run hospitals and healthcare clinics that provide free healthcare services, private for-profit hospitals and health centres, and mission-based non profit hospitals. The first two types of settings comprise the majority of the healthcare infrastructure in the country.

Trends in private healthcare projects

Private for-profit hospitals are seeing a marked growth with several facility design projects underway in different parts of the country. According to WHO health statistics from 2010, around 75% of the total annual healthcare spending in India came from the private sector. Hospital systems such as Fortis and Apollo have been immensely successful in the last 10 years in providing high-quality healthcare services to a growing educated and affluent urban population. While revenue generation is a key goal for these hospitals, emulation of Western standards and ensuring the best outcomes for patients is important in order for them to attract and retain customers. To stay competitive in the market, hospitals are opting for external accreditation through international organizations such as Joint Commission International or India’s National Accreditation Board for Hospitals and Healthcare Providers. Accreditation also is seen as an important process for improving patient safety and quality of care provided to patients. With medical tourism being an important driver, many private hospitals aspire to provide high-quality built environments similar to those found in U.S. and European hospitals.

Commenting on some of the key drivers for private hospital design in India, Gaurav Chopra, vice president and director, South Asia region, HKS Architects, says, “While there is a growing focus on patient-centred care, many new private hospitals are investing heavily in new technology and equipment, and often the built environment mandate is to house this technology. Also, given the demand for hospital beds and its direct relation to the bottom line, the focus of hospital design projects is primarily on increasing bed capacity.”
According to Chopra, many private hospitals provide a combination of multi-bed wards (15-20% total bed count), single occupancy rooms (around 70%), and luxury single rooms for high-paying customers (around 5%). Infection control is an important concern for healthcare facilities in India and selection of cleanable and durable materials is a key design driver. Local culture and traditions, as well as climate, are important factors that impact the layout of spaces and building form and design.

For example, family members are usually present at all times during a patient’s hospital stay, which requires larger patient rooms. Providing larger waiting rooms for families in the emergency department, surgery, and ICU also is necessary. In addition, 3D Power acknowledges that spirituality and religion are an important part of life in India, and hospital artwork may refer to symbols and images of the dominant culture in the region.

Public Health in British India: Health Care Centres

The evolution of public health in British India and the history of disease prevention in that part of world in the 19th and early 20th century provide a valuable insight into the period that witnessed the development of new trends in medical systems and a transition from surveys to microscopic studies in medicine. It harbours the earliest laboratory works and groundbreaking achievements in microbiology and immunology. The advent of infectious diseases and tropical medicine was a direct consequence of colonialism. The history of diseases and their prevention in the colonial context traces back the epidemiology of infectious diseases, many of which are still prevalent in third world countries. It reveals the development of surveillance systems and the response to epidemics by the imperial government. It depicts how the establishment of health systems under the colonial power shaped disease control in British India to improve the health of its citizens.

The history of western medicine in India dates back to 1600, when the first medical officers arrived in India along with the British East India Company's first fleet as ship's surgeons. In 1757, the East India Company established its rule in India, which led to the development of civil and military services. A medical department was established in Bengal as far back as 1764, for rendering medical services to the troops and servants of the Company. At that time, it consisted of 4 head surgeons, 8 assistant surgeons, and 28 surgeon's mates. In 1775, Hospital Boards were formed to administer European hospitals comprising of the Surgeon General and Physician General, who were in the staff of the Commander-in-Chief of the Royal Indian Army. In 1785, medical departments were set up in Bengal, Madras, and Bombay presidencies with 234 surgeons. The medical departments involved both military and civil medical services. In 1796, hospital boards were renamed as medical boards to look after the affairs of the civil part of the medical departments. 

In 1857, the Indian Rebellion led to the transfer of administration of India to the Crown and different departments of civil services were developed. It wasn’t until 1868 that a separate civil medical department was formed in Bengal. In 1869, a Public Health Commissioner and a Statistical Officer were appointed to the Government of India. In 1896, with the abolition of the presidential system, all three presidential medical departments were amalgamated to form the Indian Medical Services (IMS). After the development of IMS, medical duties for the Royal Indian Army were performed by the Army Medical Department, later called the Royal Army Medical Corps (RAMC). Medical departments were under the control of the central government until 1919. The Montgomery-Chelmsford Constitutional Reforms of 1919 led to the transfer of public health, sanitation, and vital statistics to the provinces. This was first step in the decentralization of health administration in India. In 1920-21, Municipality and Local Board Acts were passed containing legal provisions for the advancement of public health in provinces.

