Everyone knows the health care industry is evolving dramatically. Change is a common occurrence in the health care delivery system.

For the health care industry in our country to advance progressively and improve upon the quality of care provided to its patients, it's critical for us to focus on six major segments of the industry: the cost, health care as a business, reform, the people running the hospitals, the facility, and the patient.

The cost

Health care is costly and currently accounts for 17.5 percent of our nation's gross domestic product. This percentage has grown during the last several years and can't continue. It far exceeds the percentage of GDP that health care represents in any other country.

Health care costs rise so much for a number of reasons: the expense of new technologies and equipment; hospitals are large buildings, and the infrastructure and systems to run them are expensive; the invention of new medications and medical research to treat complex medical conditions; and the amount of money spent on seniors. These factors contributing to a health care industry that is spinning out of control. The health care industry is on pace to bankrupt the country unless major cost containment and reduction strategies are implemented.

Health care as a business

Educated people work in hospitals to attempt to treat multiple, complex diseases and illnesses. Multitiered systems and processes make it extremely challenging to understand the health care industry. For example, there are many payer sources, and they each use a different method of payment for medical procedures. These payer sources also cover different beneficiaries based on age and economic standing.

The health care industry is in business to care for people. Unfortunately, oftentimes, health care decisions are made for business reasons. This can cause all kinds of conflicts and ethical debates. There are also many different rules and regulations that hospitals must adhere to or else their payment and licensure/certification and accreditation might be in jeopardy. Take the hospital building. It has become more complex to operate and maintain, with requirements for temperature, pressurization, humidification, and filtration.

Reform

Health care is also experiencing another president's health care reform package. This time around, there is a much greater focus on "patient outcomes." It's not how many patients a hospital treats that impacts its revenue; it's how well the patient is cared for that influences the bottom line, i.e. quality vs. quantity.

There is also a strong push to insure more people, which would theoretically ensure hospitals are paid for the services they provide. The previous reform package focused on managed care and cost reduction. It was heavily focused on saving money and less concerned with quality outcomes.

Hospital CEOs

Successful hospital CEOs are typically driven strategic thinkers who see the big picture, are business savvy, competitive, mission focused, and well-spoken public figures. They want their hospital to be efficient and effective in meeting the needs of patients.

More and more hospital CEOs today are trained as physicians. They are currently captivated by the mergers and acquisitions happening in the industry and trying to position their hospital properly for the future. It's important to understand how these CEOs think and what makes them tick as health care evolves. In order to change the future of health care, the industry needs to engage these leaders and draw on their expertise and knowledge.

The facility

The buildings that house the health care that's being provided in our country are growing older by the day and need attention. While Spokane-area hospitals have made some large capital investments in recent years, many hospital buildings nationwide are decades old with minimal attention paid to their infrastructure and mechanical systems. Infrastructure often is overlooked and underfunded compared with revenue-producing equipment, such as MRI machines and CT scanners.

Capital dollars for new construction have been tight due to the economic condition of our country and the uncertainty of health care reform. Today, most hospital construction projects are remodels or equipment replacements rather than new construction.

As an example, earlier this year McKinstry Co. did an equipment replacement project with Samaritan Health Care in Moses Lake because its air handler unit that serves the surgery suite had outlived its useful life. Samaritan didn't have all the capital dollars necessary to fully fund the project, but also couldn't run the risk of the unit failing and not being able to perform surgeries, which would have cost it critical revenue. We helped them secure a utility incentive and state grant to fund a portion of the project.

Another facility trend is the emergence of new medical office buildings and outpatient care facilities being built because they are less expensive to operate than a traditional acute-care hospital. This means large-bedded acute care hospitals will have fewer patients. They may need to transition their semiprivate rooms to all private rooms and invest in specialty services to maximize the hospital space.

The patient

Health care is a vast industry and we can't forget the most valuable segment: the patient. Patients today have greater expectations of U.S. health care providers than in previous years and are more educated and informed. They ask questions and engage their practitioners on their signs and symptoms.

We can't lose sight of the fact that health care is a people business. Decision makers must make sure the hospital environment is designed, properly functioning, lighted, and controlled in a manner that improves the patient experience. Today's patient needs to be seen as a customer and their trust and loyalty earned to inspire repeat business.

The future

There are many segments or aspects of health care that might not have made this list, but are also significant. This is why the industry needs to account for every aspect, no matter how small.

The future of the health care industry has the potential to be bright. The six segments mentioned above will ultimately determine whether or not the industry takes a significant stride forward or spins out of control. Health care professionals are some of the most caring, compassionate, and intelligent people I have ever met.

The health care industry will be successful if its focus is on an exceptional patient experience and outcome. Hospitals must be updated and maintained with modern equipment and infrastructure if they're to have a positive impact on the patient.

Key parties from each of the six segments must collaborate and put their collective wisdom and minds together. No one segment or special interest group can take on this enormous challenge alone. Health care is a vital service. The industry needs to work together to position our hospitals to be adequately equipped to care for patients for many years to come.