Metrodora Institute, West Valley City, Utah

The healthcare journey for those with neuroimmune axis disorders is often a frustrating slog, involving multiple specialists, tedious shuttling between appointments, and frequent dead ends. It’s a journey that Fidji Simo, CEO of Instacart, knows firsthand—and the one that led her to co-found Metrodora Institute just outside of Salt Lake City.

“It took many years and a lot of willpower for me to get an accurate diagnosis after getting symptoms dismissed. Even once I got [a diagnosis], I bounced around between several specialists,” Simo told Utah Business in 2021. “Something was structurally broken in how we care for patients with such conditions.”

Simo partnered with Dr. Laura Pace, a rare disease expert, and James Hemp, an interdisciplinary research scientist, to create Metrodora Institute, a medical and research center designed specifically to diagnose and provide long-term treatment plans for these complex disorders.

Opened in April 2023, Metrodora plans to see approximately 20,000 patients annually. Those patients will have the opportunity to submit biological samples to the facility’s biobank and high-density data repository, allowing for focused research to advance care and, hopefully, accelerate cures.

The 60,000-square-foot facility encompasses the 8th and 9th floors of a multiuse office building surrounded by mountain views. Designed by HGA (Minneapolis) and Denton House (Salt Lake City), the design arm of Arete Collective, the institute integrates high-tech, collaboration-friendly clinical, research, and workspaces within a luxurious, high-touch atmosphere.

Designing to address neuroimmune disorders

Neuroimmune axis disorders are quite complex, triggering dysfunctional interactions across multiple body systems, including the nervous, immune, endocrine, and gastrointestinal systems. Long COVID-19 is one example; others include lupus, irritable bowel syndrome, fibromyalgia, orthostatic tachycardia syndrome (POTS), and migraines.

Metrodora reports that 40 percent of adults live with at least one chronic illness due to dysregulation of the neuroimmune axis. An overwhelming 80 percent of sufferers are women. There are currently no cures.

“These patients have chronic conditions that they don’t have answers for,” says Erin LaBrec, medical planner at HGA. “They’re coming to Metrodora from all across the country in hopes that they can find solutions through multidisciplinary care in one location.”

A visit may last several days, during which the patient will be evaluated and undergo treatment by specialists, the primary care team, and therapists across a wide range of disciplines. At the end of the visit, a comprehensive summary and long-term care plan is shared.

The facility includes three care centers across the two floors. On the 9th floor—where the patient journey begins with the main entry, waiting, and check-in experience—is the Center for Multidisciplinary Medicine (diagnostic tests and services, including an infusion center and whole genome sequencing).

The 8th floor houses the Center for Advanced Interventions (an ambulatory surgery center for gastrointestinal procedures, vascular studies, and pain therapies) and the Center for Health Creation (advanced neurorehabilitation programs integrating physical, occupational, speech, cognitive, respiratory, and nutritional therapies) along with research labs.

Each floor has a waiting area upon exiting the elevators; the ambulatory surgery center has its own dedicated waiting space, as well.

“Between the two levels, all the centers interact flawlessly due to a more open floor plan,” says Matt Dickamore, vice president of creative at Denton House.

Supporting a whole-person care model

Collaboration and transparency are key elements to the whole-person care philosophy and the cultivation of an environment where patients feel truly seen. “Creating opportunities and spaces to collaborate was huge,” LaBrec says.

Adds Dickamore, “We wanted to make sure that after [a physician] meets with a patient, they can walk, like, 10 steps and they’re able to confer with another doctor. It’s all right there.”

For example, the ambulatory surgery center, including endoscopy suites and prep/recovery rooms, is adjacent to the research labs. This creates easy access for practical matters such as transporting samples, but it also facilitates frequent, immediate conversations between staff regarding specific patient care.

A group workspace within the surgery center further supports those collaboration efforts; similar team care areas can be found amid the exam/consultation rooms and therapy spaces. For private phone calls or telehealth needs, the design also includes more intimate drop-in offices just off the team work areas.

Transparency for patients gets a literal translation in the design of the team workspaces.

“The institute founders really wanted patients to feel like they had a visual on their own care,” LaBrec says, “and so the work areas are enclosed in glass. You can see the care team in the surgery center, as well as into the lab, to get a sense of all the innovative research and collaboration happening. It really promotes the care efforts all around you.”

