Future technology must enhance quality of care

The use of technology has brought about significant changes in medicine, both in medical procedures and processes and administrative procedures. Until the 19th century, hospitals were places where the sick and the poor looked for asylum, and the concept of healing was not as well understood as it is today. However, starting from that century, science began taking centre stage through significant research.

Three key discoveries — bacteria as the cause of diseases, anaesthesia, and steam sterilisation — enabled the development of the modern hospital.1 Wolper suggests that these discoveries gave rise to the modern hospital as we know it — with their implementation, coupled with continuous technological advancements, facilitating the development of modern medicine, and significantly improving the quality and effectiveness of healthcare. By the late 19th century, in most developed countries, there was a continuous investment in healthcare services, leading to significant technological expansion in both existing and newly constructed hospitals.

A new epidemiological profile

The new epidemiological profile that emerged during this period is associated with improvements in healthcare infrastructure, increased healthcare expenditure, and services. It also correlated with emerging health issues linked to working conditions, the rapid growth of urban environments (especially since the 1960s), and changes in lifestyle patterns.2

In recent years, the healthcare sector has witnessed significant changes in hospital buildings and their equipment. Modern hospitals are designed to be advanced, contemporary, and flexible, anticipating future modifications, and focusing on patient-centered care, rather than disease-centric approaches. This approach has humanised hospitals, making them more welcoming and patient-friendly.

In 1895, Wilhelm Röntgen discovered X-rays, and in the intervening years, medical equipment has exponentially developed, with patient diagnosis and disease treatment increasingly relying on imaging. Among the most well-utilised medical equipment today is that used in diagnostic imaging, radiotherapy, and surgery, alongside adaptive artificial intelligence (AI) systems in healthcare. Hospitals rapidly began to be transformed from places where people went to die into facilities where treatments and diagnoses could cure diseases.

When treating oncological conditions, one of the most effective techniques to emerge has been radiation therapy. However, proton therapy has emerged as an innovative technique in recent years, significantly improving patient quality of life and yielding beneficial health outcomes.

Among the notable systems in this field is the ProteusONE from IBA Proton Therapy — a single-room proton therapy solution that is compact, and easy to install and operate. It prioritises patient comfort while minimising the exposure of healthy tissues to radiation.

Surgery, meanwhile, is seeing growing use of remote-assistance equipment such as surgical robots, which allow surgery to be undertaken without the surgeon needing to be in the same location as the patient, potentially enabling operations across different hospitals, or even countries. One of the best-known systems in this field is Intuitive Surgical’s da Vinci Surgical System, a highly sophisticated device controlled through a console within the operating room. The technology that the system incorporates enables surgeons to access hard-to-reach areas of the body, reducing patient pain, and shortening post-operative recovery times.

Despite the increased use of surgical robots in hospitals, some professionals still do not view this technology as a viable replacement for the manual dexterity of a surgeon. This is due to robots lacking the same sensitivity and capability to handle tissue pressures during surgical procedures. As surgical methods advanced into the 21st century, ‘Surgery 4.0’ emerged, characterised by image-guided procedures. This advance led to the creation of hybrid operating rooms, designed for complex surgical interventions requiring collaboration among various medical specialists.

The implementation of hybrid operating rooms originated from the need to perform surgical procedures while simultaneously obtaining intraoperative diagnostic images — such as during cardiac, urological, or endovascular surgeries.3 These operating rooms are equipped with imaging systems (digital angiography comprised of C-arms suspended from the ceiling or anchored to the floor), high-definition monitors, and image-guided navigation devices, allowing doctors to perform more precise and effective procedures. In addition, hybrid ORs are designed to offer greater flexibility in equipment configuration and instrument layout, allowing medical teams to customise the space to meet the needs of each procedure. One of their main advantages is that they allow for less invasive procedures, which can speed patient recovery and reduce the risk of complications. They also allow doctors to perform interventions in real time, which can be especially useful in emergency situations.

By combining neurosurgery and MRI services, intraoperative high-field magnetic resonance imaging (iMRI) is formed; this is a technique deployed in the operating theatre to provide detailed real-time images of the brain or spinal cord during surgery.

Another option is computed tomography angiography — a medical imaging technique that combines a CT scan with the injection of a contrast dye to visualise blood vessels and assess blood flow, which is used to help diagnose conditions such as blockages, aneurysms, and other vascular issues. Simplifying undertaking the various types of imaging that patients may need during surgery, the combination of the two rooms provides greater patient safety, and improves clinical workflows. By linking the two rooms, trauma patients can be managed in one room, and interventions can be performed without having to move them throughout the hospital.

The digital hospital

Information and communication technologies (ICT) have revolutionised society since the telegraph in 1843, and significantly improved daily life throughout the ’80s and ’90s. In the healthcare sector, ICT has optimised the management, exchange, and communication, of information, enabling remote diagnostics and monitoring, thereby transforming hospital structures.

