Forbes report on Healthcare and Technology

Forbes recently published a report on how technology is revolutionizing the healthcare industry. It looks at three categories: Consumers and technology, Funding and Finance and Active Lifestyles.

The report references a StartUp Health Insights report that stated digital heath companies received a record $1.8 billion dollars in funding in the first quarter of 2016 – That is a 450% increase over the first quarter of 2011.

With increasing availability of new smart tools (fitbits, smart refrigerators, etc.) and new digital platforms to make healthcare more available (Doctor on Demand, GetHeal, etc.), we are excited to see how technology will continue to transform the health landscape.

Take 5 with Dan Morris

D Morris

Dan Morris, founding partner of Environments for Health was recently asked to contribute to the Healthcare Design series, Take Five. In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject. Below is the full article, originally published by Healthcare Design.

Dan Morris is founder and managing partner of MorrisSwitzer Environments for Health, which recently merged with Ascension Group Architects and DaSilva Architects to form E4H. Here, Morris shares his thoughts on ED design, the monetary benefits of private patient rooms, and future advancements for materials in healthcare facilities.

1. Privacy, please  

We all know that private patient rooms have a host of benefits, including reduced incidents of healthcare-associated infections (HAIs), patient falls, and patient transfer and medical errors, and each one of these is a potential cost-savings driver. But what about the potential business case that can be made for private rooms not only saving money but actually paying for themselves? Through our firm research, we’ve found that does in fact appear to be true and that the cost savings achieved by converting to private rooms can actually cover the debt service on renovation costs. The question hospitals may have to consider is not whether they can afford to do it but rather can they afford not to.

2. It’s on the surface

We’re on the cusp of a material and technological shift that may largely do away with contaminated surfaces that harbor and transmit bacteria that can lead to HAIs. On the material side, there are biomorphic-inspired surfaces that make it hard for bacteria to attach to a surface. Copper used for high-touch surfaces and copper-infused materials also have excellent bacteria-fighting characteristics. Technological breakthroughs are also on the way in the form of light fixtures that can continuously kill bacteria on surfaces and in the air. It’s an exciting time to be a healthcare design professional, knowing the impact our work will have in making hospitals a truly healing environment.

3. Patient satisfaction shaping ED design

The last place anyone wants to spend time in is the ED waiting room. After all, the reason you’re there is because you thought you had an emergency and waiting for service greatly affects your perceived satisfaction of the medical encounter. Many hospitals are actively expanding their EDs in an effort to accommodate higher throughput, but that extra space needs to be well thought-out to support timely, patient-center care. Separate entrances for walk-ins and ambulance arrival to facilitate triage, testing, and treatment, layouts that adjust to changes in patient volume over a 24-hour cycle, and rapid triage and treatment areas for low-acuity patients are just some of the ideas being implemented.

4. Building a better medical home

What constitutes the perfect setting for the medical home model? There probably isn’t a pat answer, but for us it’s about giving as much attention to designing spaces for collaboration as we do for patient interaction. It’s also about flexibility and making sure that adjacent clinics aren’t so specialized that they can share spaces easily with each other throughout the day. Finally, it’s about designing those aspects into an environment that’s welcoming, soothing, and nonthreatening for the patient so that they can feel comfortable, such as organic colors and textures, comfortable furniture, and natural light.

5. Energy efficiency as a design driver

Hospitals are among the biggest energy consumers in the U.S. According to a report for the U.S. Energy Information Administration large hospitals account for less than 2 percent of all commercial floor space but consume 5.5 percent of the energy used by the commercial sector. Well-designed healthcare facilities can support new care models, energize staff, provide flexibility, and promote health while also being environmentally and operationally sustainable. According to recent reports nearly 2,200 healthcare construction projects have received LEED certification or are seeking it. Healthcare design can help lead the way in reducing energy consumption.

EMMC featured by Healthcare Design


Thank you to Healthcare Design for highlighting Environments for Health’s work at Eastern Maine Medical Center (EMMC)! Read the full article here.


EMMC has been a tremendous, long-term client of ours having worked with them on this project from master plan through implementation.

We were proud to see phase 1 open, bringing improved care to the patients and more efficient facilities for the staff. We have a great team continuing phase 2 of the project in Bangor – keep up the good work!

Food in Healthcare


There is a growing trend in healthcare to make hospitals more hospitable. One element of this trend involves hospitals cooking up food that doesn’t taste like ‘hospital food’, but instead restaurant quality fare.

Many restaurants across the country have embraced the ‘localvore’ movement (cooking with locally sourced ingredients). Chefs find that the practice is healthier (requiring fewer preservatives and processing to the foods), more sustainable (necessitating less travel distances and decreased carbon footprint) and more neighborly (purchasing directly from nearby farms and companies).  Hospitals are taking note and have begun to look local for food sourcing.