Medical Institutions

The first hospital in India was the Madras General Hospital in 1679. The Presidency General Hospital, Calcutta was formed in 1796. About four hospitals were formed in Madras between 1800 to1820. To fulfil the growing need for health professionals, Calcutta Medical College was established by an order in February 1835, which was the first institute of western medicine in Asia. Medical College Hospital, Calcutta was formed in 1852. In 1860, Lahore Medical School (later named King Edward Medical College) started in Lahore, Punjab. Afterwards, a network of hospitals was set up throughout India. In 1854, the government of India agreed to supply medicines and instruments to the growing network of minor hospitals and dispensaries. Government Store Depots were established in Calcutta, Madras, Bombay, Mian Mir, and Rangoon. Lady Reading Health School, Delhi was established in 1918. In 1930, the All-India Institute of Hygiene and Public Health was established in Calcutta. In 1939, the first Rural Health Training Centre was established in Singur near Calcutta

Vintage Exteriors 

5 Trends That Will Redefine Your Healthcare Experience In 2015

Healthcare is at a major turning point as doctors and hospitals look for ways to improve health outcomes while meeting cost constraints. Here’s how that’s going to affect you.

Technology has revolutionized many aspects of our lives (there seems to be an app for almost everything these days), but our modern healthcare system has remained largely on the sidelines of this transformation.
One small example: Electronic health records have existed for more than 30 years. As of 2008, only 38% of office-based physicians had converted to e-records, according to the Centres for Disease Control. That number increased to about 78% of office-based physicians as of 2013, but it shows how slow the healthcare industry is to adopt new digital tools.
Technological progress in the industry is more of a steady slog than headline-making disruption, but that doesn’t mean there aren’t big things happening. Here are five important trends that will shape your healthcare experience this year and beyond.
The Year Of Seamless Care.

Healthcare IT systems, which are currently shored up behind proprietary walls, will need to find ways to interact across the care spectrum. About 95% of healthcare providers say interoperability challenges limit their ability to transfer data from one medical center to another, according to a study by Premier  PINC . Essentially, that slows down the transfer of information about patients, which can create sometimes dangerous gaps in care.
Susan DeVore, CEO of Premier, a health care alliance, says that while we’ve created a large amount of e-records in recent years, those records are “not able to seamlessly talk to each other."
That will start to change this year at "both the public and private level," said DeVore. The U.S. Office of the National Coordinator will push interoperability as a core requirement in its next stage of guidelines, and providers will become more proactive in pushing for APIs and open source tools that developers can use to better connect data across medical locations.
Digital Tools Will Become More Widespread.

Digitally-enabled care is a must-have for hospitals and doctors in order to deliver the best care, but technology has been slow to infiltrate the medical world. It's not about "disruption" in this industry, it's about enhancement — and that's what you'll see more of in 2015.

Digital tools — from telemedicine to in-office software — will make your healthcare more efficient, more cost-effective and, ultimately, result in healthier patients. According to a Price Waterhouse Cooper study, half of doctors believe e-visits could replace more than 10% of in-office patient appointments, and roughly 75% of doctors said they would prescribe an app to help patients manage chronic diseases such as diabetes.

Putting A Price On Drug Innovation.

Specialty drugs will dominate conversations about health costs this year. Niche treatments are expensive to develop and target a small portion of the population, which means they often carry high price tags. Only 1% to 3% of the U.S. population uses specialty drugs, yet spending on them is expected to account for 50% of drug payments by 2018, according to a study by Prime Therapeutics.
These drugs could potentially lower overall health bills as patients are cured of chronic diseases and avoid expensive complications, but the challenge will be how to cope with high price tags today. Take a revolutionary new Hepatitis C therapy as an example. The drug, which costs $84,000 per patient for a full course, could inflate state Medicaid programs by almost 15%, according to DeVore.

That’s only one specialty treatment for one condition: when compounded, though, the effect could be huge. The average cost of filling a specialty drug prescription for a month is $1,800 compared with $54 for non-specialty drugs, such as antibiotics or anti-cholesterol medication, according to data from Express Scripts. At the same time, the number of patients filling specialty drug scripts is rising faster than the number filing for traditional drugs. The use of specialty medications increased 2.5% in 2013 versus a 0.5% gain for traditional prescriptions, Express Scripts found.
Congress will likely get into the issue this year: Democrats may push for laws allowing Medicaid to negotiate prices with drug makers, while Republicans may go after private sector solutions to inspire competition, such as creating streamlined approval for generic equivalents.
Patient Knowledge Is Power.

Transparency will become even more important in healthcare this year, especially when it comes to financial data. Services such as ZocDoc already provide access to doctor reviews from a quality and care perspective. More businesses like this will proliferate to help parse the reams of financial information that will become available.
Medicare is releasing its physician procedure charges, while insurance comparisons are available through the Obamacare exchanges. You’ll also be able to review payments your doctor is receiving from drug and device manufacturers via the Open Payments website. This is just the beginning.

"That desire for transparency will continue," said DeVore. "Consumers will become more and more knowledgeable to the availability of information."
This data is still in its early stages, though, and it will continue to take time to confirm and sort out issues with data sets, said DeVore. This year will see more progress in how we interpret and access available medical information.
Cutting Out The Cost Surprises.
Healthcare providers are now using a novel approach to cut costs without sacrificing care: bundled payments.
Bundled payments group all the services a patient receives during an episode of care under one fee. For example, say you're getting knee replacement surgery. A hospital, possibly in conjunction with other providers, will set a lump-sum cost that covers your whole course of care: pre-op, hospital stay, surgery, anesthesia, physical therapy, and follow-up. No surprise costs.
As a patient or an insurance company, you know what you’re going to pay. As a hospital, you're incentivized to provide the necessary services as efficiently as possible, and with the highest-quality care, since the hospital will keep a portion of the savings generated. On the flip side, they're also held accountable for any costs overruns.

