Competing priorities are everywhere in healthcare. Hospital Boards and senior managers must regularly make difficult governance decisions taking into account factors such as clinical need, budgetary constraints and performance targets. 

Debates about infrastructure versus IT investment can easily begin to resemble long-standing arguments over The Beatles versus the Rolling Stones, Apple versus Android or BMW versus Mercedes. The difference is that, when it comes to hospital decision-making, lives can hang in the balance. 

So, which is the right way forward? And do you really have to choose? 

IT’s impact on patient care and operational efficiency

A fit-for-purpose IT system can certainly help a hospital to improve patient care. 

Powerful analytics programs can integrate financial, clinical and operational data, uncovering valuable insights that enable hospitals to improve patient outcomes and predict staffing needs. 

A digital hospital with all its patient records, clinical results and prescribing information kept in the cloud gives clinicians real-time access to a wealth of data to inform their decisions. Such a system can also show where beds are available, enabling suitable patients to be moved out of the emergency department and onto a relevant ward more quickly. 

On the downside, hospitals must allow time and funding for staff training and remain vigilant to mitigate the very real cybersecurity risks. That’s such a serious responsibility that it rightly rests with the Board, not the IT department. 

Changing expectations of infrastructure

Health infrastructure is immensely important. It must meet a raft of standards, be hygienic, and create a positive environment for staff and patients. 

Professor Linda Luxon of the UK’s Royal College of Physicians writes,

Importantly, neither patients nor services should be constrained by the physical environment, but the environment should be configured to be fit-for-purpose, with a high degree of cleanliness, and should be sufficiently flexible to serve all patients…

Existing buildings may require reconfiguration to promote seamless and efficient healthcare, with specific services in specific sites.

So often, though, hospitals are indeed constrained by the physical environment. It’s not fit-for-purpose anymore. It limits capacity, frustrates staff and creates bottlenecks in the care pathway. 

The pandemic has created different infrastructure expectations, such as the need for negative pressure isolation rooms, segregating COVID-19-positive patients from others, improving ventilation and increasing capacity to tackle a lengthy backlog of elective surgery cases. 

Then there are demographic changes arising from the pandemic. The Regional Movers Index, powered by Commonwealth Bank data, shows that migration from capital cities to regional Australia increased by 16.6 per cent to reach a new high in the March quarter of 2022. 

Things changed a little in the June quarter. People once more began moving from the regions to the capital cities but net migration to the regions still outstrips pre-COVID-19 levels. And the June and December quarters do tend to have reduced flows from cities.

As the June report notes, 

The latest level of net migration to regions is 30.2 per cent higher than what prevailed in the two years prior to the pandemic. The sheer level of net migration during the lockdown period of COVID-19 is likely to have represented a step change in the overall size of many regional communities. The latest reduction in net inflows will hopefully be giving many communities some breathing space to adjust.

It will be interesting to see what happens next. COVID-19 may no longer be pushing people out of capital cities but 5 consecutive interest rate rises may make the thought of a smaller mortgage in a regional (rather than a capital) city very attractive. Major coastal cities near east coast capitals seem to be the main destinations for those leaving the capitals. Popular spots include the Gold Coast, Sunshine Coast, Geelong and Wollongong. 

The movers are in their early to mid-thirties. That means regional hospitals will need the infrastructure and staffing to increase services for women’s health needs (including maternity care), chronic disease services and cancer screening – colorectal cancer, for example, is already affecting many younger people who are struggling to access colonoscopies

Climate change is also having an impact on hospital infrastructure. As The Conversation reports, Australia has 75 hospitals and health services within 200m of the sea, placing them at risk of coastal inundation and flooding by the end of the century. Many other Australian hospitals are built on cheap land near rivers.

As the authors comment, 

Hospitals have already been left without power for days due to flooding, while others have been forced to evacuate patients. Only last year, floods up and down the east coast cut roads and forced authorities to find alternatives to hospitals for people unable to get through.

Other trends affecting future infrastructure requirements include continuing advances in medical research, technology and digital innovation, sustainability initiatives and a shift towards more personalised care. 

However, infrastructure improvements aren’t undertaken lightly. They take years to complete and they’re costly, disruptive and time-consuming.

Or are they? 

Mobile and modular infrastructure

Writing about the pandemic’s impact on healthcare systems, Deloitte notes,

In the near term, healthcare systems will face two major, additional, “collateral” issues. The first will be the physical and mental exhaustion of the healthcare workforce, along with worn-out hospital infrastructure. The second will be the growing “backlog” of healthcare procedures. 

Staff burnout is a huge issue that’s not easily fixed. But you can do something about worn-out hospital infrastructure and a backlog of healthcare procedures. 

Mobile and modular facilities are a cost-effective and relatively quick way to create flexible, fit-for-purpose infrastructure in both metro and regional hospitals, enabling you to reduce waiting lists for elective procedures and meet performance targets. 

These facilities can be brought onto hospital sites to provide a temporary boost in capacity for anything from diagnostic capability or bed numbers to operating theatre space. They require utilities connection for power, water and drainage but other systems are integral, reducing the need for complex development works. 

Flexible infrastructure 

  • Offers a high-quality clinical environment that is operational only for the time it is needed
  • Integrates with the hospital’s existing pathways to streamline patient flow 
  • Creates capacity to manage demand 
  • Maintains a key revenue stream
  • Increases your responsiveness and efficiency
  • Enables you to meet key performance indicators in activity volumes and revenue flow that could only otherwise be met through substantial investment programs.

So what about IT investment? Mobile and modular facilities are much cheaper than a major build, meaning you may not necessarily have to choose between physical and digital infrastructure needs. In any case, it is often wise to take an incremental approach to IT improvements

The right infrastructure for healthcare delivery is more important than ever as COVID-19 casts its long shadow over healthcare systems. If you would like to learn more about how mobile and modular facilities could help your hospital create fit-for-purpose infrastructure, please contact Q-bital Healthcare Solutions.