This trend is not new to The University of Vermont Medical Center (UVM Medical Center). Through our ongoing relationship with the health network, both as architects and as patients (many of our employees utilize the UVM Health Network for care), we have come to appreciate firsthand the benefits of delicious locally sourced food. As part of their sustainability initiative, the University was one of the first to sign the Healthy Food in Health Care Pledge in 2006, dedicating itself to, “providing local, nutritious and sustainable food”. As well as supporting local farmers, it maintains a roof garden which supplies the cafeteria with fresh blueberries, kiwi and assorted vegetables, when in season.

E4H has worked with UVM Medical Center to support multiple sustainability initiatives, during our recent design of the Robert E. and Holly D. Miller Building  at UVM Medical Center, representatives from Nutritional Services were a part of the design team, contributing input on how to best address the nutritional needs of patients in the acute care setting. We have also worked with department leaders to achieve LEED Gold Certification for the  newly renovated Mother Baby Unit and Clinical Research Center.

It is also interesting to note that Hospitals & Health Networks recently reported Connecticut’s New Milford Hospital saw its patient satisfaction scores rise from the 30th percentile to the 95th percentile after implementation of its Plow to Plate local food sourcing movement. Serving tasty local food may also be good business.

We are happy to partner with forward thinking companies like The University of Vermont Medical Center and are excited to see the trend of locally sourcing food to spread across the country.

Virtual Reality and Architecture

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We are excited to announce E4H Healthcare Architect Mike Bennett, AIA, EDAC will be speaking at the 2016 New England Healthcare Engineers’ Society Fall Conference in Whitefield, NH!  He has teamed up with Ailyn Mendoza, Director of Architecture at Iris VR for a presentation titled, “Virtual Reality and the Design of Healthcare Environments.”

Bennett has used Virtual Reality (VR) during project delivery and is excited about its many applications in design and construction. He has found it has tremendous impact on client communications – clients no longer have to decipher complex plans or ‘try to imagine’ a space because they can actually visualize the 3D environment through VR.

The NEHES session seeks to provide a solid foundation for understanding of VR and will explore the various ways healthcare professionals and design teams can use VR during project delivery. The session will also connect attendees with real-world examples of the many applications of VR as demonstrated through a series of case studies.

Here is a quick video demonstrating the neat ways IrisVR is bringing virtual reality into architecture.

Imaging Technology

In Bore_Press 2Technology is getting smarter. It is helping professionals all over the world do their job faster and better – and doctors are no exception. From new equipment to cloud-based medical records to telemedicine, technology is changing the way physicians provide care.

Israeli based start up Zebra Medical Vision is seeking to revolutionize the way radiologists work. Zebra is developing imaging analytics software to read and diagnose medical imaging data. Pulling from hundreds of thousands of cases, the software platform uses big data to construct predictive algorithms which may be used to inform clinical decision making. Current algorithms exist in the fields of bone health, cardiovascular analysis, and liver and lung indications. These algorithms have been applied in the clinical field to provide health and risk management insights to patients and providers.

Zebra, founded in 2014, recently announced an additional financing round of $12 million led by Salt Lake City based InterMountain Healthcare. InterMountain is a not-for-profit health system thought to be one of the top performing integrated care providers in the United States.

E4H is excited about the Zebra’s imaging analytics technology and its potential for clinical adaptation through collaboration with InterMountain Healthcare’s service providers. Technology is changing the way healthcare is provided and, consequently, the way healthcare spaces must be designed. Our appreciation for cutting edge imaging research and technology was fostered during the design of a state-of-the-art MRI suite at Beverly Hospital in Danvers, Massachusetts.


Bringing Policy into Medical Education


George Washington University Medical School is taking full advantage of its neighbors. Less than a mile from the highest offices in the United States government, George Washington University Medical School has begun to integrate public health policy into the curriculum through hands on practice. Recent projects include pitching ideas for managing asthma to city health officials and making suggestions for AIDS and HIV policy to the national AIDS czar at the white house.

The following article from NPR introduces how medical students are shaping the way policy makers look at health – and learning a lot about public policy issues along the way. Read the whole article on NPR: This Med School Teaches Health Policy Along with the Pills

E4H is excited by the idea of being a holistic partner in the pursuit of public health. We are encouraged by the innovations and ideas coming out of medical school campuses across the country. #Changemakers

How E4H is Organizing Knowledge


A Community of Practice

Architecture is more than a set of drawings. While drawings are a tangible commodity of practice, the Architect’s most valuable product is knowledge.