The design aims to support the care team, as well; Dickamore remembers how Pace and Hemp described other medical facilities where “it was like they were coming up out of the grave when they left work.”

The collaborative spaces in Metrodora include windows for natural light, comfortable furniture, decorative light fixtures, and other tangible details to avoid “back of house” vibes.

“Even in the locker room, the staff have beautiful showers. They have beautiful bathrooms,” Dickamore says. “Everything was considered.”

Serving a mostly female clientele

Metrodora Institute goes all in to recognize its mostly female clientele, starting with its namesake, a female Greek physician from 200-400 A.D. who wrote an influential medical text called “On the Diseases and Cures of Women.”

“There’s power in femininity, power in women,” Dickamore says. “[Pace and Hemp] wanted to create a space that was not only different as far as the services they provided, but also different in the way that it feels. For patients who’ve been going from one medical facility to the next for years, we wanted them to walk in and think, ‘This is something new.’”

Curved sofas and lounge chairs with ottomans, gentle lighting, and soft materials set a spa-like tone in the main lobby. Inspired by Pace’s elegant black wardrobe, the interiors team incorporated chic dark tones (including black wallpaper), then offset them with neutral, textured hues. In the lobby, 45 gold-toned pendants hang delicately from the ceiling, designed to look like rose petals blowing in the wind.

Other artwork in the facility tells subtle stories about the history of Utah, the power of collaboration, and hope.

Quarter-curve archways frame the main hallways. Windows are everywhere to maximize the 360-degree views of the Salt Lake Valley, Oquirrh and Wasatch Mountains, and Kennecott Copper Mine while bringing in daylight and helping patients orient themselves.

HGA, Denton House deliver bold design

Teaming up HGA, with its depth and breadth of healthcare design experience, and Denton House, known more for luxury residential and hospitality work, helped Metrodora Institute deliver on its design goals of immersive care and comfort.

“There were a lot of questions back and forth between the two teams,” LaBrec says. “Especially in the surgery center, which has much more stringent requirements. There’s a learning curve: How do you make it feel like it’s not a clinical space but also meet all the guidelines, and address facility and maintenance concerns, too?”

That meant conversations about hiding medical gases and equipment in the prep and recovery rooms, for example, and integrating crash rails and wall protection along corridors for stretcher movement.

Sourcing fabrics and surfaces for healthcare was another learning experience for Denton House, but Dickamore says that post-COVID, the options have opened up.

“We used a lot of natural stone, as well as quartz, which is very cleanable,” he says. “And many fabric mills now have lines that are bleach-cleanable but don’t feel like they are. We were able to dig through our vendors and find bleach-cleanable velvets and chenilles. So, the overall aesthetic is really comfortable and soft.”

Considering the long-term pain, frustration, and disappointment endured by so many people with neuroimmune diseases, Metrodora is hoping that this attention to detail—and dedication to research—will mark a turning point in its patients’ journeys.

Kristin D. Zeit is a contributing editor at Healthcare Design and can be reached at kristinzeit@gmail.com.

Metrodora Institute project details

Completion date: April 2023
Owner: Metrodora Institute
Total building area: 60,000 sq. ft.
Total construction cost: $13.8 million
Cost/sq. ft.: $268
Architect: HGA, Denton House
Interior designer: Denton House
General contractor: Layton Construction
Engineers: Dunn Engineering (structural), EELD (electrical), B&D (MEP and medical gas)
Medical consultant: HGA
Builder: Layton Construction
Art consultant: R Cline Arts, Denton House Design Studio, Sue Barratt
Carpet/flooring: Patcraft, Regency Royale, Masland
Fabric/textiles: Momentum Textiles, Larsen Textiles, Bernhardt Textiles, Herman Miller, Perennials, Brentano, Moore and Giles, Pollack, Three Sheep, Arc Com, Stratford Hall Textiles, Luna Textiles, Tiger Leather, Maxwell Fabrics, Kravet
Surfaces—solid/other: Daltile, Bedrosians, Tile Bar, Crossville, Eleganza Tile, Arizona Tile, Bellezza Ceramic, Schluter, Patcraft, Shaw Contract, Tarkett, Bering, Prosoco

Project details are provided by the design team and not vetted by Healthcare Design.