How Telehealth, Telemedicine and Telecare are Relative to Healthcare Design

During the height of the pandemic, everyone was surrounded by terms like ‘Telehealth’, ‘Telemedicine’ and ‘Telecare’,  but are these truly new concepts in healthcare design? The short answer is no. The truth is that each of these terms refers to a different way of administering health care via technologies or a different area of medical technology and yes, it affects the overall design of healthcare facilities.

Believe it or not, since the 1950s, healthcare providers have been offering and providing remote clinical services to their patients. Some of those first offerings were through the use of telemedicine, which began via landline telephones. Telemedicine refers to remote, non-clinical consultations that were developed as means for doctors to relay information to colleagues or their patients quickly. Telemedicine refers to specifically the education or information over a distance and the provision of health care services through telecommunication tools. Telehealth is a broader scope of health care services provided through various technologies at-a-distance, but not clinical services. These technologies enable remote diagnoses and evaluation of patients in addition to the ability to remotely detect fluctuations in the medical condition of the patient at home. Telecare is the term related to technology that enables patients to maintain their independence and safety while remaining in their homes. This technology includes mobile monitoring devices, medical alert systems, and telecommunication tools like computers and cellphone/telephones.

Still confused? It’s ok, so were we. Here’s another example to help explain this better. Telemedicine is being able to email your doctor about pain in your knee after exercise. Telehealth is your doctor requesting your Fitbit data, a remote monitoring system, from the last week to see if there is any other physical activity that may have caused your knee pain. I mean you did hike, bike, and run a triathlon last week! Telemedicine is when you virtually see your doctor to better understand what may be going on with your knee and he ended up finding you have had an irregular heartbeat during exercise because of that data. Telecare is the phone and computer you are using to communicate with your doctor about your ailments and set your next appointments.

Ok, let’s talk tech. With the rapid advancement of technology over the last decade, the medical service offerings and opportunities of telehealth have expanded significantly; including but not limited to online portals through your medical provider and/or personal doctor, video software for remote consultations, and numerous apps managed by companies offering telemedicine/health services. As mentioned above, telehealth also includes the wearable technology we all love and use to track our fitness and overall health. This industry, in general, has boomed over the past 2 years! Take a pause and think about how many devices you are connected to and how they help you track your health. Fitness trackers are all the rage. Garmin, Fitbit, Apple Watch, and even the newest in health monitoring – a ring that you wear on your finger. Several of these devices are tied to doctors and emergency contacts which can prove to be lifesaving for the end-user. Companies take their employee’s health very seriously and have begun to reduce healthcare premiums for those that actively engage in reaching certain health benchmarks for specifically defined periods (think daily step count and active days per week). Shoot, we now have access to devices like a Peloton and SmartMirrors that bring the gym to the comfort of our own homes.  The concept of integrating “wearables” into telehealth is just one part of the recent evolution of an ever-evolving digital healthcare landscape.

So now back to how this relates to interior design. The big question is how will the future of telehealth affect design strategies for ambulatory (outpatient) and acute care (inpatient) environments. Healthcare facilities have had to think on their feet about how to provide services to their patients without having to travel and adhere to infection control protocols thanks to Covid-19. Based upon a study from Hord Coplan Macht, telehealth will likely have a long-term effect on the design of outpatient facilities either by increasing the capacity of the existing footprint or changing the types of spaces. The trend of creating open, collaborative spaces continues but the effect of the pandemic is shaping how we design the space with social distancing and increased technology in mind. Exam rooms, for example, may be outfitted with better connectivity and digital technology for providers to discuss patient care with other specialties when they aren’t located in the same building or campus. Dedicated telehealth rooms have been part of space planning for many healthcare facilities post-2020 while flexibility and adaptability are the key drivers in transforming existing spaces, and new environments. Another key consideration is the outpatient environment in the waiting room. The healthcare trend of expedited patient rooming will continue but the overall waiting room size has fluctuated. The instinct mid-pandemic was to decrease! Smaller, more separated groups and reduced overall seating improved infection control but it isn’t a sustainable approach. Some doctors have opted for dedicated telehealth days where they see sick visits or follow-up visits with patients to reduce waiting room log jam while others simply ask you to wait in your car until they call you up. A simple, cost-effective change! Healthcare designers create environments with an increased sense of comfort, security and confidentiality post-2020. Acoustics are imperative to reduce noise from outside the telehealth office(s). Another important piece is lighting and background or setting. Patients need to see the mannerisms and facial expressions of the physician with quality lighting and the setting of the space should be designed to be calming in muted tones not to distract the patient. New furniture designs and configuration is another way to keep the current waiting room size. Physical dividers/barriers and seating with full height divided arms support spatial distancing and reduce/increase seating as needed. Connected-style seating gives way to more clustered arrangements of single seats that can be positioned away from each other to accommodate varying sizes of groups…the flexibility and adaptability piece mentioned above! Designers also look at circulation patterns and physical separation walls to control how people get up and move around the space. Lastly are the short-term changes made in waiting rooms, exam rooms, and other high trafficked areas of healthcare. They are hygiene stations, touchless hardware and durable materials used that will hold up to the more rigorous and frequent cleaning in the designs.

Telemedicine, telehealth, and telecare are super convenient but are not to be accustomed to being “the normal” and deter us from in-person, regular checkups with our healthcare professionals. They aren’t appropriate for emergencies like heart attack, stroke, lacerations, or broken bones that require X-rays, splints, or casts. Rather it is best suited for simple issues, consultation, and follow-ups with our doctors when we cannot find an appointment or travel to the doctor’s office, especially for those that reside in more rural areas. The rise in these services has grown tremendously and will not be “a thing of the past” in our lifetimes. We as designers will evolve and change along with the healthcare trends which started because of events like the pandemic and continue to put the end-users first when transforming spaces for our clients.

Written by Amanda Medlen