How to create the hospital of the future based on lessons of the past

By Susan Morse for Healthcare Finance

What does the hospital of the future look like? That depends on how health system and hospital executives apply the knowledge learned during the COVID-19 crisis to their strategic plans moving forward, according to Michael J. Dowling, CEO and president of Northwell Health.

Dowling gave the HIMSS21 Digital Visionary Keynote: Leading for the Future, Tuesday, August 10, during the HIMSS21 Digital conference.

Over the past 15 months, everyone has emerged from an extraordinary experience, and no one was spared, Dowling said. The outcome for too many was disastrous and deadly.

“We were at war with an invisible enemy,” he said. “Over the past 15 months that we could not touch and could not feel. It tested us and it changed our normal way of living.”

The pandemic, which continues with the spread of the Delta and other variants, highlighted the ability of health systems to be agile and respond quickly during a crisis, when regulations are relaxed as they were when the pandemic began.

“We were able to do things we could never have done,” Dowling said. “We created beds where they didn’t exist before. We moved staff from place to place that we would not have been able to do before. As we look at reform going forward, to what extent should we be modifying our regulatory process and our compliance processes to allow the freedom to be flexible? It is very, very hard to be entrepreneurial in a culture of compliance and regulation.”

At the pandemic’s height in New York in April 2020, Northwell had 3,500 patients in the hospital on a daily basis.

From March 11 to June 1, 2020, 4,516 probable COVID-19–associated deaths were known to have occurred among New York City residents, according to the Centers for Disease Control and Prevention.

“We were at the epicenter,” Dowling said. “Looking back, we performed quite well.”

He said he personally witnessed the compassion, dedication and heroics of the staff.

Investments made 15 years ago in the central lab, transport system and supply chain infrastructure paid off as they proved to be successful and worthwhile during a time of crisis.

“COVID changed our relationship with technology forever,” Dowling said. “Our compact with technology is now very different. Digital health accelerated.”

Hospitals must now decide how to best use digital health and how to maximize technology, Dowling said. Other questions for executives about the hospital of the future, are, how do they define ambulatory and outpatient care?

Other issues arising from the pandemic are the care and treatment of physicians, nurses and other healthcare employees and how to resolve health equity.

The healthcare veteran said walking through the COVID-19 units at the hospitals caused him to think about things differently.

“I think it raises our obligation,” Dowling said. “In my view, this is a new beginning. To create a new health system for the future based on the experience of the last 15 months.”

Northwell is among the largest integrated health systems and private employers in New York State. Dowling has been there for 25 years. Prior to becoming CEO in 2002, he was the health system’s executive vice president and chief operating officer.

“Because of what we learned, we have opportunities to rethink what our organization should look like, to rethink our strategies, to rethink our own roles, to ask ourselves, are we going to be different now because of what we experienced? We have an opportunity here. The question is, are we ready and willing to take it.”