Designing the Medical Office Space of the Future
If your practice is considering an office redesign or building an entirely new space, make sure you ask the right questions first.
Medical practices are rapidly changing:
▪️ EHRs have replaced mainly paper charts.
▪️ Mobile devices can chart patient notes.
▪️ Video chat allows remote access to patients.
Dr. Muronda, founder and president of Shalom Interior Design says she’s seen monumental change in design requirements for medical practices over the past ten years. “As time has gone on, the exam room is the center of the interaction with the patient. And has increased in size because of the nature of the work being done there,” she says.
Muronda can remember when patient charts “would gobble up three filing cabinets” per physician, and a new medical office design for a solo physician would include a couple of exam rooms, a consultation room, and a small lab or processing station. Now, she says, the theme is consolidation and partnership with other physicians, a hospital, or a combined health system so that providers can share space and separate expenses costs for items such as new technology or new staff to maintain system management.
If your budget is limited, don’t despair. The beauty of undertaking a practice redesign or new build is that you can customize the scope and timeline of the project to suit your practice’s individual needs. Here are some of the factors you’ll need to consider before building your new space.
CHANGING NEEDS FOR SPACE
Practice design and configuration have undergone significant changes over the years. There are several factors at play:
▪️ Incorporating new technology
▪️ Improving patient flow and staff efficiency
▪️ Reassigning new space that has opened up
Specialists say these are some of the methods that practices are growing up their physical space:
The physician’s office. Many practitioners no longer have a dedicated office with the accouterments of their service like medicinal degrees on the wall, human skeletons, and pharmaceutical swag. Often several physicians will share a single space for patient consultations, freeing up practice real estate for more exam rooms.
Private patient registration area. Due to HIPAA privacy rules, seating patients close to the check-in desk could compromise patient privacy. Many practices opt for a second patient registration area that offers more privacy for check-in, payment, and completion of the medical and social histories.
Larger exam rooms. Now that medicine has adopted a more consultative relationship between patient and physician, more patients are bringing a family member along to help them remember what the physician has to say and advocate.
Cloud-based IT solutions. Depending on the size of the practice and its technology choices and infrastructure, there may not be a server room or centralized computing center with desktop computers, printers, fax machines, and scanners. If a practice chooses a cloud solution, they may only need a local area network (LAN) and devices with Wi-Fi capability, like laptops or tablets.
A well-designed system has multiple advantages for both patients and staff, say experts. Eliminating chat rooms can open up space for various waiting rooms, consultation rooms, and separate check-in and check-out areas – all of which can develop patient progress and staff effectiveness.
Another boon to patient flow is providing a fixed computer in each exam room. The medical assistant (MA) can chart patient vitals and reconcile med lists directly in the EHR before the physician’s arrival. Puffer says the MA can return to the exam room after the patient has seen the physician to schedule follow-up appointments or even diagnostic testing – eliminating the need to return to the front desk for check out.
That’s the benefit of having a computer system [in the exam room]; it gives you access to the data no matter where you are. So now you can have a unique experience.
Practices need to decide on the types of technology they want to include in their new/redesigned course. It is always enough to know what your design needs will be upfront, rather than having to go back and retrofit your space because of a last-minute technology change or increase. Depending on the size of your budget, you may or may not be working with an IT consultant, but it is always a good approach to speak to a tech specialist before starting production, says Muronda.
Aside from the benefits of EHR, new technology can help patient comfort, satisfaction, and expedite patient registration and insurance confirmation, to name just a few advantages. It is also a patient pleaser: for example, in-office Wi-Fi, made possible to patients with a guest login, allows them to use personal mobile devices like smartphones and tablets while waiting for the physician.
PATIENT PORTAL OR PHONE TREE
Most experts will tell you that the advent of the patient portal was a game-changer for physicians and their practices. The portal is probably the most significant change to a practice workflow. Prior to the implementation of portals, he pointed out that staff members were dedicated to answering, triaging, and returning patient phone calls. Now it is possible for patients to leave secure messages for their physicians and/or nursing staff using the portal and to receive an e-mail notification that their question or request has been answered.
So what are the first steps once your practice has approved the plan for a new build/redesign? Well before approaching an architect, your practice should assemble focus groups in each department. Dr. Muronda says it is vital that the practice has a clear vision about what it wants and needs from a new space, and it is also important for staff members to voice their opinions on what doesn’t work in the current environment. “Everyone needs to be involved in the process. It’s just not the provider input; it needs to come all the way down to the greeter,” she says.
Once that is done, Dr. Muronda says the best way to proceed is to designate a project chair, and create individual teams that will take on decision-making responsibility for elements such as physical layouts, color palettes, selecting furniture, job timelines, and deciding on budgets.