Healing by design
By Ooi Ow Wen
What is the fundamental difference between treating and healing? Treating is merely a process to combat the disease, while healing is a holistic journey focusing not only on treatment, but to save lives with empathy. The statement that “Good healthcare design begins with empathy, not equipment” is the operational reality of modern medicine. Imagine modern healthcare design that prioritizes equipment; hospitals will be no more than a factory fixing broken bodies.
However, if it begins with empathy, the result is an environment that actively contributes to recovery. My core philosophy rests on the belief that dignity is the non-negotiable asset of healthcare and empathy is the currency of it. Throughout my experience of doing courseworks in hospital, I have seen too many patients who are vulnerable in health, emotion and even autonomy once they enter the hospital. Deeply in heart, I believe that the primary goal of healthcare design must combat the learned helplessness. Healthcare design must create spaces that restore agency, ensuring that the patient remains a person, not just a subject of treatment. From my perspective, the hospital environment, medical instrument and patient-doctor interactions embody the empathy element in healthcare design.
The current hospital design principles that favor institutional efficiency over human experience is a clear opposition to an empathy healthcare design. For instance, many modern hospitals are designed as labyrinths of white walls and fluorescent lights without clear signage and instructions, indirectly stripping patients of control and subjecting them to the Nocebo Effect, where anxiety inhibits the immune system, leading to a feeling of powerlessness when they are inside the hospital. In my opinion, the solution is to restore the agency of the patients. A good healthcare design should at least allow the patient to control their ward’s condition, such as the lighting, temperature and privacy. This is to transform them from passive victims into active participants in this holistic healing journey.
In shared zones, such as hallways, the design must be oriented around intuition. For example, clear, color-coded wayfinding to guide the patient naturally to their destination. A patient should never feel ‘stupid’ for getting lost, nor fear being scolded by stressed staff, thus the building itself should provide the answers. Finally, we cannot expect empathy from staff who are exhausted by their environment. A design that prioritizes staff well-being through efficient workflows and restorative break areas can effectively reduce burnout. By caring for the protectors of life, we ensure they have the emotional capacity to care for the patients with patience and compassion, thus closing the loop for empathetic healthcare design.
The second battleground for empathy lies in the instruments of care, which frequently fail the patient by prioritizing functionality to the point of brutality. Vast majority of the current medical instruments fail in empathy design from the perspective of visual security, materiality and auditory. Dental drills that look like power tools, speculums made of freezing cold metal and the ever buzzing monitoring device can cause immediate physical recoil and psychological fear to the patient, leading to a tense, difficult environment for the clinician, ultimately compromising safety.
To solve this, biomedical engineers should use a “Soft Semantics” approach. Instruments should be redesigned to resemble approachable technologies such as utilizing matte finishes and concealing invasive components until necessary. Moreover, we must utilize high-performance polymers like silicone that offer thermal comfort, rejecting the unnecessary use of cold stainless steel. Last but not least, we must address the alarm fatigue issue by replacing the high frequency alert sound with melodic prompt in the case of non-critical parameters and routed non-critical machine data to the central dashboard.
We can have a warm, silent, perfectly designed room, but if the doctor stands over the patient, looking down, and speaks in jargon the patients don’t understand, the empathy is gone. The problem arises when the abundance of diagnostic data causes doctors to focus more on the numerical values rather than the suffering human being, especially when the doctor spends the consultation facing a screen, leaving the patient feeling ignored and isolated.
From my own perspective, I believe the solution is to integrate empathy in designing the interaction method between the doctor and the patient. For example, we can physically structure the consultation room to enforce connections by implementing the golden triangle layout where the patient, doctor, and screen form an inclusive shape that allows data to be shared with the patient, looping them inside the treatment process. Furthermore, we must design behavioural triggers, such as placing seating at the patient’s eye level, to indirectly impel the clinician to sit. These designed physical acts can signal equal status between doctor and patient, thus reestablishing the trust that is essential for honest communication and accurate diagnosis.
Looking toward the future, the integration of Artificial Intelligence presents the final frontier for empathetic healthcare design. We inevitably face the issue regarding AI potentially replacing the human element in healthcare, leading to a robotic, cold experience where algorithms determine fate. The consequence of an unregulated AI adoption would be the total loss of the social involvement that is central to healing.
In my view, it is impossible to avoid AI in healthcare, but we have to establish strict protocol and regulation to utilize AI as a tool for efficiency, not a substitution of caregivers. AI should serve as a doctor’s partner in analysing the diagnostic data, thereby liberating the doctor to focus entirely on the patient. By using technology to buy back time, we allow the doctor to return to their core purpose, which is to provide the human intervention and emotional support that no machine can ever replicate, ultimately linking back to my standpoint, “Good healthcare design begins with empathy, not equipment”.
Ooi Ow Wen is a final year student at the Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, enrolled in an elective course entitled “Healthcare Technology and Clinical Management”, and may be reached at nahrizuladib@um.edu.my