After a yearlong effort, the American College of Healthcare Architects (ACHA) has released its VA Task Force 2023 Report, which comprises its recommendations for providing all Veterans equal access to high-quality care and positive outcomes regardless of gender, race, language, socioeconomic status, or location.
Haskell Project Principal Ted Moore, this year’s ACHA President, facilitated the think tank, which comprised seven ACHA Certified volunteers and a representative from the Veterans Administration Office of Construction and Facilities Management (VA OCFM). It built its findings by answering the following questions:
- How do we improve access to care?
- How will healthcare be delivered in the future?
- How can we create an equitable system of care?
- What new spaces or facilities will be needed to accommodate this new paradigm?
What resulted was a tiered, four-dimensional hub + spoke model. A traditional hub + spoke model uses distributed outpatient clinics to drive patients to more acute centralized facilities. The task force’s version reverses the flow to meet the Veteran where they are in multiple ways by their choice and convenience. The approach focuses less on the built environment and more on technology- and mobile-based strategies.
“We felt like the idea of flipping it on its head changes the traditional philosophy of ‘Build It, and They Will Come,’” Moore said. “This new model of pushing care out could greatly reduce the time and effort of coming in for care.”
Technologies currently in use and those soon to come – think AI-supported predictive care, active monitoring using wearable trackers, proactive remote case management that reminds patients to take their medications and advanced medical vehicles – make it possible to affordably personalize the Veterans’ health experience to improve their experience and outcomes.
“A lot of the technologies that we demonstrate in the report exist, a lot of them are also prototypes and a lot are patent applications,” Moore said. “We are going to start seeing some incredible jumps in wearable healthcare monitoring technologies, and we hope to translate the technology and the artificial intelligence to get the care directed to the right person at the right time.”
In-person treatment will remain a critical and significant component of healthcare, and the report lays out a solution to the obstacles to access that Veterans face. Many VA enrollees either live beyond a reasonable drive time from critical healthcare delivery points, lack transportation options for financial reasons or are limited by disability.
The AHCA’s VA task force recommends developing what it calls the Rapid Deployment Health Utility Base (RD-HUB), a prototype modular building created from a kit that is easy to deploy and scale to any area’s population and needs. Strategically located and fully sustainable RD-HUBs would serve as the centers of care in remote areas, supporting person-based care by offering a hub for mobile-care vehicles and drones, a technology shop, a telehealth center, a pharmacy and more. They also could serve as disaster relief centers in a time of need.
“What can we get out to vets as soon as possible at a low cost?” Moore said. “We wanted to keep our ideas light and nimble to have the ability to flex with where vets are moving. So, we came up with the idea of using more technology and creating different types of facilities to support that. That’s what the RD-HUB is.”
The release of the task force’s findings coincides with a VA imperative to develop a new, integrated strategic approach to meeting Veterans’ needs and addressing aging infrastructure systemwide. Dr. Michael Brennan, OCFM Executive Director, told a recent ACHA Town Hall that the report provided immense value when Veterans Health Administration leaders met to envision the department’s future.
“The timing was impeccable to have a group of thought leaders, peers from industry, analyzing from the outside, based on (their) expertise and experience in the private sector and working with the VA on an unconstrained project that imagines what the future should look like based on the Veteran’s experience,” Brennan said. “That was a really powerful thing to be able to hand off to all the groups, in real-time, preparatory materials coming into this meeting. It drove a lot of discussion. I don't want to get ahead of the brief, but almost every aspect of this (report) became a talking point.”
Moore said the task force’s collaboration and findings highlight the benefit of receiving board certification from the American College of Healthcare Architects and how valuable the members are to the healthcare design community.
“Haskell has been very supportive of my involvement,” Moore said. “The ACHA is made up of board-certified specialists in healthcare design; it’s a unique specialty, and we must hold a high standard to maintain that recognition with the American Institute of Architects (AIA). For this project, we worked to transfer our ideas to the VA and hopefully have them run with it. We're not sure how that's going to happen, but they're excited about it. I hope it can translate into something real and meaningful to Veterans.”
Healthcare design is just one of the myriad disciplines in which Haskell subject-matter experts provide architectural, engineering and construction thought leadership. Contact our SMEs to discuss your organization’s next capital project.
