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ORIGINAL PAPER
The Evolutions of Medical Building Network Structurefor Emerging Infectious Disease Protection and Control
Shanshan Zhang • Nan Liu
Published online: 6 August 2014
� Springer Science+Business Media New York 2014
Abstract Emerging infectious disease is one of the most
minatory threats in modern society. A perfect medical
building network system need to be established to protect
and control emerging infectious disease. Although in China
a preliminary medical building network is already set up
with disease control center, the infectious disease hospital,
infectious diseases department in general hospital and basic
medical institutions, there are still many defects in this
system, such as simple structural model, weak interopera-
bility among subsystems, and poor capability of the med-
ical building to adapt to outbreaks of infectious disease.
Based on the characteristics of infectious diseases, the
whole process of its prevention and control and the com-
prehensive influence factors, three-dimensional medical
architecture network system is proposed as an inevitable
trend. In this conception of medical architecture network
structure, the evolutions are mentioned, such as from
simple network system to multilayer space network system,
from static network to dynamic network, and from
mechanical network to sustainable network. Ultimately, a
more adaptable and corresponsive medical building net-
work system will be established and argued in this paper.
Keywords Emerging infectious disease � Medical
building � Network structure � Three-dimensional network �Dynamic network � Sustainable network
Introduction
Infectious disease coexists with the emergence and evolu-
tion history of the living things in its history, which
accounts for more than half of the human beings from the
prehistory to the modern times. Either the Athens plague in
BC and ‘‘Dance of Death’’ in medieval century—the Black
Death or the follow-up smallpox, cholera, and AIDS bring
the catastrophe to human beings. Currently, the develop-
ment of the technology fosters the emergence of new
infectious disease indirectly, which is hard to control,
although it popularizes the antibiotics, obliges the vacci-
nation, and improves the public sanitary. Moreover, glob-
alization and urbanization promote the transmission of
infectious disease. From 2003 to 2009, SARS, Anthrax,
influenza A (H1N1), and other new emerging infectious
diseases have constantly been beating the alarms only in
these six years [1].
Infectious disease threatens us everywhere. The control
network of infectious disease, therefore, needs further
improvement. Unbalanced medical facilities and weak
control ability hardly constitute the effective control net-
work. The higher demand for the planning and designing of
medical buildings to control and protect the emerging
infectious disease is thus required. The concept of network
of medical buildings is inevitable.
Trend of Network of Medical Facilities
The present emerging infectious disease is featured with
unexpectations, collectiveness, and serious harmfulness for
community, which needs the comprehensive and system-
atic treatment, demonstrating strong ability to deal with
emergency, quick cure, large protection, and wide curing
S. Zhang � N. Liu (&)
School of Architecture, Harbin Institute of Technology, Harbin,
China
e-mail: [email protected]
123
Cell Biochem Biophys (2014) 70:1741–1748
DOI 10.1007/s12013-014-0123-1
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scale. What is required for us is to understand the general
characteristics and evolving rules of emergence and spread
for the emerging infectious disease. The various medical
buildings of infectious disease involved is dispersed and
integrated in a certain form to generate the network system
of medical facilities [2].
Net originally referred to weave the ropes for fishing.
The ancient saying goes that loose but never miss, which is
the best recognition for the net; net-like things mean to
combine the ropes in the form of cross with mutual con-
nection; these two points are combined to express the
ultimate expectation when faced with emerging infectious
disease. This means to save the sick people as soon as
possible during the emerging period of infectious disease to
further eliminate the infectious source radically; the
accessible net system is used to transmit the message
quickly to cut the transmission ways, protect sensitive
people, and strengthen the control and protection efforts.
History is a mirror to appreciate the rise, decline, and
alteration; the network pattern of the infectious disease-
oriented medical building network and the nodes and
connections in the pattern call for the review and ana-
lysis of the existing medical building system in its
exploration.
The Existing Pattern for Network Structure of Medical
Buildings Aiming at Infectious Disease
A set of systems for control and protection of emerging
infectious disease have been formed in the existing medical
regulations, and it is also easy to know the network
structure of medical buildings. The medical buildings of
emerging infectious disease control and protection mainly
consists of four types in China.
(1) Center for disease prevention and control. It is the
public welfare institutions and the brain and center to
control and protect emerging infectious disease held
by the government, which is to implement national
control and protection of disease and the manage-
ment and service of public sanitary technology [3].
