A View on the Future of Health Infrastructure: A Q&A with Matthew Holmes

Health systems today must flex to thrive through constant change.

Emerging and evolving science and technology drive constant change in models of care and health service delivery. Growing populations, changing demographics and communicable and non-communicable diseases that continue to flourish in our communities are pressuring service capacity and budgets.

And that was before COVID-19 emerged.

The global pandemic raised serious questions about multi-faceted supply chains and health security of nations. It put the spotlight on the importance of biomedical education and research facilities and pharmaceutical manufacturing capabilities as part of a broader holistic health system. And it's highlighted the role of other critical services providers, such as water supply and transport, in keeping populations well and thriving.

Around the globe, we're helping clients reimagine approaches to create and sustain, well-functioning, thriving and resilient health systems and contributing to personal, societal and economic wellbeing with help of our teammates like Matthew Holmes, our global solutions director of health infrastructure. In this Q&A, we connect with Matthew to discuss the trends and opportunities ahead for health infrastructure and how we're instilling wellbeing into planning facilities of the future.

Tell us a bit about what a day in the life is like as Jacobs Global Solutions Director for Health Infrastructure, and what we offer to our clients in this area.

I started my career as a healthcare architect, primarily in the U.K. and France. Now delivering solutions for health infrastructure, I get to lead and shape some of the most significant healthcare projects around the globe. I focus on the built environment, meaning the physical locations and formats from where healthcare services are delivered.

Jacobs works across multiple regions, including North America, Europe, the Middle East, Asia, Australia and New Zealand, serving health system operators and providers, academic medical centers and research institutions and the world's leading biopharmaceutical companies across the full asset lifecycle from funding, planning, design and procurement to construction, asset management, commissioning, and operations and maintenance. We provide end-to-end solutions that respond to our clients' needs by delivering innovative facilities that are sustainable to operate and enhance economic, social and environmental outcomes.

What are the biggest challenges for health infrastructure?

One of the greatest challenges in healthcare, which impacts all regions, is a change in the patient profile for hospitals and healthcare. The types of patients spending significant time in hospitals have changed from previous generations. We have a larger aging population, so constructing hospitals and infrastructure to meet the needs of a growing geriatric cohort with increasing complex care requirements is changing our approach when designing the built environment of healthcare.

The other major challenge is the availability of the workforce to deliver care. Almost every healthcare client globally will articulate that there is a deficit of healthcare workers and specialists. The challenge on many of our projects is providing these clients with solutions to improve operational efficiencies. As an example, we have been working with the Ministry of Health in Singapore, where the care model fully embraces the role of the caregiver as an integral component in supporting the delivery of care in the hospital, having two benefits: it helps the workforce in the hospital as well as helps the caregiver to continue care delivery once the patient has returned home.

How are you helping our clients think differently to respond to future challenges?

Each location and market are unique and different. We work with critical infrastructure operators as they continue to evolve their understanding of the role they play in keeping communities healthy and well as part of a holistic health system, providing environmental, engineering, scientific and advisory solutions that support improved public health outcomes. For example, I'm currently working on the Alexandra Hospital Redevelopment Project, probably one of the most significant new-build hospitals we're delivering. This project is expected to enhance facilities and provide greater accessibility for healthcare services, while also integrating community and green spaces linked to the rail corridor park in Singapore. It's a great example of how we're helping infrastructure owners think beyond just the building or services themselves and how the investment can support the wider community wellbeing.

Is there a project you're particularly proud of?

We've been doing some exciting things covering the entire lifecycle of healthcare - infrastructure, asset management planning, and beyond. In New Zealand, we have been working with New Zealand Health on an infrastructure prioritization framework to support the decision-making on their capital investment program. By combining our asset management, facilities and clinical capabilities, we built a methodology encompassing all facets of the built environment along with clinical and non-clinical operations to provide a structured framework for identifying recommendations on investment prioritization.

We developed a bespoke tool, Echo, for this project that identifies the clinical efficiency or effectiveness of the health infrastructure and supports the decision-making process on investment prioritization for replacements and upgrades. Following this successful first use, we've now implemented Echo on other projects across New Zealand and Australia and recently had the opportunity to use it in the U.S. I'm excited to see how we're able to apply it on future projects and for other sectors in the future.

Speaking of the future, what are some of the biggest opportunities ahead in health infrastructure?

Like other markets, we're seeing lots of opportunity in automation, artificial intelligence (AI) and generative design.

In conversations we've had with various health operators and clients, there's a clear knowledge and lack of evidence in how health facilities are performing, and a strong interest in developing methods to measure projects and what they're achieving. We're working with clients to improve design outcomes, with a team focused solely on a generative design methodologies that provide measurable results related to various data sets, such as operational measures or average length of patient stays in the hospital.

Another area of focus for us is examining the facilities we provide and assessing whether they're achieving their stated goals and outcomes. Often, after projects get delivered, teams move on and there's little follow-up on the longer-term results. Our team is interested in working with the infrastructure owners to take a more in-depth look: helping develop methodologies and assessment tools to capture the data, measure the outcomes, and then using this evidence to improve not only the current facility but facilities of the future. As these new clinical and functional assessment tools become available, clients will be able to envision their future health facilities by looking holistically at their entire health needs.

It's an exciting time to work in health infrastructure and the healthcare environment. I think I'm quite lucky in my job. You know you're doing the type of work that is a benefit for society and for the good of people - we're contributing to personal, societal and economic wellbeing and helping create more resilient, thriving communities.

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