Hospitals of the future: Robots and super technology

The hospital of the future, "a medical dream come true": That was how a reporter described the California Kaiser Permanente Hospital when it opened in 1953.

It was fitted with a pneumatic tube system to post patient documents to doctors, "baby drawers" to send babies from the nurses' area to the mother's room, and waiting rooms for stressed fathers outside maternity units which were kitted out with extra large ashtrays.

At the time it was considered revolutionary, and drew interest from around the world.

But within a decade, a lot of the technology was already outdated.

That is the challenge facing Christchurch as close to $1 billion is set to be spent rebuilding and redeveloping our hospitals.

Do it right, and we have an opportunity to lead the world and take advantage of amazing technology being developed.

Do it wrong, and we could spend millions on things that will quickly be outdated and a burden to maintain.

It was almost impossible to estimate what the hospitals of the future could look like, Canterbury University School of Health Sciences professor Ray Kirk said.

Development of different treatments, as well as the ageing population, could mean the conditions people needed medical care for were very different in the future.

He was excited about the potential to develop things like robot-assisted surgery, with da Vinci surgical robots already in use in Christchurch.

Even simple things like paperwork could change, he said.

"Christchurch has accelerated progress in the digital health revolution, because after the earthquakes, paper records in some buildings were too dangerous to access or got wet. So Canterbury needed to go down that pathway perhaps more quickly than they might have otherwise," he said.

Technology could also move people away from the hospital, allowing people both to diagnose more health problems at home, and spend less time having to be monitored in hospital after treatment, he said.

Teams from across the world are currently competing to create a hand-held, non-invasive device which can diagnose anything from whooping cough to HIV, after $10 million in prize money was offered by the X Prize Foundation for the best design.

Combined with video conferencing technology many hospitals are already using, that could mean people could have tests run, diagnose the problem and consult a doctor about it without leaving their home.

"People usually prefer not to be in hospital, they prefer to be with their families. And that's also good for rural New Zealanders," he said.

So how do we plan for these changes in our hospitals?

Although a major part of the CDHB Design Lab's purpose is looking ahead, there is only so much stargazing they will do.

Business development manager Richard Hamilton openly admits he has no idea what the hospitals of the future will look like.

But the one thing that will not change, no matter how much technology does, is people.

You could be forgiven for assuming all hospitals were designed for patients, but traditionally that was not the case, he said.

Take the design of a ward.

If you left hospital design up to architects, the space was likely to flow beautifully but simple issues, like nurses not being able to see a bed from the corridor, could cause huge problems.

Leave it up to nurses, and patients would be grouped together in wards, which made it easy to treat them but meant they sacrificed patient privacy and their own space.

Even consulting patient's families wasn't the answer - many hospitals had switched to single bedroom models as it was what families wanted, forgetting that outside visiting hours the patient could be left feeling lonely and isolated.

To find a solution, the Design Lab team went right back to basics, Mr Hamilton said - they built a "playpen".

Using foam, cardboard and PVC pipes, they built life-sized scale models of the new wards they imagined in a 3000 sq m warehouse in Middleton, then brought in literally thousands of staff members and former patients to test and discuss them.

"We had a design challenge: How do you reinvent the Florence Nightingale-style barracks environment," he said.

And when everything was tightly constrained by budgets, being open with your ideas wasn't easy, CDHB director of nursing Heather Gray said.

"Should you go for what you want and risk people's disappointment?"

The design for wards they have come up with includes four beds - five would be too many to keep the nurses' line of sight across

all of them. Each room is set up at an angle, so the patient can have privacy if they lie back in bed, or talk with their neighbour if they sit up. Glass doors and curtains can be shut for extra privacy, and every bed faces a large window.

The large headboard they have designed, which they are currently in the process of patenting, incorporates two touch screens and has space to hide all kinds of medical equipment, with modular parts that can be swapped out if technology develops. The large hood over it is sound-deadening.

And even the walls are built to adapt. The ceilings in the wards have been designed high enough that it could be adapted as an operating theatre in the future, space left in the floors to run cables, and the positioning of columns carefully thought out.

Ministry of Health critical projects delivery director Michael Hundleby said the buildings were designed to last up to 50 years.

Even in the years between designing the new buildings and being able to open them, he believed some of the technology used would become outdated.

But that was not necessarily a bad thing, he said.

"It is very difficult to predict where technology will go in that time, so what we have focused on is building hospitals more modular and generic, so a surgical ward can become a medical ward," he said.