Advances in this field include Hospital Information Systems (HIS), Picture Archiving and Communication Systems (PACS/RIS), and Electronic Health Records (EHR). Initially focused on administrative management, recent efforts have targeted the digitalisation of professional tools, and especially EHR systems, aiming to innovate healthcare delivery models.

According to a patient survey conducted in 2023 in Argentina, 59.1% of respondents successfully changed doctors or healthcare centres to continue treatment elsewhere (see Figure 1). A separate 2023 patient survey in the same south American country identified that just 27.9% of respondents had been able to transfer their electronic health records to their new healthcare provider (Figure 2). Among the consequences of the lack of EHR adoption were patients being forced to repeat tests, and an impact on continuity of care, resulting in duplicated examinations, diagnostic errors, and treatment delays. Implementing EHR systems is crucial for quality healthcare.

Meanwhile, a patient survey in Germany during 2023 found that 73.5% of respondents had managed to change doctor or hospital to continue their treatment (Figure 3), while another in Germany, the same year, revealed that 66.7% of the patients surveyed had successfully transferred their health records (Figure 4).

Technology has also introduced minimally invasive surgical techniques and telemedicine, improving efficiency and quality of care, while acknowledging that personal interaction remains crucial. The COVID-19 pandemic has significantly impacted hospitals globally, altering daily tasks and processes. Telemedicine has been widely adopted for consultations and treatment follow-ups, offering benefits such as reduced infection risk, time and cost savings, and improved efficiency and accessibility to healthcare services. However, challenges include the need for appropriate technology, and training for staff. Many professionals, such as surgeons and ophthalmologists, find it impossible to replace their current practices with telemedicine.

A comparison between Argentina and Germany on telemedicine app usage in the two countries during 2023 revealed that people in both nations prefer applications provided by their health provider. In Argentina, 52.6% also use WhatsApp for healthcare purposes (Figure 5), whereas in Germany, it is not used at all due to greater concerns about data security and privacy (Figure 6).

Another tool that has been developed, and is increasingly used in the healthcare environment, is what is known as ‘Big data’ — a term that refers to large datasets that can be analysed to extract valuable information. In the context of healthcare, big data can be used to improve the quality of patient care, the efficiency of healthcare systems, and clinical decision-making.

Modern organisations recognise the urgent need to collect, store, and analyse data to leverage these valuable assets. In the healthcare IT arena, Big data’s anticipated benefits include the development of more innovative and ‘intelligent’ services, improved disease management, optimal use of both healthcare budgets and limited medical equipment, and improved patient quality of life — by preventing emergencies, and predicting epidemics to respond more promptly.⁴

In summary, ICT is enhancing healthcare quality and reducing costs, but it is crucial to implement these advancements ethically, and in conjunction with human clinical judgment, to ensure effective and humanised care.

Changes in hospital design due to technology

The hospital building is undoubtedly one of the most complex and demanding environments in terms of design and functionality — due to its size, rigorous facility demands, and high energy consumption. Over the years, technology has played a key role in transforming these buildings to enhance operational efficiency and healthcare quality. I will now focus on a number of key aspects of this technological transformation in the hospital environment:

Specialisation and flexibility

Technology has driven greater integration and specialisation in hospital design, promoting specialised medicine and the development of outpatient-orientated hospitals. This has led to a redistribution of medical services, where outpatient care and primary medicine have gained ground over traditional hospitalisation. This reconfiguration of services has not only optimised resource use, but has also reduced costs within healthcare systems.

‘Hospital at home’

Technological advancements have facilitated the delivery of medical services in patients’ homes, complementing traditional hospital care. This involves effective coordination with general hospitals and telemedical support for clinical information management over the internet. Standardised home care ensures adequate quality of care and greater patient safety.

The hospital of the future may look significantly different from today’s. Rapidly evolving technologies, increasing consumerism, and demographic and economic changes, are expected to reshape hospitals worldwide. An increasing number of inpatient healthcare services are shifting towards home and outpatient centres; however, complex and critically ill patients will continue to require acute hospital services.⁵

Advanced hospital management

Artificial Intelligence is being used to enhance energy efficiency and resource management in hospitals. Through machine learning algorithms, AI optimises HVAC systems, lighting, and other environmental aspects, based on variables such as outdoor temperature, humidity, and building occupancy. This not only reduces operational costs, but also improves occupant comfort and safety.

Security and monitoring

AI systems enable early detection of issues such as fires, gas leaks, or intrusions in hospitals. Additionally, AI can monitor and analyse the building’s energy consumption, identifying areas for improving energy efficiency and reducing environmental impact.

