That is a big shift in the way that care is delivered in hospitals. Around the world healthcare systems are facing huge challenges as they adapt to delivering higher quality, accessible and affordable care to aging populations and societies with increasing incidences of chronic diseases.

With more Americans over the age of 65 than at any other time in history, the pressure on healthcare systems has grown. The population of senior citizens will increase by 75 percent to 69 million between 2010 and 2030¹, meaning one in five Americans will be a senior citizen.

In New York State more than 40%² of adults suffer from a chronic disease, such as heart disease, cancer or diabetes; chronic diseases are responsible for 23% of all hospitalizations in the state.

“Our original mission as an institution, as a hospital, was to take care of patients that came to us, that entered our organization. That role has been greatly expanded. We now employ hundreds of physicians, we have community-based centers in dozens of locations to provide care at all stages of illness,” says Mr. Calbone.

“From primary care to chronic disease management to ultimately acute care inside of the institution. For us to be successful we have to touch patients at all those stages of their life. That's required investments of resources, property, technology, so that the scope of what a successful hospital needs to be has expanded greatly in the last 20 to 30 years.”

Calbone’s 35-year career in healthcare began in housekeeping. Now he sets the long-range goals for Saratoga Hospital working closely with his staff and leadership team. With expanding responsibilities to the region, executive decisions around resourcing, property or technology are set against key priorities: clinical outcomes, cost effectiveness and return on investment.

“Pressure due to budget restraints are real,” he says. “It doesn't matter what size institution you're in. Big, medium, small, urban, rural. Our expectations or interest to do things typically outstrip our ability to do them 3 or 4 to 1. That pattern has existed in almost every institution I've worked in, regardless of the size. So it all comes down to priorities.”

“The questions I ask myself: ‘How can we give the best clinical care possible with strong clinical outcomes in a very, very cost effective way?’ And, ‘how do we invest our money to make that happen?’ We're very, very frugal in those investments we make because we expect a very, very substantial return on that investment,” he says.

For a hospital to be successful with its new expanded role in the community, technology needs to be used to “knit all of the pieces together” and break down information silos to link each part of the patient journey together - from hospital to home - and to give caregivers all of the data needed to make that happen.

“We take care of a patient, not just in the hospital but while they're at home, while they're in their physician's offices and we're really having to develop connectivity to see that patient through that entire continuum,” says Calbone. “All of our multiple points of services can't live as independent entities. They have to be aware of how the patient has come in to all those points of service - the diagnostics they've received, the treatments they've received - so that as they end up inside of the hospital environment, all of that information is available to the caregiver.”

“That can't be done without a technological solution, we simply wouldn't have enough people to trade that information, create all those touchpoints, and assure that information was shared across the entire patient care experience.”

More connectivity will enable that to happen and both healthcare professionals and the patients they care for believe that to be the case³. With a full picture of the patient, the focus of hospitals can shift away from treating critical patients to preventing health problems before they happen or deliver more accurate treatments and better health outcomes to large sections of society, wherever they are.

“30 years ago information was essentially being carried from person to person. We relied on the awareness of the caregiver, the physician or the nurse and they wrote things down,” says Carbone. “We're moving to a world now where the collective experience across large groups of patients, the country, the world, whatever grouping you want to look to is now turning into best practices, very precise protocol. The amassing and use of information may be the most impactful technological change that we may be experiencing right now.”

 “The biggest game changer for how we ultimately practice medicine and take care of our patients, may be the availability of our information, not just data, but really constructive information that helps our caregivers make better decisions.”

“So to do well in an environment where we know our patients, we track them, we work to keep them healthy, we have to touch them through the entire continuum from childhood, middle-age, and elderly, and to do that we have to live outside the building.”

“And again, I think any institution would tell you that we have to be broadly community based, not building-centric, which was essentially the role of hospitals 50 years ago.”