CREJ - Healthcare Properties - October 2017
Even after the two most recent failed attempts in the Senate to repeal the Affordable Care Act, the health care industry is still left in a state of uncertainty wondering what will come under scrutiny next. This state of influx has a trickle-down effect on health care design and building practices where hospital systems are shifting from large medical campuses to smaller outpatient facilities such as medical office buildings. While MOBs certainly are not a new building type, they are becoming a staple in the architecture, engineering and construction health care industry subject to several design trends. MOBs first took shape as a solution for large hospital systems seeking to move nonacute medical services to off-campus facilities, and typically included standard doctors’ and dentists’ offices, urgent care clinics and diagnostic laboratories. In the last five years, designers have noted several trends in the MOB marketplace that include a greater diversity of MOB tenants, designs influenced by emerging medical practices, and health care emulating design features in other industry sectors. Diversity of MOB Tenants MOBs are not just for general practitioners and dentists anymore, as specialized provider-specific offices are becoming more commonplace. One such type of MOB on the rise lately includes brain-care facilities. These facility-types can be likened to an “adult day-care center,” where health care providers are furnishing a place for the aging baby boomers to interact and socialize, all while receiving proper medical care. According to the U.S. Census Bureau’s latest report in June, the nation’s older population is still growing with 49.2 million people aged 65 and over in 2016, as compared to only 35 million aged 65 and over in 2000. These aging baby boomers will continue to influence health care design to provide a variety of needs beyond those offered at a standard hospital facility. Another increasing MOB tenant-type is that of skincare specialists or estheticians. According to the Bureau of Labor Statistics, esthetician employment is projected to grow 12 percent from 2014 to 2024. BLS indicates that this percentage growth is faster than average for all other occupations. The maturing baby boomers also are seemingly contributing to this increase in MOB tenant type as this growing population segment seeks to reduce the effects of aging. Specialized MOB designs for estheticians call for a more “beau monde” style where the offices reflect a modern salon as opposed to a sterile medical office. Medical Care Practices As a subset of the health care construction market, MOB designs are influenced by emerging health care practices. As physicians start to embrace more technological advancements in their daily routines, MOBs are beginning to reflect these changes in their overall design and construction. For example, with the advent of all-electronic recordkeeping, the need for large file rooms for medical record storage become obsolete. This once necessary storage space can now provide more square footage for a roomier lobby/check-in area or the ability to have more flex space to add or subtract medical care rooms. In addition, with greater efficiencies in scheduling of medical appointments online with texting services, and online doctor visits where patients can Skype with doctors for certain nonemergency circumstances, less staff is needed on-site. This trend leads to smaller units for MOBs, where building owners can allow for a greater tenant diversity. Another health care practice influencing MOB design lies in the competitive arena of pharmaceutical drugs and the rising popularity of patient online ordering for prescriptions. Places like King Soopers and Walgreens are becoming more cost competitive in their supply of drugs, and online services where patients order 90-day supplies of their prescriptions are eliminating the need for doctors to store drugs on-site. With doctors downsizing or removing their supply of prescriptions all together, MOBs do not require as much storage space, and the need for retail space to sell prescriptions is eradicated. Incorporation of Outside Industry Designs In an increasingly competitive health care market, providers are incorporating best practices and building designs from industries outside health care to improve the patient experience. One emerging trend includes the influence of the hospitality industry on health care designs like MOBs. According to the International Journal of Hospitality Management in a study called “Hospitality healthscapes: A conjoint analysis approach to understanding patient responses to hotel-like hospital rooms,” high-end material finishes and hospitality certified health care staff were the two greatest influences on patient choice for places to receive medical care. The study also found that patients that need more extended care are willing to pay, on average, 13 percent higher out-of-pocket expenses for hotel-like hospital rooms. The hospitality industry also has influenced the design of the lobby or waiting room in MOBs. Designers are now moving away from the typical harsh/sterile designs to a more “warm and cozy” atmosphere with waiting rooms reflecting lounge areas typically found in hotels. Large couches, fireplaces, oak flooring and softer lighting are finding their way into the lobbies of MOBs to reflect a more nonmedical design. One example of this can be seen in the Colorado Springs Health Partners’ facility designed by RMG, where the MOB design contained a central check-in station with comfortable seating, soft lighting and more open space so that patients are not crowded into one small waiting room. Although the health care industry is tied to the uncertain political climate, the demographics of baby boomers, technology advancements and a greater focus on patient preferences will continue to influence the design and construction of the growing MOB market.