The implementation of advanced technologies has facilitated the integration of sophisticated medical equipment, creation of more flexible spaces, and significant improvement in communication and connectivity among healthcare professionals. These advancements have streamlined hospital processes, and contributed to reducing operational costs, making healthcare more accessible and efficient for patients.

In conclusion, technology continues to be a pivotal factor in the evolution of hospital design and operations. From AI system implementation to the promotion of hospital-at-home concepts, these advances are actively reshaping the healthcare sector to ensure more effective, efficient, and patient-centered care.

The implementation of advanced technologies in hospitals is revolutionising healthcare, and improving the efficiency of healthcare systems. Some of the advancements currently in trial phase that will have an impact in the future include AI, virtual surgery, assistive robots, and nanotechnology. Their development will enhance healthcare quality by reducing operational costs and increasing the efficiency and sustainability of healthcare systems. These advancements must be implemented ethically, and complement human clinical judgement, to ensure effective and humane medical care.

AI in medicine

AI’s use in the healthcare field has significantly grown, especially in areas such as diagnosis and treatment, research, telemedicine, and health management. Adaptive AI systems in healthcare use machine learning algorithms to analyse large volumes of health data, and generate personalised predictive and recommendation models. Examples of such systems include IBM’s Watson Health, Google’s DeepMind Health, and Suki AI. In medical diagnosis, AI can assist doctors in analysing images and electronic records, offering personalised therapies based on patients’ medical histories.

AI will also increasingly be used in hospital architectural documentation, with models like OpenAI’s DALL-E2 generating realistic images from textual descriptions, aiding in visualisation and hospital structure design.

Virtual surgery

This innovation utilises simulation technologies such as virtual reality, augmented reality, and 3D physical models, to create environments where surgical procedures can be practiced before performing them on real patients. Virtual surgery aids in procedure planning and simulation of complex surgeries, and improves precision — contributing to more professional healthcare. It also enables remote studies and participation in seminars without the need for travel.

Assistive robots

Assistive robots assist healthcare professionals in various tasks, from direct patient care to medical equipment management. They can collaborate in physical and occupational therapy, transport medications and supplies within the hospital, and assist patients by monitoring vital signs. Although currently costly, and not accessible to all populations, robots can enhance the efficiency and quality of healthcare. However, it is crucial to use them ethically to avoid the dehumanisation of medical care.

Nanotechnology

This technology has the potential to revolutionise medicine by interacting with the body at molecular and cellular levels. Nanomedicine offers alternatives for monitoring, control, construction, repair, and enhancement of human biological systems. It enables the creation of highly sensitive biosensors for early disease detection and controlled drug delivery, improving treatment efficacy and safety. Nanotechnology is also used in the treatment of neurodegenerative diseases through genetic and protein therapies.

Conclusions

Technology in the hospital setting significantly improves patient care and optimises time management, while transforming healthcare building, planning, and construction. It has replaced manual processes with more effective approaches, curing and preventing diseases. However, it is crucial that its adoption is not solely driven by commercial benefits, but instead responds to real needs, and enhances the quality of care.

Artificial intelligence will play a crucial role in healthcare, impacting both patient care processes and architectural documentation for future construction work. Many jobs are likely to be replaced by technology, leading to economic and time savings. It is thus essential for new generations and the current workforce to be trained with advanced technological foundations to efficiently integrate into the job market, both in the medical and construction fields.

Technology has enabled the development of new treatments and cures, positively impacting life expectancy. However, it raises ethical and political issues, particularly in terms of human rights and public policies. It is crucial to ensure equitable access to new treatments and technologies, protect the privacy of medical information, and address inequalities in healthcare. Political leaders and decision-makers must engage in creating public policies that address these issues and promote fair and equitable healthcare for all.

References

1 Wolper LF. Health Care Administration: Managing Organized Delivery Systems. 5th edn. ISBN: 9780763757915. 2011.

2 Robles González E, García Benavides F, Bernabeu Mestre J. Health transition in Spain from 1900 to 1990 [In Spanish]. Rev Esp Salud Pública 1996: 70 (2): 221-33.

3 Giménez ME, Vazquez AG, Yanes N. Image-guided surgery [In Spanish]. 2020

4 Elghamrawy SM, Hassan MK, El Desouky AI, Sarhan AM. Big Data Challenges and Opportunities in Healthcare Informatics and Smart Hospitals. DOI: 10.1007/978-3-030-01560-2_1. 2018.

5 Gordon R, Perlman M, Shukla M. The hospital of the future. How digital technologies can change hospitals globally [In Spanish]. Deloitte. 2020.

Acknowledgement

• This article, titled ‘Technology in hospital: past, present and future’, first appeared in the IFHE Digest 2025. HEJ thanks the author, the IFHE, and the Digest’s Editor, Matt Seex, for allowing its re-publication here.