Professor Roger Wong is Executive Associate Dean, Education in the Faculty of Medicine, University of British Columbia (UBC). He is a consultant geriatrician at Vancouver General Hospital, where he founded the Acute Care for Elders (ACE) unit that is replicated across Canada and internationally. He tweets at @RogerWong10 and is a key opinion leader in geriatrics and ageing. In this blog article he discusses the determinants that can transform the future of acute care for older people. He will be speaking at the upcoming BGS Autumn Meeting in London.
For all of us who work with seniors in the hospital setting, we often wonder what the future holds for acute care for older people. While our crystal ball may appear blurry on some of the exact details, we can certainly take a sneak preview now on three determinants that can change and shape the future of acute care geriatrics.
First, disruptive innovation in the medical sciences has already begun to transform the delivery of healthcare in seniors. Take cancer for example, which affects a significant number of older people every year. The application of cancer genomics (the genetic sequencing of individual cancer cells obtained from a patient) now allows for custom-designed treatment regimen in an individual patient. Precision medicine, one patient at a time, is a new paradigm that will transform the delivery of acute care. At the very minimum, health professional services that may not be traditionally found in hospitals, such as genetic sequencing and genetic counselling, will become more integrated into the acute care setting.
Second, there is already a growing emphasis on community-based geriatric care at the present time, and there will be further increased connectivity between community and acute care in the future. The digital revolution provides a platform of virtual connectivity that can be impactful for many aspects of healthcare. One example is the emergence of “big data” or health data informatics, which can connect the community and acute care sectors by seamlessly (and automatically) transferring important health information that can be used to tailor care plans for seniors, especially during the points of transition between community and acute care. Data science will become a critical part of healthcare delivery. Obviously, it will be important to build processes to safeguard the confidentiality of the data transfer.
Last but not least, transformation in acute care for older people will leverage and build on the features of the future hospital, which include providing person-centred care to both the patient and the care-provider, and designing spaces and facilities that promote wellness rather than the illness model. The principle here is to design form that follows function, a familiar concept in geriatrics. For instance, traditional hospital wards that used to be constructed and organized around organ-specific diseases can be transformed into functional and modular spaces that enhance inter-disciplinarily and health promotion. Ideally, the redesigned acute care environment will also integrate clinical care with research and teaching.
I am most honoured to be delivering the prestigious Trevor Howell Lecture at this year’s BGS Autumn Meeting in London, whereby I shall discuss the topic of “Improving acute care for older people: Lessons from Canada”. Please join me in this thought-provoking discussion on how to meet the needs of older people in the hospital setting, key strategies to translating and implementing best practices in acute care, and the opportunities and challenges of improving acute care for older people.