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Hospitals in the future 'without' walls

What does this mean for health care delivery systems in the future?

What will the hospital of the future look like? How will it operate? Health care leaders agree that hospitals of the future will be…More digital. More innovative. More efficient. More accessible. More integrated. More sustainable. More personalised. The hospital of the future will be a hospital without walls.

The global health care sector was already using new technologies and processes to extend care delivery outside the hospital setting when COVID-19 forced providers to transform operations overnight and dramatically adopt virtual visits and remote patient monitoring. This shift will augment physical and virtual care in a meaningful and integrated way that delivers a superior patient experience and better clinical outcomes. It will also impact the health workforce and reshape what, how, and where work is performed and by whom.

While the envisioned future still calls for brick-and-mortar hospitals, all but the highest acuity care and procedures will shift away from this setting and be delivered in the community; whether it’s stepped-up/-down clinics, retail locations, schools or community facilities, workplaces, or, most often, a patient’s home. This move will be enabled through interoperable/joined-up data, digital technologies, remote patient monitoring, value-based payments, scientific discoveries, and consumer demands.

A radical frame shift to the Future of Health

What we have experienced over the last couple of years is a collision of forces that has accelerated changes within the health industry toward a Future of Health that will be radically different from what we see today. These forces include:

  • A global pandemic of historic proportions
  • Collaboration among government, health care, and life sciences organisations that is generating exponential advances in medical science
  • An explosion of digital technologies, data access, and analytics
  • Informed and empowered consumers who are globally connected through social media
  • Movement away from fee-for-service, activity-based, disease care to value-based, population health models focusing on prevention and well-being.

We have identified six key clinical and operational areas that will be impacted by these forces, moving health care organisations toward the hospital of the future; the hospital without walls.

It’s time for health care to meet consumers where they are.

Consumers want more convenient health care; often delivered to them at home, in local pharmacies, in retail stores, or at their workplace. They also demand the utmost safety and security and a seamless engagement experience.

The pandemic’s social distancing measures have already forced many providers to employ virtual care technology for scheduled outpatient appointments. In addition, hospitals and health systems are turning to cloud computing, artificial intelligence (AI), 5/6G wireless technologies, and interoperable data and analytics to address current challenges and build digitally powered care delivery models. This transformation will ensure that the care delivered outside of the hospital is just as safe and reliable, if not more so, than that delivered in person.

Consumerism is driving health care digital technology use.

As health systems move to consumer-centered care and care without walls, providers and the wider health ecosystem will position virtual health care as an integral delivery channel—one that increases access and convenience while reducing the total cost of care. Digital transformation will require health systems to embed virtual health within the fabric of their delivery model. Forward-thinking organisations are assessing and investing in this infrastructure today to align and enhance capabilities across the organisation to create the hospital of the future.

While many health system executives would say that they have been able to overcome consumers’ and physicians’ reluctance to adopt virtual health, interoperability, platform integration, and data vulnerabilities continue to be a challenge. Solving for this will require thinking about virtual care and the hospital of the future as an essential part of the core business, alongside inpatient care, and not merely a discretionary add-on.

Sensors and devices connect hospitals and homes, providers, and patients.

Capabilities that support remote or non-brick-and-mortar care are exploding on to the health care market. Medical devices with sensors and AI monitor and collect clinically relevant data to help millions detect and manage chronic health conditions and avoid serious illness. In the future, health systems will map digital care capabilities to individual patients based on population health segmentation—from healthy and wellness care patients to high-risk, acute patients—as well as the individual’s clinical, determinants of health (DoH) factors, and care needs.

Clinicians are also leveraging virtual reality/augmented reality (VR/AR), customer relationship management systems (CRM) and data analytics to provide a 360-degree view of patients with personalised, omni-channel engagement. These technologies and others provide the capabilities and flexibility health systems need to deliver the right care at the right place at the right time. However, they also produce extraordinary amounts of new data, pushing many organisations to accelerate long-planned digital transformations. The majority of health system executives are now turning to cloud computing to act as a catalyst for these changes and to strengthen data security and cyber controls, which will be imperative in delivering the hospital of the future.

Environmental, social, and governance (ESG) will help drive health equity and increase interest in planetary health.

