How Vancouver's St. Paul's aims to become the hospital of the future

Vancouver was a rough-and-tumble but burgeoning frontier town when a group of nuns from Quebec arrived by train in the late 1800s, looking to establish a hospital.

The sisters purchased seven lots of land for $9,000 on Burrard Street on what was then the outskirts of town.

St. Paul’s Hospital, a four-storey, 25-bed facility opened there in November 1894, an event heralded by The Province newspaper as “an epoch in the history” of the city, which had been incorporated eight years earlier.

“It is the first Roman Catholic institution of any importance which has been erected in the place,” the newspaper reported.

The facility was managed by the Sisters of Providence, the order of nuns from which Providence Health Care, the modern-day Catholic health-care provider and current St. Paul’s operator, takes its name. But the hospital was “strictly non-denominational,” and would serve patients of any faith, including “labourers,” “lumbermen,” and “paupers.”

Not including the furniture and equipment, the original St. Paul’s reportedly cost nearly $27,000 to build. The Province described it as “a remarkably fine building of considerable size … fitted up with all modern conveniences, such as bath-rooms, operating-rooms, furnaces, etc.”

By the turn of the next century, however, the aging building had leaking pipes, electrical problems, hazardous asbestos, and critical infrastructure deemed “at risk of cataclysmic failure.”

In 2012, Providence’s then-CEO Dianne Doyle, a former St. Paul’s nurse, told The Province: “We’re on life support.”

Three years later, Providence announced plans for a new St. Paul’s Hospital and health campus, three kilometres east of the Burrard Street site, next to the Pacific Central train station near Main Street and Terminal Avenue.

The seven-hectare campus has been described by Providence as the first of its kind in Canada, along the lines of the Cleveland Clinic or Johns Hopkins campuses in the U.S. It will feature a 1.2 million-sq.-ft. acute care hospital, almost double the size of the current facility, connected by a skybridge to a 370,000-sq.-ft. research facility.

This $2.18-billion hospital, which is designed for the latest technologies of today and future technologies that do not yet exist, is taking shape now.

‘Future-proofing’

Postmedia recently took a guided tour of the new St. Paul’s building on Station Street. With more than 2,000 people currently working there (and more than 10,000 workers through the life of the project so far), the construction site feels like a small village.

A sea of trailers provides on-site office space, a gym for the workers, and a lunch stand that serves hot meals and drinks.

A Postmedia reporter and photographer were accompanied on the tour by officials from Providence and PCL Construction, as well as B.C. Infrastructure Minister Bowinn Ma.

“Everything here is bigger, better, and brand new,” Ma said.

The new hospital, which is expected to open in 2027, also includes space for some very old ways of healing, like the sacred space and medicine garden designed in consultation with local First Nations.

When the new hospital opens, every in-patient can expect their own room with a private bathroom, window, lockable safe, wardrobe, and sleeper chair to promote family staying at the bedside.

That’s a big change from the current configuration at St. Paul’s, where as many as four patients sometimes share a room.

“Now, in emergency, you have to sort of pretend that the curtains are soundproof, but we know they’re not,” Providence Health Care CEO Fiona Dalton said during the tour.

Private rooms help promote faster healing and better sleep for patients, and reduce the spread of infectious diseases, which helps the whole hospital function more efficiently, Dalton said.

The building is designed to withstand earthquakes and sea-level rise.

“This hospital is definitely built to last. For the foundations, we dug down to glacial till … as far as we could possibly dig down,” said Providence project manager Clayton Wong. “Which means that no matter what happens, our hospital is not going anywhere.”

The key mechanical rooms are on the fourth and fifth floors, which means if there is tsunami — this low-lying location was historically a marshy tidal flat — the hospital could keep running at full capacity for three days uninterrupted, Wong said.

The new St. Paul’s will be B.C.’s first hospital to use what are known as automatic guided vehicles. These are not unlike robot attendants, transporting material around the hospital and freeing up human staffers.

