A vision for evaluations of responsive environments in future medical facilities

Medical facilities in the United States (US) are facing growing demands due to shifts in patient demographics, healthcare policies, costs of care, and medical technologies. An emerging trend is the growing importance of outpatient and ambulatory care relative to inpatient care. Whereas the term "inpatient" involves a patient needing admission into a hospital over an extended period of time, ambulatory care (i.e., outpatient clinics, dialysis clinics, ambulatory surgical centers, etc.) generally involves medical and surgical services performed outside a hospital environment, with the overall patient visit duration typically lasting less than a few hours. Changes in healthcare policy and advances in medical technologies are driving the need for ambulatory facilities to be more flexible in terms of functionalities and environmental qualities (e.g., light, acoustics, etc.). Responsive environments, as a design approach focusing on how spaces can change in response to user and environmental input (e.g., user interfaces, sensors), can uniquely address these changing and contemporary needs of medical practices. Architectural robotics, a key element of responsive environments, can facilitate rapid changes in building component configurations, such as interior wall, display screen, and furnishing layout, enabling spatial flexibility for medical staff. In this paper, we envision a novel application of responsive environments in the context of outpatient clinics and ambulatory care facilities. We present two ambulatory practice scenarios demonstrating architectural robotics use cases, based on preliminary observations of six ambulatory care medical staff and their patterns of interactions with existing technologies, building spaces, and navigation between spaces. Virtual environments, modeling those two scenarios, have been scripted and tested with an initial group of nine medical professionals activating architectural robotic transformations and experiencing the changes in configurations, with feedback collected through a follow-up questionnaire. Collected data on participants' feedback on the scenarios' applicability to healthcare practice and usability are presented in this paper. We expect to develop subsequent responsive environments to serve specialized medical practices as we identify them by shadowing a larger cohort of medical staff. Outcomes will be helpful for design practitioners as our findings suggest updates to the typical medical building layouts given digital technology advancements in healthcare practice. This work serves as an initial proof of concept for how responsive environments and architectural robotics can improve the spatial flexibility of future ambulatory care settings in particular and medical facilities overall, and how these are positively perceived by medical staff.