Healthcare Design’s annual Forum event, to be held Sept. 4-6, at the Biltmore Estate in Asheville, N.C., will welcome two keynote speakers to the stage to talk about finding balance in the built environment through very different approaches.

Jack Gilbert, professor, department of pediatrics and Scripps Institution of Oceanography at University of California San Diego, will discuss the topic through the lens of microbiology and integrating microbiome into design to foster healthier buildings, while Hans Neubert, global creative lead of digital experiences at Gensler, will discussing pairing empathetic caregiving with sophisticated technological advances.

Here, the speakers preview their discussions, some of the challenges and solutions they’ll share, and what ideas they want the audience to take away from their presentations.

Thursday, Sept. 5: “The Microbiome of the Built Environment: A New way of Looking at an Old Problem”

Healthcare Design: Your talk at Forum will explore how the microbiology of our built environment can influence health. What led you to a career exploring microbial ecology?

Jack Gilbert: Mostly luck! I was working as a butterfly taxonomist at Natural History Museum in London when a group offered me a PhD position working on finding bacteria in Antarctica that could control how ice freezes. They sent me down to live in Antarctica for 18 months, which was too exciting a thing to pass up. I had to learn microbial ecology and physiology, but it was worth it. From there, I spanned out into marine microbial ecology, then soil, and humans, and from there into buildings. It’s been a complex trip.

How is the microbiome of the built environment an “old problem” and how is your work offering new solutions?

We’ve known for millennia that the air inside buildings can be harmful; it’s even mentioned in the Bible. Since the 19th Century, we’ve known that the microbes indoors can come from people and that this could be harmful for human health. I’m applying advanced molecular approaches to catalogue and explain the mechanisms by which microbes colonize buildings and how that shapes their physiology and evolution. We’ve been able to use this to track how microbes move within the building, how they grow, and how they can recolonize people. This is helping us to design specific interventions that can improve the health of built environments.

How can understanding the bacteria and fungi around us help improve health and reduce disease?

Bacterial antibiotic resistance is key. Buildings tend to be quite hostile to bacteria, and the ones that survive in the building are often the same ones that can easily acquire resistance to antibiotics. We’ve found that by adding certain kinds of non-harmful bacteria to the building surface we can change how bacteria respond to the building system, reducing the likelihood that the harmful bugs will grow and acquire resistance to antibiotics. We’re trying to figure out why now.

What are some of the ways you investigate what microorganisms are in an environment or building?

We sample the air, water, and surfaces in a building and extract DNA and metabolites from those samples and use molecular approaches and sequencing to characterize them. This helps us to figure out who is there and what they are doing to survive and thrive.

Why is this an important topic for our audience of design professionals to understand and what role can they play in addressing it?

Designers are often focused on making the building and interior design so that it supports the health of the body and mind of the occupants. This is essential. But if you ignore the microbiology of the building or just assume that if you try and kill everything then it will all be ok, then you are missing a huge component. By integrating microbiome into design, it may be possible to make healthier homes, offices, healthcare facilities, and schools—and everyone wants that.


Friday, Sept. 6: “Balanced Buildings: Designing for Technology, Embracing Humanity”

Healthcare Design: Your presentation at Forum will discuss the challenges facing healthcare as it tries to balance empathetic caregiving with technological advances. What’s the secret to getting it right?

Hans Neubert: Those doing it best are thinking holistically about place, service, digital engagement, and mobility as an integrated system that must be designed together. And it all starts with people—recognizing ethnographic differences in groups of people, not just obvious cultural ones, but individual differences regarding the use of technologies. It’s not about balance; it’s about clarity, simplicity, and specificity.

What commercial design sector do you see as getting it right and what can healthcare learn from their example?

Retail and hospitality can teach a lot about ease of access, efficiencies, and service. When the “experience” is the value, a business has much to lose when too much friction keeps people from enjoying themselves. Disney’s next-generation attractions, parks, cruise ships, and hotels are great examples of getting it right by using digital technology to enhance their visitor flow in ambient and very personal ways. Some in healthcare are getting it right, too; they’re just in the minority. And many of those are still point solutions, not systematic enough to engage the entire customer/patient journey. The highly regarded health systems (Cleveland Clinic, Geisinger Health System, Kaiser Permanente) are continuously engaged with their members to learn and improve, not only when [members] get sick.

What type of digital experiences are today’s patients and their families expecting in healthcare?

As a base, patients and families expect digital to simplify access, choice, and record keeping. Yet, customers have moved beyond comparing healthcare choices to each other; instead they compare ALL personal experiences, across industries, disciplines, time, and place. With most diagnostics and procedures unbundling from hospitals and facilities, it will create a new strategic planning paradigm in the design of healthcare facilities. New levels of self service, 24/7 virtual care, digital therapeutics, precision medicine, self-diagnostics, and monitoring are leading the way to better patient experiences.

What’s one lesson or idea you hope attendees will take away from your presentation?

Stop imagining there’s an inherent conflict. Stop imagining you must give something up. These are false dichotomies. If your staff, systems, and buildings are not offering the highest level of care/use/experience, they need to be redesigned. Think holistically for patients and the staff. Bring digital in early as a key component and as part of an overall program to simplify access, support robust communications, and enhance the clinical experience.

HCD Forum is an invitation-only event that’s open to qualified senior-level healthcare design industry members. For more information and to request an invitation, visit