(2) Special hospital of infectious disease. It is the
principal agent of medical savings when the emerg-
ing infectious disease happens.
(3) Infectious department of comprehensive hospital. As
the main site to find and control the infectious
source, this department is responsible for the partial
treatment when the emerging infectious disease
happens.
(4) Primary medical agency. These types cover villages
and towns, street health center and sanitary service
agency of the community. The basic task is to
prevent and find the infectious source without curing
ability because of the medical condition.
The above medical buildings, which constitute the
medical building subject of the current infectious disease
prevention and control, have the jobs individually and form
the preliminary network structure pattern of nodes–surface
using the layout of points–surface (see Table 1), displaying
types of topology structure (see Fig. 1).
This network structure is still pale when it fights with the
emerging infectious disease. Recently, in 2003, the
excessive loose of medical system hardly led to the
effectiveness and transparency for the investigation and
prevention system of SARS when SARS came; and the
disadvantages of medical management and prevention are
unfortunately shown although the control is well done in
the following arrival of bird flu. Should we broaden the
scope of the net, strengthen the structure of the network, or
should we change the thoughts and evolves and alter the
structure pattern of medical buildings network from a
deeper view with the aim to strengthen and improve the
Table 1 Combination pattern of medical buildings aiming at infec-
tious disease
Location
elements and
its
combination
Subsystem
of medical
buildings
Types of combination for
medical buildings
Types of
topology
structure
Point–line Prevention Municipal center for
disease control–county-
level center for disease
control
Tree
structure
Point–surface 1 Center for disease
control–comprehensive
hospital-local medical
agencies
Star
structure
Surface–
surface
2 Local medical agencies–
local medical agencies
Net
structure
Point–line Control Municipal special
hospital of infectious
disease–county-level
special hospital of
infectious disease
Tree
structure
Point–surface 3 Hospital of infectious
disease–infectious
department of
comprehensive hospital
Star
structure
Surface–
surface
4 Infectious department of
comprehensive
hospital–infectious
department of
comprehensive hospital
Net
structure
Point–surface Information Network platform of
public sanitary
information–national
public data network
Bus
structure
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public sanitary system and social public crisis emergency
system. The answer is definite undoubtedly.
Network Structure Evolution of Medical Center
for the Emerging Infectious Disease Control
and Prevention
Should we broaden the scope of the net, strengthen the
structure of the network or should we change the thoughts
and evolves and alter the structure pattern of medical
buildings network from a deeper view with the aim to
strengthen and improve the public sanitary system and
social public crisis emergency system. The answer is
undoubtedly positive [4].
Since 21st century, the applications of electronic infor-
mation technology have affected medical field signifi-
cantly, especially supporting and supplying the control and
prevention system of infectious disease technically. The
network layout of medical buildings, however, gradually
demonstrates the structural reciprocity, technical move-
ment, and spatial extension after the experience of shock
from the new epidemic situation, such as SARS and bird
flu. Based on this background, the author put forward the
conception of stereoscopic spatial network of medical
buildings for prevention and control of emerging infectious
disease. The network system of medical buildings will be
evolved from network structure, connection, and network
nodes.
From Single System Network to Many-Sided
and Stereoscopic Spatial Network
The network structure pattern of medical building for the
existing emerging infectious disease protection and control
is single, showing the planar network model with single
system. Although structure of each subsystem for protec-
tion and control is various including tree, star, and network,
single systems have certain defects inside their own
structure. The network connection between subsystems,
what is more important, should not be separated but form
an effective and completed spatial system.
Monitor and treatment are the prioritized two aspects in
the protection and control system of infectious disease. The
recent relapse trend indicates that the traditional large-scale
vaccination rarely has influence on the unknown infectious
disease such as SARS. Therefore, the fully monitored and
in-time discovery of infectious become the most crucial
one in the prevention with positive measures. It is the most
effective control methods to save and eliminate the infec-
tious source systematically and rationally during the
emergency period of infectious disease outbreak.
Starting from the characteristics of these two behaviors,
treatment behavior relies on accurate medical equipments,
professional staff, and objective and actual network space
of medical building to afford this function. Several prin-
cipal points which determine the network space of medical
buildings are divided into A distance, B accessibility, C
concentration, D scale, and E relative position. That is the
network what we call the solid spatial network of medical
buildings.
