How hospitals could be rebuilt, better than before

IN A nondescript part of Cleveland, in a room known as the bunker, a doctor, nurses and medical technicians gather to keep watch over 150 patients in special-care units and intensive-care beds. Their patients are scattered around the region, in clinics that have no specialists covering the night shift. On a wall of beeping screens the bunker team members track their charges’ vital signs. They can zoom in on any patient via a camera at the foot of each bed. “These here are PVCs [premature ventricular contractions]; they’re bad things,” says Jim Goldstein, a cardiac technician, pointing to a graph of a patient’s heartbeat. The PVCs are getting worse, warns a flashing light. It’s time to alert a nurse on the ground.

Health-care providers such as the Cleveland Clinic, the big American hospital group that runs this remote intensive-care unit (ICU), are rethinking the way hospitals work. Today, hospitals are where patients go for consultations with specialists, and where specialists, with the help of medical technicians and pricey machinery, diagnose their ills. They are also the main setting for surgery and medical interventions such as chemotherapy; and where sick people go for monitoring and care. But high-speed internet, remote-monitoring technology and the crunching of vast amounts of data are about to change all that. In the coming years a big chunk of those activities—and nearly all the monitoring and care—could move elsewhere.