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Now that the U.S. election is over, our healthcare industry may be able to get on with reform. And even though the train had already left the station before November 6, with President Obama is still in the White House, the Patient Protection and Affordable Care Act will move forward.

Republicans are expected to keep trying to slow its implementation and block funding. Should be interesting to see how that plays out over the next four years.

One of the law’s hot button issues is the requirement for all Americans to carry health insurance, which, if implemented, will add 30 million more people to the system.

Where and how are 30 million more people going to get their care?

Mostly at clinics — community clinics, specialty clinics, retail-based clinics. These may be managed by their local healthcare system or by CVS, Walgreens, Target, or Wal-Mart.

Many will use the emergency department, whether they need to or not, but the system will push them to clinics, reserving the ED for true emergencies.

Some will also be hospitalized (women are not going to have babies in Wal-Mart), but will spend less time recovering from a major health event in a hospital, instead opting for home based care.

We can’t add 30 million people to the system without it affecting every aspect of it.

While it’s unlikely more hospitals or EDs will be needed, existing ones will have to be renovated and redesigned. We’ll need more clinics (check out this website for the latest ideas on clinic design). And we’ll have to renovate our existing homes or design new ones that accommodate people of all ages and health status (check out this website for resources on universal design for the home).

The ancient Chinese philosopher Lao Tzu once said, “If you do not change direction, you may end up where you are heading.”

Clearly, the U.S. healthcare industry is heading in a different direction.

Next week: Other trends influencing healthcare facility design and construction.

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Sara Marberry, EDAC, is a healthcare design knowledge expert, thought catalyst, and strategic marketing and business development consultant. The author/editor of three books, Sara writes and speaks frequently about industry trends and evidence-based design. She can be reached at sara@saramarberry.com.

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