During my shift at the Emergency Department (ED) yesterday, I experienced another one of those moments. An elderly lady was registered for admission due to pneumonia. In itself, not a strange diagnosis or an odd plan. But then follows the whole circus surrounding it. First, waiting for half an hour in a crowded waiting room. Then, in a wheelchair to a bed, waiting for blood collection, waiting for the doctor, waiting for blood results, waiting for the X-ray, waiting for the diagnosis, waiting for the treatment, waiting for the arrangement of a clinical bed, and finally waiting for the department to come and collect her. It is waiting, waiting, waiting...
We drag vulnerable people out of their safe, familiar environment. We put them in an expensive, stressful, and sometimes even dangerous building. A building for the frailest, yet organized as a mega-complex where you can easily get lost both physically and in the bureaucracy.
What if we bring 90% of care back home?
This is the question that healthcare must now answer. Do we dare to stop building new care palaces and instead invest in a network? And what does this mean? Imagine that Mrs. Johnson does not have to leave her house for all the care she needs. That it is organized at her couch, not as an emergency solution for overcrowded departments, but as the new norm: the Home-pital.
The home environment is better than the hospital for several reasons. The biggest risk in a hospital is contracting an infection you didn't have when you arrived. In addition, stress levels are much lower: you sleep in your own bed, eat what you want, and are surrounded by your own things and family. Faster recovery is guaranteed. Finally, it is much cheaper. A hospital bed costs on average between 500 and 900 euro per day, while your own bed is free. This leaves money left over to organize the truly necessary care at home.
Is Walmart the salvation for healthcare?
This shift can only happen if the logistics are perfect. We must see care as a service, not as a building. Look at roadside assistance or companies like Walmart. What do they do? At the roadside assistance, they bring the specialist and the equipment to your location if your car breaks down. The mechanic in the garage is only needed for the most complex operations. At Walmart, you used to shop in the store, but now everything is delivered to your front door.
What does this mean for healthcare? We must be able to bring expertise and equipment to the patient quickly, instead of making the patient travel for hours and lie in a bed for days waiting for the next white coat who comes to talk for three minutes.
This sounds like science fiction, but it is the opposite. The technology is ready. We already have advanced sensors that, like a patch on your skin, continuously measure your heart rate, oxygen levels, and even inflammatory markers. In a few years, (micro)robots will be advanced enough to perform minor procedures in the living room, such as suturing a wound, under the supervision of a remote physician. It is like bringing the operating room to your home, without needing ten staff members to come along.
If the measurements signal a problem, AI-driven logistics can ensure that a nurse with a mobile ultrasound or a specialized medication infusion reaches Mrs. Jansen within fifteen minutes. This is our golden hour, but at home. The care of tomorrow starts today, but we are too slow in shedding our old, sluggish systems.
What do we do with the 10% that is truly acute?
Of course, as an ER doctor, I know better than anyone that an arterial bleed or major trauma requires a physical and specialized team. For this care, we no longer need massive, all-in-one hospitals. We need Nano-Hospitals.
What is a Nano-Hospital? It is the roadside assistance garage: small, hyper-modern, and extremely efficient. The focus is solely on life-saving, acute, or hyper-specialized care. No outpatient clinics, no heavy administration. It is a compact, technology-driven hub. Patients arrive, are stabilized, operated on, and as soon as it is safe—which is often within 48 hours—they go home for their Home-pital trajectory. This model removes all logistical noise and allows the best specialists to focus on saving lives. The rest of the care is managed by a smart, adaptive network.
The bureaucracy and the fear of change are currently our greatest enemies. We have the technology, we have the urgency, and we have the necessity to keep care affordable and human. We must challenge the status quo in healthcare. My call: let’s stop dreaming about the improvement of the hospital. Let’s start by reinventing the location of care.
Do you have a radically better blueprint for the healthcare of 2040 than the concrete palaces we are building now? Share your vision! Sign up now for the ICT&Health Most Innovative Session to present your revolutionary concept, such as the Nano-Hospital or the Healthcare Network of the Future, to the people who can make it a reality. Let’s place the bomb under the care palace together.
