The future of healthcare? Hospitals without walls, says architect Sandra Woodall. Consultations in the metaverse and cyber clinics — healthcare is about to go green.
Travel Pants is a time-travelling patient. Or he’s a patient with time-travelling pants, he pulls them on and whoosh — who doesn’t enjoy a good nonsense hypothetical?
So, one morning, Travel Pants waits his turn in a congested hospital lobby. A routine check — diabetes, no more, but the clock shows they’re running behind. It’s fish-market busy, the man in the seat next to him has a cough to rival thunder, he might just hack up a lung, and wailing howling infants, and rushing whitecoats, cold faces behind masks.
Mr Pants? Mr Pants? Come, sir, your vitals, and Travel Pants follows the nurse through a door. She straps a pressure cuff on him. In the next room, someone lets out a scream.
His pressure reading — unsurprisingly — is through the roof. Hypertensive? the nurse inquires. Travel Pants shakes his head and walks right out — and slips into his time-travelling pants.
Diabetes — chronic, so you do need routine consultations, but must you get all the way to a hospital each time? A few years down the same timeline, Travel Pants sits before a monitor in the comfort of his own home. His doctor comes on, checks his stats — these, routinely recorded and sent through via home monitoring devices — and recommends perhaps some minor adjustment to Pants’ insulin dose, and that’s that.
Paradox of healthcare buildings
If the healthcare industry were to be seen as a single nation, in terms of greenhouse gas emissions, it would be the fifth-worst performing country in the world — no, seriously, healthcare’s carbon footprint is a staggering 4.4 per cent of the world’s total emissions.
Incidentally, that’s equal to some 514 coal-fired power plants — and coal, widely seen as the single-largest cause of climate change.
Break it down, and a healthcare building puts out two-and-a-half times the greenhouse gas emissions of any similarly-sized commercial building — makes sense, they can never really power down. Now around 5 per cent of those emissions is nitrous oxide — yes, laughing gas. Sadly, laughing gas is nearly 270 times more harmful to the environment than carbon dioxide, says a UN assessment launched at COP29, that calls for urgent cuts.
So, the very buildings that are meant to heal us are also contributing to making us sick, says expert architect and environmentalist Sandra Woodall.
Hospital without walls
Of course, the greenest answer is to not build at all, because anything you build will impact the environment — but where would that leave us?
Woodall also serves as design principal at tangram group’s MENA region studio. A few years ago, she and her team were approached to design over a hundred new hospitals, as well as retrofit a few hundred existing ones, by developing a prototype ‘Hospital of the Future’ solution.
‘Sustainability, that’s the absolute first thing we looked at. Because of the scale of the programme, we knew that anything we designed, because of repetition, would have an enormous impact on the environment. Especially if we were to keep to the typology that has always been followed when building healthcare facilities.’
See, hospital buildings are not just monster greenhouse gas emitters, they’re also notoriously expensive to build. You have to design them in line with the hypervigilant specifications of infection control protocols. For instance, if any two pieces of material are to fit together, gaps between them could become a bacterial breeding ground.
So, you must keep to these protocols, says Woodall. But we realised we could instead reduce the size of the buildings themselves.
‘We saw COVID take so many healthcare services online. Patients, providers, we all jumped onboard. So, we looked into how we could expand on this model, how we could digitise healthcare ever further. Certainly, there are services that don’t need to be provided in such high-spec, high-tech facilities, in such acute, resource-intensive settings.’
Travel Pants, for instance, need not go all the way down to a hospital for his routine diabetes checks — he could just meet with his doctor in the metaverse.
Boosting accessibility
It’s patient-centric healthcare, yes, but the benefits go well beyond just patients. ‘Healthcare practitioners can consult with each other online, you can hold teaching and training sessions in the metaverse, research and development can leverage digital twins,’ adds Woodall.
For those not quite familiar with the term, digital twins are exactly what they sound like — digital replicas of actual products or systems or people. You can run simulations on these digital twins, test, analyse and improve design, all at a much faster, AI-enhanced rate.
But, of course, there are barriers to widespread adoption — if you want to meet your doctor in the metaverse, you need connectivity, and that’s not always a guarantee, not with blackouts in many parts of the world, and some parts too remote. In answer, Woodall and her team have designed cyber clinics to boost accessibility.
‘Cyber clinics are cheaper to build. They don’t have to be manned by clinicians. And they can be fitted with back-up generators, so they provide continuous service. They can be built where they’re most needed and they can connect you to far-off specialists. This is the true democratisation of healthcare. And in time, these cyber clinics can have small laboratories and pharmacies attached to them, to become more of a one-stop.’
Future-ready
Outside of better facilitating online consultations, Woodall and her team are also looking into building robotic surgery centres, led by remotely situated surgeons. She mentions haptics — now this is an interesting one. Say you’re out shopping in the metaverse, but you’d like to touch and feel the material of your purchase before buying it. Haptic technology can recreate the experience of touch by applying forces, vibrations or motions to your fingertips.
Impressive. But think of the uses in a healthcare context. ‘Simulations for surgeons, for training and advancing skills — the possibilities run on. But it’s critical we start building for this now, so that when these technologies do become widely available, we can just add them on, slot them in, and not be forced into a complete overhaul.’
Woodall regularly discusses this model for the ‘Hospital of the Future’ across the Gulf, Africa and more recently in the UK — the concept is gaining traction. And as more healthcare services are transferred to the metaverse, the more cuts are seen to the environmental impact of the industry.
‘Even the smallest reduction in the size of these buildings multiplies and significantly reduces the environmental impact of the industry,’ concludes Woodall.
And since we are already exceeding the consumption boundaries of a healthy planet, this evolution of healthcare could prove yet another crucial step in fighting climate change — so Travel Pants at least has a future to zip off to.
Davina Raisinghani | Nov 26, 2024
