What should the hospital of the future look like?

The programme moved from nanostructured antibiofilm coatings for urinary catheters (Antonio Jesús Puertas Segura, ESEIAAT-UPC) to the risks of extreme temperature events (Alexandre Perera, UPC–Mútua Terrassa), from textiles and health (Meritxell Martí, INTEXTER-UPC) to Digital Immersive Twins reshaping the relationship between doctors, patients and medical data (Pedro Omedas, VRAIN Medical–CITM-UPC, with Eloy Opisso, Institut Guttmann). But it was around two closing round tables — with Laura Buguñá (Mútua de Terrassa) and Aurora Torrents (FOOT-UPC) also at the table — that the day’s underlying tension crystallised most clearly.

Two ways of asking the same question

Iolanda Jordan (GIPS, Universitat de Barcelona — Hospital Sant Joan de Déu) made the case for a more humane assistance: care built around the empathetic physician, around the relationship, the presence, the time given to the patient rather than to the protocol. It is an argument that needs no defence to anyone who has sat in a waiting room. But it is also, read carefully, a diagnosis of scale: how does a system under growing pressure protect the very thing — attention, empathy, time — that makes care feel like care at all?

Xavier Gironès, director of Innovation and Research at the Consorci Sanitari de Terrassa, answered from the opposite end of the same problem. His starting point is a figure that should unsettle anyone who still equates “health system” with “hospital system”: clinical care determines only between 11% and 20% of a population’s health. The larger share belongs to lifestyle (43–50%), environment (19%) and socioeconomic and working conditions (19%) — determinants that are social in nature and sit largely outside the walls of any hospital. Hospitals, Gironès argued, are only one part of a health system that must shift toward a person-centred, ecosystemic model, one where hospitals, primary care, mental health and intermediate care coordinate not only with each other but with local government, citizens, businesses, universities and research centres.

The urgency behind this is demographic as much as it is philosophical. Catalonia already counts 20% of its population aged 65 or over, a share expected to reach 30% by 2050. Chronic disease and dependency are rising accordingly, and a system that remains overwhelmingly biomedical while the pressure toward a more holistic model keeps building is, in Gironès’s words, a system heading toward collapse unless it transforms itself.

Policy is already moving

What made the presentation more than a diagnosis was the evidence that Catalan health policy is already turning in this direction. The RIS3CAT 2030 strategy, approved in December 2022, drives community-health transformation projects and has produced a “shared agendas” methodology together with a systemic transition map published in February 2025. The Department of Health created CAIROS in October 2024 to evaluate and reform the health system, alongside CSIR — Integral Reference Health Centres, meant to give primary care hubs more capacity to adapt to their territory — and the AIS, Integrated Health Areas designed to bring primary care, hospitals, mental health and emergency care under a single territorial governance. More recently, AGAISS-Cat (November 2025) has begun unifying health and social services, and the Pla CURA (April 2026) aims to reinforce and streamline the dependency care system. None of this is speculative architecture; it is policy already being built.

Five infrastructures for a different kind of hospital

For Gironès, the hospital of the future keeps its full biomedical capacity but stops being only a place to treat disease. It becomes an open node connecting hospital, primary care, mental health, social services, community and territory; it activates health determinants that lie beyond the health system itself — care, physical activity, culture, food, environment, work and social bonds; it integrates research and innovation to validate solutions in real-world settings; and it orients the economics of health and care toward public value: health impact, autonomy, quality of life, equity and sustainability.

He grouped what this requires into five infrastructures. An infrastructure of ecosystemic governance — shared-agenda offices, territorial health round tables, digital ecosystem platforms and hybrid social-health integration units. An infrastructure of impact-oriented health and care economics — an exchange of health and care assets, an innovation and impact-investment fund, a public-procurement office for adopting validated solutions, and a public observatory of health impact. A connected high-complexity care infrastructure, where specialised hospital units work integrated with the territory rather than in isolation, supported by clinical continuity platforms and simulation centres. An infrastructure to activate health determinants, from a living territorial catalogue of health assets to units that prescribe social, cultural, sporting and environmental resources, and community health laboratories built through co-creation. And, described by Gironès as the differential core of the whole vision, an infrastructure of transformative innovation and research — living labs, social labs, citizen labs and beta labs; pre-accelerators for early-stage ideas in health and care; and expanded units for real-world impact evaluation and validation, covering not only drugs and devices but care processes, community interventions and digital tools.

Technology runs through all five: platforms that integrate health, social and community data; artificial intelligence supporting clinical decisions, risk detection and personalised social prescription; remote monitoring and hybrid care; digital management of community health assets; impact dashboards; open-innovation and entrepreneurship platforms; simulation of new care models; and territorial intelligence systems to support governance and public decision-making.

The infrastructure and the encounter

Placed side by side, Jordan’s and Gironès’s positions read less as a disagreement than as two halves of the same argument. An ecosystem of shared agendas, impact funds and living labs is only worth building if it ultimately protects — rather than crowds out — the empathetic encounter between a professional and a patient that Jordan defended. And that encounter, in turn, cannot scale to a population where three in ten people will be over 65 without the governance, financing and technological infrastructure that Gironès laid out. The hospital of the future, if the Terrassa conversation is any guide, will have to be measured by both standards at once: how well it connects a territory, and how much humanity it still manages to deliver inside a single consultation.

The session confirmed why IRIS UPC convenes conversations of this kind: health innovation is rarely a matter of technology alone, but of the governance, economics and human relationships that decide whether that technology ever reaches the people it is meant to serve.