For many years our respective offices have produced and fostered knowledge regarding the design and construction of healthcare facilities. Our ability to stay competitive within the marketplace was contingent upon our ongoing generation and distribution of intellectual capital. Stepping out of our silos, we look at E4H as an opportunity to further cultivate our knowledge base through collaboration and cross pollination.

Knowledge and the appropriate organization of knowledge are critical to our practice. In the article Organizing Knowledge Dr. John Seely Brown and Paul Duguid, experts in the science and business of information, contend, “Intercommunal relationships allow the organization to develop collective, coherent, synergistic organizational knowledge out of the potentially separate, independent contributions of the individual communities.” Through organization we seek to cultivate and direct our most valuable resource: our knowledge base.

Know-What versus Know-How

Knowledge may be filed away for reference in an individual’s brain or an interoffice database, but this does not produce organizational knowledge. Such archived information is know-what and it is relatively ineffective without know-how, the understanding of how and when to utilize it. If information is our most valuable asset, but it is rendered relatively useless without know-how, then how do we begin to foster both? Brown and Duguid explain that such dispositional knowledge is best acquired through collective practice – communication with colleagues, contractors and clients. They write, “Collective practice leads to forms of collective knowledge, shared sensemaking and distributed understanding that doesn’t reduce to the content of individual heads.” E4H is organized into communities (aka “workgroups”) designed to foster collective knowledge through collective practice.

Specialized Knowledge

E4H is a 100% healthcare design firm. The benefit of specialized knowledge was introduced by Plato and enriched by the father of modern Economics, Adam Smith. Smith explained in his treatise, The Wealth of Nations, “The greatest improvement in the productive powers of labour, and the greater part of the skill, dexterity, and judgment with which it is anywhere directed, or applied, seem to have been the effects of the division of labour.” Specialized groups are able to produce highly specialized bases of knowledge. The healthcare industry recognizes this fact through increasing demands for fellowship trained physicians and specialty practices. As healthcare design evolves and grows ever more complex, a specialist is necessary for the design of healthcare environments.

Ecologies of Knowledge

We believe the sum of our intellectual capital is greater than its parts. We seek to forge a synergistic community of practice in order to expand our intellectual capital and achieve collective understanding. Brown and Duguid describe the mutually beneficial qualities of interdependent communities, “Such hybrid collectives represent another level of in the complex process of knowledge creation. The outcome is what we think of as organizational knowledge, embracing not just organizational know-what but also organizational know-how.” Our architects and planners are excited to share best-practices and project experience across E4H.  We believe embracing a culture that fosters both know-what and know-how will contribute greatly to our organizational knowledge and bring tremendous value to our clients.

How Tall Buildings Touch The Sky


Yesterday afternoon, in a quiet moment as I was staring out of my office window in midtown south, I was thinking about the skyline and how tall buildings touch the sky. Louis Sullivan theorized that the skyscraper (the new building form in his time) should be designed like a column, with a distinct base, shaft and top or capital. If you look at many late 19th century buildings in NYC, this directive seems to have been widely adopted.

Other architects, at the same time, took this in another direction. Drawing inspiration from Gothic architecture, they seemed to think that tall buildings should pile up and up in ever narrowing masses, culminating in points like those of the spires of a cathedral reaching toward heaven. All around us are examples of this design thinking. Then there are the modernist boxes, which disregard all of this previous thinking, and replace it with geometric repetition, sometimes with vertical elements to emphasis the height and sometimes with horizontal banding which often ignores both height and scale, piled repetitiously one of top of the other.

From my office I can see examples of all of these schools of thought as well as other idiosyncratic buildings, which seem to adhere to no particular theory. I see Raymond Hood’s Radiator Building on Bryant Park (peeking up out of anonymous masonry masses) ending in vertical spires, masonry buttresses and arched windows, gilded and glistening in the sunlight, piling up around an octagonal element (does it enclose a water tower?) spilling out white streams of smoke or steam into the blue sky around. Directly behind it is the WR Grace Building, an SOM geometric box, which rises in horizontal concrete and black glass bands to a banal flat band. Down the street, 200 Fifth Avenue grows in multiple masonry increments pushing itself in vertical limestone and brick ribbons upwards to a lovely pinnacle, which unfortunately is now held in place, silver boxes of air handling units. Peaking through a slot between fussy repetitive orange brick 1970s boxes is the glory of the Chrysler Building, shining in silvery arches pushing back into itself through to its iconic needlepoint. This building does not so much scrape the sky as inoculate it with Deco cadmium splendor. Lower down, squatting on top of multiple receding piles of masonry are those wooden barrels, variously hued, NYC water towers.

What a composition this cityscape is, so full of diversity and complexity, reflecting the imaginations and hubris of various ages, reaching upwards and upwards as if after some constantly receding prize in the sky! What a joy to look out upon it and to live and work in it.

Author: Jaques Black