Health care is on the front lines of addressing health equity and ESG. Structural flaws in the health system, systemic and unintentional bias, and inequities in the drivers of health (DOH) have contributed to health inequities in communities across the globe and over centuries in complex and systemic ways. While health care alone cannot solve for poor outcomes resulting from social determinants of health, we do know that insufficient and outdated health system infrastructure remains, for many, a major hurdle to achieving optimal health status. As the transformation of health care occurs, we must carefully consider the role that the hospital—the most-costly site of care—can and should play.

ESG considerations to reduce health care’s carbon footprint and to mitigate and adapt to climate change will be as important in the design, build and operate model of the future hospital as the current quadruple aims of cost, quality, access, and patient centricity. The increased frequency, intensity, and variability of natural disasters and their downstream effects—including the patterns and prevalence of disease—are already challenging health care systems’ infrastructure, supply chain, and workforce. Advancing health equity and ESG presents a global opportunity to remake the foundations of health care and introduce new operational models—including virtual care and hospitals without walls—providing greater flexibility, agility, resilience, and sustainability.

Changing conditions are changing roles.

COVID-19 has become the catalyst to a future of work and talent in health care that might otherwise have taken years to attain. After nearly two years of lockdowns, quarantines, and remote work, many people are reevaluating their professional lives. The resulting “great resignation” is making it challenging for virtually every industry to attract, motivate, and retain high-quality employees; perhaps more so for hospitals and health systems where clinicians and staff are stressed, overworked, and burned out.

Hospital leaders are trying to retain talent while also navigating changing workplace dynamics and workforce roles. Introducing digitally enabled agile ways of working, such as using remote clinical and nonclinical staff, to address capacity and demand challenges is becoming increasingly commonplace.

The skills and talent required by the health care system is also changing. Increasingly, skills such as coding, behavioral science, and data management, analysis, and visualisation are needed. Health system and hospital executives are having to rethink their job specifications, where they attract talent from, and understand the competitive environment for that talent. This, in turn, is driving new models of organisation and structuring of work as providers experiment with contingent workforces, associate models, partner ecosystems, and the sharing of scarce human skills and capabilities.

New technologies, business models can help regulators keep pace with health care innovation.

Against the backdrop of a rapidly changing health industry regulators are looking to utilise emerging technologies and new business models to reduce the burden of compliance and drive better efficiencies and regulatory outcomes.

Health regulators are being driven to become increasingly agile, innovative, supportive, customer-centric, and digitally savvy. Increasingly, they are incorporating emerging technologies into their new toolkit. Globally, we have seen the use of robotics and AI-driven smart cameras, the combining of data and behavioral science to “nudge” compliance, and the use of augmented reality in training and technological advances in virtual inspections. We have also seen a shift to innovative business models that focus on human-centered service design, organization culture, and future skillsets needed to regulate in an era of shifting expectations from citizens and authorizing environments.

If not now, then when? A call to action

The transition to hospitals without walls is happening. It is no longer a choice but a future reality. Virtual health is augmenting and extending care delivery outside traditional hospital buildings—clinicians and patients are demanding it; funders and regulators are supporting it. This transition is absolutely integral to creating a more sustainable and equitable public and private health system in the future. However, it doesn’t mean we’re no longer going to have the physical buildings we know as “hospitals.” Rather, the role of these will change as more and more care delivery will take place in the home, at work, and in our communities.

To support health system executives on their journey, Deloitte has built an easy-to-use assessment tool that measures your current progress against the six dimensions outlined in this paper that we believe are essential to delivering the hospital of the future. Importantly, this assessment tool provides comparative data from similar hospitals/networks and the ability to join a global community of practice—to share, learn, and collaborate with like-minded leaders who are all facing the same challenges and opportunities. If you would like to learn more, please contact Deloitte Global’s Health Care Chief of Staff, Michael Hood, at for further information.

About Deloitte’s Global Life Sciences & Health Care Industry Group


Life sciences and health care is transforming and moving at an unprecedented rate of change. From strategy to delivery, Deloitte’s life sciences and health care industry group combines cutting-edge, creative solutions with trusted business and technology acumen to help navigate, define and deliver tomorrow’s digital business, today. Our capabilities, together with industry insights and experience across the health care ecosystem, can help guide organisations to stay ahead of health care transformation and prepare for the Future of HealthTM.

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