Nowadays, under the information society, monitor
behavior is more characterized by cyberspace, and its ideal
is to connect every point using the virtual network from a
purely technical level only if there are sufficient informa-
tion collection points. Such monitor and prevention pattern
is no longer an infinitely great network which depends on
any certain point on the earth [5]. And its pattern is defined
by the relevancy and band width rather than the traffic
convenience and utility of land use. That is the virtual
spatial network.
The new transitional space, also called as intermediary
space, which is responsible for the connection and trans-
formation between solid and virtue, is formed by the inter
influence and integration between solid and virtual spatial
network. This kind of space distinguishes significantly
from the above two in the form, function, and others [6].
The connection of traffic system and logistic system, even
the buffer and separation system of medical buildings with
some infectious source, among every saving medical
buildings is supported under the allocation of information
monitor for the planning level; the traditional four medical
buildings are extended and supplemented in architectural
level, such as the information treatment center and
Fig. 1 Types of medical
buildings topology structure
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emergency commanding center of disease control center
supported by the urban monitoring sites for information
collection. This intermediary space, which neither spread
everywhere like virtual network or replace the solid net-
work pattern, is able to support the real and virtual space
through offering the saved time and cost to ultimately make
the mutual support between prevention and control and
convert at a fixed time based on the organic coexist.
Solid spatial network, virtual spatial network, and
intermediary space are integrated organically to constitute
the leveled and three-dimensional spatial networks (see
Fig. 2) to realize the unification among prevention, moni-
tor, control, and treatment.
From Static Network to Dynamic Network
For the network connection, the elements in the existing
medical building network of emerging infectious disease
control and prevention is relatively fixed, showing the
static characteristics that this causes weak interoperability
of subsystems in every link and prioritized ways among
people flow, logistics, and information flow which is hard
to figure out of the entire medical building system when
faced with emerging infectious disease for every medical
structure because of poor mutual interoperability and slow
connection. Emergency prevention center has insufficient
information exchange with medical agencies at different
levels and ambiguous administrative function with city
emergency command center; it is hard, moreover, to make
swift reaction for the surrounding medical building system
when the outbreak curing demands occur at the partial
network nodes [7]. Unfortunately, the potential medical
equipments and medical ability cannot be transformed into
infectious department and hospitals which could deal with
infectious disease in a minimized time.
The intermediary space provides the new conception
for the solution of this problem. The medical buildings
in the intermediary space can be applied to adjust
dynamically when the medical building in the solid
spatial network has been fixed or the density of medical
information sites in the virtual spatial network cannot be
altered. Under these circumstances, some certain medical
buildings in the intermediary space just like the sus-
pension body for the solid and virtual space, which
either supply the virtual and solid space or serves as the
transformation bridge of virtual and solid space accord-
ing to the development situation of emerging infectious
disease (see Fig. 3). For Martini Hospital in (Groningen,
Netherlands), the architect built an ideal building in
zigzag or arc-type combination, 60 9 16 m and
1,000 m2, following the principle of industrialness,
flexibility, and detachableness (see Fig. 4). The func-
tional exchange is available during the design phase or
Fig. 2 The leveled and three-dimensional spatial networks of med-
ical buildings
Fig. 3 Medical buildings intermediary space
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later period once this building is used: a nursing
department can be converted into clinic or office and
expansion is possible on the surface of any buildings to
get extra floors, even establishing a larger department.
To address the inadequate ability of information
exchange, emerging command center can be built in the
intermediary space to organize and set up a completed
series of work for the information collection, analysis,
distribution, treatment, and check and form the supple-
mentation of the information network centered on the
disease control center.
The occurrence of emerging infectious disease is split
second in time and an aggregation in space, which usually
leads to the blowout of treatment demands. The profes-
sional infectious disease seems unlikely to meet the treat-
ment requirement. The relevant medical departments and
local hospitals are called for the instant transformation
ability within corresponding area to limit the epidemic
situation in a minimized scope in a minimized time; some
hospitals can be selected as designated receiving hospitals,
concentrated clinical hospitals, and reserve hospitals of
temporary observations beyond the main infectious disease
hospitals. During the period of non-infectious disease
outbreak, these medical depart should afford the normal
medical work to economize the hardware of infectious
disease control and prevention medical system and
improve the endurance capacity of the whole medical
network during the outbreak of infectious disease (see
Fig. 5). For instance, the layout of medical building net-
work in Harbin (see Fig. 6) under the treatment pattern of
emerging infectious disease and structure of medical
building network under the outbreak pattern (see Fig. 7),
which are made by the author and her team, fully take into
account the prioritized high-low loop with the urban
demographical density, put forward the concept of control
unit in the outbreak area and suggested that several
receiving hospitals, temporary observation hospitals, and
reserve hospitals should be allocated in every unit.
