The retailing of health care

heir urban context and are thus developing more integrated design solutions to create live/work/play urban environments, focused on health and wellness as well as community engagement. Healthcare Village In their 2014 Report, Healthcare Villages – A Growing Trend in America, Navigant Consulting defines a healthcare village as a mixed-use setting that is anchored by a healthcare provider. Either healthcare system-driven or developer-driven, these villages include mixed-use components like retail and housing, in addition to healthcare components like hospitals and medical office buildings. Located in Henderson, Nevada, Union Village (UV) offers a glimpse of the future of healthcare and, when completed, it will be first integrated health village in the world. Being built on 92 hectares over the next 10 to 15 years, it is cited by the leading industry publications, Engineering News-Record and Health Facilities Management, as one of the top healthcare projects currently under construction in North America. This “visionary model for health care” will offer a world-class hospital complex and health centre, residential, entertainment and specialty retail space, hotel and conference facilities, a senior retirement community and a civic and cultural arts centre, all integrated into a masterplanned community. The development will also contribute billions to the local economy, with 12,000 healthcare and retail jobs created. Moreover, Craig Johnson, the co-founder of UV, claims the village represents a tremendous opportunity to launch the region as a lucrative medical tourism destination. For medical tourism to work, Johnson said the area has to be easy to get to, provide something for patients and their families to do and offer world-class healthcare, all of which he said UV would be able to provide. A similar project is Florida Hospital Health Village in downtown Orlando, Florida. The emerging health village is transforming 70 hectares of its current Florida Hospital surrounding area into a major healthcare development and residential wellness destination, for visitors and residents seeking world-class care. The village is part of a 20-year masterplan and includes several hospitals, a college campus, research institutes, multiple health and fitness centres, apartments, retail stores, restaurants, hotel and conference facilities, all surrounded by acres of parks and green space. With the projected creation of thousands of jobs over the next 10-plus years, the hospital is also conscious of the need for public transportation, and has incorporated the commuter train into its progressive urban design. By creating an environment rich in resources that encourage whole-person health, Florida Hospital can extend their healing mission beyond the hospital doors, and create a greater impact in the collective health of the community that surrounds them, all while providing cutting-edge medical and research facilities. As David Banks, Florida Hospital’s chief strategy officer, puts it, “Health Village is not just about science. It’s a place to live, to work, eat and shop.” While most healthcare villages are still under construction, already half-built Metro Health Village near Grand Rapids, Michigan, had the first suburban hospital in the region and now includes an entire community of support services, retail, restaurants and large-chain hotel, with Metro Health Hospital as its focal point. According to their website, “the concept in this suburban setting is to create a town centre with an ideal mix of healthcare and retail infrastructure to make the development a destination.” Metro Health Village has been promoted as a place to meet, eat, play, exercise and shop for a more health-focused lifestyle, all within easy walking distance in a park-like setting with vibrant streetscapes. Health and wellbeing are main urban design drivers, hence every building in the Village is LEED-certified, with a strong focus on stormwater management, recycling and energy conservation. Moreover, the Village is designed to take advantage of the surrounding natural environment to provide a calm, healing and healthy setting that’s ideal to serve patients, families and the surrounding community. In a true community spirit, the Village hosts the weekly open-air farmers’ markets, with a wide array of vendors selling fresh fruits, vegetables, flowers and other locally grown and produced foods, as well as handcrafted artisan items. In addition to vendor offerings, market visitors can participate in free community health screenings, including blood pressure checks and more. Jason Granger, vice president of the Granger Group, the company behind the Metro Health Village concept, further explains that this is also an efficient model to meet the needs of the growing population of seniors, as it’s meant to allow residents to ‘age in place’. Over the next three years, Granger Group expects to develop $1 billion in senior living communities as part of so-called “healthcare villages” around the country. Finally, with plans for a nearly 9.3-hectare complex, there is The Focal Point community campus, which is being developed by the Chicago-based, not-for-profit development corporation that prides itself on creating unique and innovative community projects. As cited in their brochure, “the campus is a first-of-its-kind development designed to empower more than 400,000 residents”. Focal Point is a mixed-use healthcare facility, home of the new Saint Anthony Hospital as well as a number of retail, wellness, education, arts and recreation services customised to the needs of the community, with focus on the complete wellbeing of community members, instead of purely on one element, such as healthcare. City within the city Roger Ulrich, one of the pioneers of Evidence Based Design (EBD), the scientific field of study behind the concept of Healing Environments, argues the essence of Healing Environments is that a well-designed building can contribute to the recovery process. Research has shown that the exterior, the interior design, the atmosphere, the views and the use of colour in the building, all together affect the wellbeing of the patient. Another key consideration is to eliminate that often unsettling, mechanical and clinical character of hospital buildings by making them more familiar and welcoming spaces. Established in 2005, The University Medical Center Groningen (UMCG) in Holland is a successful