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So the healthcare architectonics industry is alive on medical appointment designs that facilitate medical home goals. Clinics and medical appointment barrio are actuality advised with added appointment areas breadth multidisciplinary affliction teams can allotment account or accommodated with patients’ families. Alone offices and bankrupt doors are actuality replaced by accessible assignment areas that advance collaboration. And application Lean ability concepts, architects and designers are alive carefully with providers to actualize added seamless, patient-centered workflows that advance affection of affliction and abate costs.

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Integrated activity commitment assets accepting as it shows results

Providers alert as architectonics firms see added outpatient advance potential

But experts adumbrate that added of these patient-centered medical accessories anon will be amid in retail mall-type settings rather than in medical appointment barrio in or a hospital campuses.

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The aftereffect of the medical home movement on architectonics volumes is not yet clear, however. The 151 companies that alternate in Modern Healthcare’s 35th anniversary Architectonics & Architectonics Analysis appear that 2013 was a active year on the medical appointment architectonics front. But the numbers of MOBs built, broadcast and adapted were not all that altered from the numbers generated in 2012.

Survey participants appear commutual 104 new MOBs, accretion 28 and renovating 218 in 2013. By comparison, the 169 companies that alternate in aftermost year’s analysis appear commutual 110 new MOBs, accretion 25 and renovating 313 in 2012. For 2013, this year’s participants appear starting architectonics on 63 new MOBs, 18 expansions and 92 renovations. That compares with 98, 18 and 92, respectively, in 2012. Also, 92 new MOBs were advised in 2013, as were 35 expansions and 167 renovations. In 2012, the numbers were 121, 21 and 158, respectively.

“We see things this year actuality appealing akin with 2013,” said Deeni Taylor, controlling carnality admiral of Indianapolis-based MOB developer Duke Realty Corp.

Taylor sees two big architectonics and architectonics changes consistent from the advance of the medical home concept. Added affair amplitude is actuality added, as able-bodied as added base and abstracts to facilitate Internet, Wi-Fi and cellphone use.

He added that appointment apartment are now included in the amplitude that multispecialty groups admeasure for their primary affliction doctors.

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The trend is to get primary-care doctors and their medical home practices abroad from hospital campus-based MOBs and afterpiece to their patients, said Scot Latimer, managing administrator at Jones Lang LaSalle’s Healthcare Solutions Group in Evergreen, Colo. Integrated systems seek to actualize cast adherence amid associates by accouterment acceptable admission and abbreviate biking times, he said.

He sees primary affliction affective into retail storefronts. “I anticipate we’re activity to see abundant beneath (MOB) development,” Latimer said. “The development will be off campus and attending and feel actual different.”

Andrew Quirk, chief carnality admiral for Skanska USA Architectonics in Nashville, agreed. “Physical breadth is actuality angry upside down,” he said. “The abstraction of a medical home is absolutely breadth healthcare is headed.”

Patients additionally appetite one-stop shopping, Quirk said. A ancestor is Vanderbilt Health’s One Hundred Oaks medical capital in Nashville. The outpatient ability is housed in a repurposed arcade centermost that now appearance 22 specialty clinics. “It’s ablaze marketing,” he said. “You can see it from the highway.”

After signing a abiding charter in 2007, Vanderbilt began affective in clinics, starting with women’s health, again dermatology. “Primary affliction was about backward in the clearing process,” said Dr. Rob Hood, medical administrator for One Hundred Oaks. “This is not absolutely the aforementioned as a medical home.”

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Multidisciplinary collaboration—another arch aspect of medical homes—was a cornerstone of the One Hundred Oaks project, both in the architectonics and architectonics action and in the final product. Early on, Hood said, approved affairs brought calm physicians and administrators from anniversary analytic section. Complaints were aired, suggestions were offered and announcements were made.

The ability has affluence of affair spaces, including several 10-seat appointment apartment that can be acclimated by association groups and a appointment allowance that can be configured to bench 85 bodies for above presentations. The apartment are able for teleconferencing with the capital Vanderbilt campus.

But added providers are activity for a purer anatomy of the medical home model, said Dr. Andy Ellner, co-director of the Harvard Medical School Centermost for Primary Care. Many new medical home offices accommodate quiet areas for clandestine buzz calls and “touchdown spaces” which serve as a hub for the multidisciplinary affliction aggregation to accept abbreviate consultations with anniversary other.

At the Centermost for Primary Care, Ellner works with physicians, association and medical acceptance to advance addition at 19 physician practices that see some 275,000 patients. He said a key barrier to medical home transformation is a abhorrence to accord up alone appointment spaces. Still, account about what constitutes the ideal concrete amplitude for the medical home archetypal are evolving. “We are not at the point of standardizing—we accept 19 practices and every one is different,” Ellner said.

One of the 19 offices is the Dimock Centermost in Boston, breadth Dr. Julie Tishler practices centralized medicine. Tishler said assignment at the Dimock Centermost is organized so the multidisciplinary aggregation comes to the accommodating rather than accepting the accommodating biking from allowance to allowance to see anniversary blazon of professional.

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How we did it A absolute of 151 respondents alternate in Modern Healthcare’s 35th anniversary Architectonics & Architectonics Survey.

This year’s absolute includes 77 architectonics firms, 32 accepted application firms, 25 architectonics administration firms, 11 development firms and six design-build firms that were acceptable to be ranked.

Announcements and reminders for accord were beatific via e-mail and fabricated accessible online at modernhealthcare.com from Dec. 3, 2013, through Jan. 24.

A lot of absorption was accustomed to issues such as assay allowance layouts that advice clinicians advance eye acquaintance with patients.

Architect Ken Duncan, in the Tulsa appointment of the Dewberry architectural, engineering and consulting firm, said baby elements that actualize decay in a medical appointment can add up to a lot of time and money. Duncan advocates application Lean methods to architectonics patient-centered affliction accessories that annihilate careless and inefficient processes.

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Efficient ability architectonics can accumulate affliction delivery. Duncan acclimated Lean methods—both in the architectonics action itself and in the final plan—to actualize physician offices for St. Louis Park, Minn.-based Park Nicollet Bloom Services.

That action led to architectonics a simple concrete blueprint that allows patients to acquisition their own way to their assay allowance after accepting a medical abettor or assistant escort them. While accompanying patients to a allowance may alone booty two minutes, if assorted by 25 patients per doctor and eight doctors, that can eat up a full-time staffer’s absolute assignment day.

Charting the patient’s experience, from the patient’s point of view, is a acceptable way to assignment on the design, Duncan said.

Follow Andis Robeznieks on Twitter: @MHARobeznieks

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