From Mechanical Network to Sustainable Network
The existing network is mechanical in its constitutional
elements, ignoring the coping issues as the time goes. The
network has no ability of self-evolution and the whole
network of prevention and control is a even, simple, and
balanced state, which is easy to handle based on the
existing experience and saving projects when faced with
normal infectious disease. This even, simple, and balanced
system will evolve to the order, complex, and unbalanced
steady state when faced with the new infectious disease;
the macro level demands the self organization, self adapt-
ability, and self realization; the medical building, the point
element, is required the self movement an self-evolution in
the micro level, which is the sustainable architecture, with
the aim to get the ability to deal with various types of
emerging infectious disease [8].
The current emerging infectious diseases, such as SARS
and H1N1, indicate a fact that the infectious disease is
impossible to eradicate fundamentally in all districts
because it evolves as human history develops. Human has
to absorb the experience and lessons from the temporary
victory of struggle against the infectious disease to wish to
find out and cope with the next arrival. At First, the
increase of monitoring network sites and construction of
information network control and prevention in the virtual
spatial network should display the progressive extension
relationship after every emerging infectious disease. The
solid hospital building in solid spatial network, then, must
becomes increasingly mature in struggles. The compre-
hensive hospitals of infectious disease should reduce the
number of room for infectious disease, department for
single infectious disease, even narrow down the department
of infectious disease, in the process of new construction,
reconstruction, and expansion but permanent experts for
prevention of infectious disease should be set up for local
hospitals. The flexibility can be used to scatter the infec-
tious rooms in comprehensive hospitals to the communi-
ties, which is beneficial to capture infected people in the
first time and on the first site when the epidemic occurs; the
expert panel from comprehensive hospitals will assist the
local hospitals to conduct the treatment of infectious dis-
ease and trains the medical staff regularly during the non-
epidemic period.
Fig. 4 Sketch Martini hospital [9]
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Fig. 5 Paradigm shift
Fig. 6 Medical building network under the emerging infectious disease
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Conclusion
In general, a perfect medical building network of
emerging infectious disease prevention and control also
needs the coordination from policy, management, public
crisis treatment, and disaster prevention and reduction in
its normal operation. However, it is fundamental to
renovate and improve the network structure of the
medical buildings. This task requires time and energy. It
involves the deeper adjustment of the existing network
structure, layout, and each element with the coexistence
of difficulties and risk. What is fortune is the information
system under the globalization has become increasingly
stronger and the above evolving trends have displayed in
many developed countries, which also offer the reference
for the development of medical building in our country.
With the new medical building network system, emerg-
ing infectious disease can be controlled efficiently, and
the trend of this new network is clear in China step by
step.
References
1. http://www.studa.net/yixue/120508/08463917.html.
2. http://www.studa.net/gonggong/100301/15074155-2.html.
3. General Office of China National Committee for Disaster Reduc-
tion. (2000). Emergency aid handbook of emerging infectious
disease events (Vol. 7). Beijing: China Society Press.
4. Song, Fenghua. (2010). Overall participation in Dujiangyan
reconstruction implementation plan. City Planning Review, 07, 83.
Fig. 7 Structure of medical building network under the outbreak pattern
Cell Biochem Biophys (2014) 70:1741–1748 1747
123
Page 8
5. Qiou, Baoxing. (2010). Challenges and opportunities at middle-
and-late-stage of China’s urbanization: New trends of urban
planning in transformation. City Planning Review, 01, 15.
6. Katrien, B. D., BOS, K., & Reniers, G. L. L. (2012). An expert tool
for integrating safety into project management. Safety and Security
Engineering, 2(2), 131–144.
7. Eglite, M., Vanadzins, I., Matisane, L., Bake, M. A., Sprudza, D.,
Martinsone, Z., et al. (2012). Assessment of occupational health
and safety system in Latvia. Safety and Security Engineering, 2(4),
305–316.
8. Ghomashchi, V. (2012). Building sustainability through collabo-
rative planning. Sustainable Development and Planning, 7(1),
14–25.
9. SEED Architects, translated by Jianmei Li. (2011). The New
Martini Hospital, Groningen, the Netherlands, Urbanism and
Architecture, 6.
1748 Cell Biochem Biophys (2014) 70:1741–1748
123