example of integrating a large hospital complex into the existing urban fabric. According to the centre’s comprehensive information booklet, the UMCG has been designed as a ‘city within the city’. It brings the outside world in, with all the usual services and amenities, such as a bookshop, a supermarket, a hairdresser, shops, cafés, bank, a travel agency and much more, creating a familiar and comfortable environment where patients are able to continue to participate in society. The UMCG provides patient care and medical education, and performs cutting-edge scientific research, focused on ‘healthy and active ageing’. Today, this is one of the largest hospitals and also one of the largest employers in the country. As per the centre’s website, every day some 18,000 staff, students, patients and visitors attend the UMCG. In addition, every year dozens of major conferences are organised with participants from all over the world. Its size alone makes it a ‘city within the city’ and, like in any real city, the UMCG offers shopping, catering and hospitality facilities. The similarity to a city is further emphasised by the remarkable architecture of the UMCG which is closer to that of an urban shopping zone than a sterile hospital. The grounds are organised into quarters, streets, squares and green spaces, with areas dedicated to research and education, commerce, and culture. In the hospital’s public area there is a large, inviting shopping street with surprising interior design and artwork.The roofed-in streets which house the nursing units and outpatient clinics are such that you can easily forget you are, in fact, in a hospital. At the core of the complex is the ‘promenade’: a tree-lined urban throughway for pedestrians and cyclists which leads to a large square with the fountain in the middle. There are plenty of relaxing meeting spaces all around, with sensibly designed lighting and furniture, including a sculpture and a tropical garden – even a theatre. Patients who are capable of leaving their bed meet visitors, employees, students and local residents in the inner streets of the UMCG so they temporarily stop feeling like a patient. As Jan Hamel, director of UMCG explains, a successful “hospital’s ambience must take up a middle ground between the familiarity of a community centre and the solidity of a bank.” Convenience is king According to the recent study by BMC Health Services Research, as the decline of the traditional US shopping mall couples with the growing interest of hospitals and health systems in consumer-focused healthcare, there has been an increasing interest in ‘healthcare retail’. Healthcare retail refers to both bringing retail to a healthcare site, such as a hospital campus, as well as offering healthcare services off-site in a retail space, such as a shopping mall or a major retailer. Medical malls, as they are often referred to, are defined as retail spaces repurposed for healthcare tenants or mixed-use medical/retail facilities. At present, there are about 30 medical malls across the US, the majority of which opened in the past five years. The medical mall model offers many potential benefits to both patients and providers. The key strengths of medical malls are more convenient access, including public transportation, extended hours and greater familiarity for patients, and ‘one-stop shopping’ for primary care and specialty services as well as retail needs. In turn, for mall operators, it is a great way to get reliable healthcare tenants and to increase foot traffic, with a captive audience of patients and families, on top of regular staff. While medical malls are still somewhat rare, Americans have already embraced retail health clinics – walk-in, often comprehensive medical facilities located in retailers such as Wal-Mart and Target. Retail health clinics began showing up 15 years ago and now there are about 2000 clinics across the United States, according to data by Merchant Medicine LLC, a strategic planning firm. “Convenience is king, topping even personalisation in some cases,” says lead BMC study author, Dr Ateev Mehrotra, an associate professor of healthcare policy at Harvard Medical School. While you shop at your usual retailer, you can walk into a retail health clinic without an appointment, even at night and on weekends, when other doctors’ offices are usually closed. When retail clinics took off in 2006, Wal-Mart became interested because of its massive footprint and customer volume, says Jennifer LaPerre, senior director of health and wellness for Wal-Mart. Today, Wal-Mart has well developed a retail-clinic strategy, working with local health systems and leasing space within its stores for clinics focused on providing a broad scope of medical services to their employees and customers at more than 260 locations. Wal-Mart isn’t the only big retailer moving into this space. Target has introduced a new partnership with Kaiser-Permanente to bring convenient, high-quality health solutions to Target customers. For big-box retailers, like Wal-Mart and Target, healthcare became yet another lucrative initiative to drive new customer traffic through the door and gain loyal customers. Recently, Whole Foods CEO John Mackey also announced plans to join the game with Whole Foods health clinic, where employees and customers could walk in and consult practitioners about minor health ailments or chronic conditions like diabetes and high cholesterol. Whole Foods’ strategy would be to attract the kind of consumers who are deeply health-conscious but sceptical of mainstream medicine’s heavy use of pharmaceutical products for lifestyle-related diseases – some of which can be prevented or treated with exercise and dietary changes. Designing for wellness Healthcare consumers are demanding more, therefore health facilities will inevitably become physically, organisationally, socially and culturally more integrated. Our society is more focused on preventative medicine than ever before, and these new mixed-use developments provide a wellness aspect clearly lacking on a traditional hospital campus. Integrating different components allows people access to various services in one place, as well as promoting wellness and community spirit. In short, those that successfully bridge the gap between healthcare and retail will not only drive a medical care model that responds to how we live, but will create environments that are sources of health and not just places to heal. SCN