Intended for healthcare professionals

Hospitals Of The Future

The impact of medical technologies on the future of hospitals

BMJ 1999; 319 doi: (Published 13 November 1999) Cite this as: BMJ 1999;319:1287
  1. Charles B Wilson, director (
  1. a Institute for the Future, Menlo Park, CA 94025-7020, USA
  1. b Correspondence to: Department of Neurosurgery, University of California at San Francisco, San Francisco, CA 94143-0350, USA

    During the next decade diseases requiring medical intervention will be much the same as those being treated today. The site of care may, however, be moved away from the community general hospital to a non-hospital site or to a higher order or specialty hospital at a distance.

    With the applications of technological advances, procedures that once were performed in hospitals are now done in free standing facilities, accelerating a trend that began in the United States in the 1980s with the introduction of magnetic resonance imaging, fibreoptic endoscopes and arthroscopes, and ambulatory surgicentres. Just as the discovery and successful treatment of Helicobacter pylori for peptic ulcer replaced a commonly performed operation so new advances will eliminate the need for care once provided by hospitals, and hospitals will become places that treat conditions that cannot be treated in other settings.

    Summary points

    Pharmaceuticals will replace some procedures and will decrease the need for admission to hospital, and newer vaccines will treat as well as prevent disease

    Minimally invasive surgery will reduce hospital stay and promote outpatient operations

    Sensors will change central laboratories and intensive care units of today

    Digitised images will be accessible to all clinicians

    Xenotransplantation from transgenic pigs is ever more likely

    Economics and superior outcomes will favour specialty hospitals


    An abundance of new pharmaceuticals will alleviate a wide range of common diseases that account for a large proportion of patients currently admitted to hospital for inpatient care. New pharmaceuticals will reduce the incidence of atherosclerosis, coronary artery disease, and in particular stroke. Other pharmaceutical advances will promote the opening of stenotic arteries and the dissolution of acute thrombi Biotechnology companies are developing products that will prevent, modify, or treat a variety of cancers—breast cancer being one of the first treated.1 2 How significantly pharmaceuticals will affect infectious diseases, and …

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