It's already a voluntary federal program, and states are also test-driving bundled payments. Arkansas' Medicaid program has mandatory bundled payments in place for 10 conditions, and Tennessee and Ohio are set to announce their own programs in 2015. Even some employers — including Kroger, Boeing and Lowes — are starting to adopt similar initiatives.
Bundled payments not only take out the cost surprise, they also encourage providers to provide connected care. At the end of the day, that’s what patients want: “connected, consistent, coordinated care,” said DeVore.

Narayana Hrudayalaya plans to set up 100 low cost hospitals across the country

-newsonprojects.com

Narayana Hrudayalaya Hospitals (NH) is planning to invest nearly Rs 5,000 crore on setting up a chain of 100 low-cost speciality hospitals and at least three more health cities in the country.

The low-cost hospitals will add 30,000 beds in five years. The company will invest Rs 25-30 crore on each of these hospitals, using prefabricated construction materials.

The first such hospital is being built by L&T in Mysore. The company want to prove that a state-of-theart, 300-bed multi-speciality hospital can be built for $6 million to $7 million (Rs 35 crore).

How To Choose The Right Hospital

Health consumers now have access to more information about quality and safety at hospitals than ever before. They can use the Internet to find out what percent of surgery patients are given antibiotics at the right time, how many heart attack patients are given aspirin upon arrival, or even what percent die of pneumonia while hospitalized.

What this flood of information cannot tell them, however, is how to make the right decision when choosing a hospital. This process should be a deliberative one instead of an emotional one, say quality and safety experts, who emphasize the importance of looking at available data and other indications of excellence like how staff members interact with patients and the hospital’s appearance.

“The important point is that there is no one metric,” says Dr. Jerod Loeb, executive vice president of quality measurement and research at the Joint Commission, a nonprofit agency that accredits and certifies hospitals and health care programs. Rather, it’s the combination of factors that make a convincing case for a hospital.

Comparing Hospitals 

In an effort to help consumers gauge one hospital’s performance against the national average or a local competitor, various nonprofit organizations and private companies and organizations have begun offering consumers a host of rating and comparison tools.

The Joint Commission, for example, tracks performance over dozens of types of care, including addiction, intensive care or podiatry, and allows users to compare six hospitals at once using its Internet database.

The Leapfrog Group, a consortium of corporations and public agencies that purchase health care for their employees, surveys more than 1,300 hospitals across the country on four quality and safety practices, including ICU staffing and computerized records. Consumers can search its online database to see how various hospitals performed on 10 different procedures like weight-loss surgery and high-risk delivery.

While Health Grades, a private company based in Golden, Colo., charges a fee to access performance data at individual hospitals, it tries to distill the many statistics into ratings that reflect safety and quality. In its annual study of mortality and complication rates, for example, the company collects administrative coding from millions of Medicare patient records for 26 common inpatient procedures and diagnoses, to determine which hospitals had the best outcomes. Its ratings are available for free.

Despite the amount of available data, there may be a disconnect between what a patient is looking for and the statistics, says Dr. David Lansky, CEO of the Pacific Business Group on Health, a coalition of health care purchasers. Much of the data is gleaned from the billing codes listed in administrative records instead of from clinical records, which shed more light on a patient’s experience and outcome. This is also the case with Medicare’s comparison tool, Hospital Compare.

A patient undergoing a knee operation, for example, won’t be able to find out when the average patient returned to work or for how long he or she stayed at the hospital.

In order to be a more discerning consumer, says Dr. Loeb of the Joint Commission, it’s important to find out how ratings data are collected and whether they are controlled for things like increased risk among certain populations or variations across age.

Looking Beyond Ratings 

But perhaps most important, says Lansky, is a conversation with your doctor. Trying to select the right hospital for a bypass or birth is much easier when you’ve been told what qualifies as optimal care. A physician or specialist will be able to outline what matters to most patients, whether that’s pain management or cutting-edge technology.

Dr. Rick May, a senior physician consultant for Health Grades, says consumers can also judge a hospital based on its environment. “Does the hospital look and smell clean?” he says. “Do the staff members seem to be friendly and relaxed?” Such impressions speak to pride in the facility and a healthy work environment, both of which may help lead to better patient experiences and health outcomes.

Finally, Lansky always insists on asking for internal data from hospitals and physicians. “There’s no reason to be embarrassed to say, ‘How many of these procedures did you do last year? What was the success rate?’ says Lansky. “I wouldn’t go to someone who isn’t willing to have that conversation with me.”

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3D Power have worked on many hospital rendering projects such as Hospital Design, 3D Hospital   Exterior Design, 3D Hospital Interior Rendering, 3D Hospital Rendering, Hospital Exterior Design, Medical Render.