Dusting Off the Master Plan

Posted on August 25, 2010

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Let’s face it:  the old 15, 20, 25-year master plan is dead. It is simply too difficult to plan that far into the future. No one knows what healthcare will look like five years out.

Given the speed of information and industry change, forcasting is minimally fruitful due to its relative inaccuracy. Technologic, informational, economic and legislative change all affect industry direction, and change happens so rapidly that master plans are in a state of continuous revision. In the past, master plans were commissioned and treated like a work of art, mounted on foamcore or physically modeled out of matteboard, foam and wood, and hung on a wall or put on display. Or they were bound reports that were filed and forgotten.

The master plan remains a very useful tool. Master plans are still crucial for recording strategy, for documenting and for communicating intent. However, the snapshot model everyone is used to is too static to capture change and the constant adjustment required to steer a healthcare facility or system. A master plan, like any forward-thinking tool, is only as good as its utilization. In the past, plans were retroactively measured for their “accuracy” of prediction, whereas now the emphasis is on a tool used to help make decisions.

More specifically, a plan’s effectiveness relies on the frequency with which it is revisited. In a conceptual anecdote related to me recently:  if you take off from San Francisco bound for Boston three degrees off-course and never revise your coordinates, you will land closer to New York City, but if you readjust every 500 miles you will still end up in the correct zip code. This illustrates the power of an initial miscalculation which can be compounded by not reviewing and correcting as necessary at regular intervals.

Master plans should be used this way, but to do that we need master plans that employ today’s technology. What will that look like and how will it be used?

Master plans need to be something closer to Google Earth than a Polaroid. The master plan of today needs to be interactive and portable, a plan without a single owner, where every C-level administrator can have a desktop short cut to it, if not a smart phone app. It needs to be a mashup and data-rich, more interconnective iPhone and less tethered land line.

Technology offers much to help transform the master plan into its modern 3.0 version. Today’s master plan needs to be a 3D digital construction at least, like Sketch Up or BIM, and maybe 4D and 5D with time and cost data attached. Or imagine a master plan that incorporates every image of your entire healthcare facility or campus linked together in a growing, living composite model similar to Microsoft’s Seadragon / Photosynth applications debuted at TED three years ago.

I see augmented reality at work in the near term where the smart phones we carry everywhere can help translate the mundane plan into something quite useful. Imagine walking around your facility campus and your “master plan” comes to life in the form of data pop-ups that provide information on a building—or see in a virtual, perspectival way what the neighborhood will look like when that new addition is built, with true massing data of existing and future planned facilities. Touch, pan or roll over to see a screen that lists building square footage, bed counts, age, infrastructure and the entire renovation and project history of every building. Move to the parking lot next door and get parking counts and traffic flow numbers.

The future for recording what we know now, and imbuing it with a living quality, is here. Master planning will be a more enriching experience because the master plan will soon become interactive, relational and truly strategic.

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