This fleet of about 20 driverless vehicles will scoot around the hospital transporting linens, equipment, food, pharmaceutical carts, supplies, mail, and waste to and from patient-care floors, using their own dedicated elevators and making around 1,700 trips a day.

The hospital’s larger operating rooms are designed to accommodate future robotic technology for more intricate surgeries.

It’s about “future-proofing,” Dave Ingram, Providence’s vice-president of major capital projects, said while standing in one of the operating rooms.

“No one knows what’s going to change, but we know there’s going to be a lot of change, and we know that change is coming at an ever-increasing pace,” Ingram said. “So we’re doing the best we can to try and cope with whatever comes at us.”

The redevelopment of St. Paul’s is also expected to transform two neighbourhoods.

New towers are expected to follow the opening of the health campus (officially named the Jim Pattison Medical Campus, in recognition of a $75 million donation from the B.C. billionaire) in the False Creek Flats, including market housing, offices, and possibly a new hotel.

It’s not clear yet what will replace the site of the current hospital on Burrard, but considering its size and prime location, the redevelopment is expected to dramatically change that part of the West End. The property was sold in 2020 for $850 million to local developer Concord Pacific, with all proceeds going to Providence’s new development on Station Street.

Concord vice-president David Ju said in an email that his company has had a series of meetings with City Hall about different design concepts for the large site, which he called an “important piece to the future of downtown Vancouver.”

‘The Mayo of the North’

Standing in an open-air space on the future hospital’s second storey — which will eventually be a rehab patio where patients can exercise in the fresh air — Dalton, the Providence CEO, gestures west across the street, to a massive excavated pit. This will be the site of the clinical support and research centre, the 12-storey tower that Providence says will be one of Canada’s most advanced research facilities.

The centre, slated for completion in 2029, will have wet labs, dry labs, physicians’ offices, data centres, and more. It is intended to provide what Providence calls a “sandbox” space where scientists and inventors can test and prototype new technologies.

“It will contain everything that you need as a researcher to go from a good idea, through to a product that is in the market,” Dalton said.

Seven storeys above ground-level, a two-storey skybridge will be installed late next year to connect the centre with the new hospital.

That skybridge is “really important, both practically but also symbolically, in terms of innovation, connecting research and clinical care,” Dalton said. “So the problems that we see … the hurt that we can’t yet cure, the diseases we can’t yet address, those problems go over the bridge, our researchers work on them, and we bring back the solutions over here.”

The traffic between the two sides of that skybridge are also top of mind for Brian Simmers.

Simmers, who has a background working in the world of software startups, is president of Providence Health Care Ventures, a for-profit, wholly owned subsidiary of Providence Health Care that works with companies and entrepreneurs in various ways, helping them access physical facilities, patients, specialists, data, and in some cases, investment.

PHC Ventures, established in 2018, may not yet be a household name outside the life sciences sector, but it has big ambitions.

“Companies need to know what clinicians think, and what patients are going through. And the only way that patients ever get the benefit is if things are productized, they’re brought in, developed, and then be able to deliver to them,” Simmers said.

“The other part of it is that clinicians have great ideas, but they often don’t know: ‘How would I turn that from an idea into something that I could actually build a business, raise money, create a product?’ So we also help companies come out of Providence. It’s that permeability, in and out.”

PHC Ventures was launched with seed funding from the St. Paul’s Foundation — Simmers declined to share the precise amount, but said it was a “multi-million” figure — and became self-sufficient within four years. So far, PHC Ventures has made 10 equity investments in small Canadian startups, and has worked with many others.

“If we make a profit, that profit can … flow back into Providence and pay for innovative health-care service delivery,” Simmers said. “There is no external shareholder who’s going to benefit and just pocket the money. The investor is the health-care system.”

PHC Ventures will have a presence in the new research centre when it opens in 2029, including state-of-the-art technology such as 3D printing that can be used for creating prototypes.

“We’re like, ‘Hey, we want to actually show up on the map,'” Simmers said. “But you need the facility to play in those big leagues.”

In the U.S., organizations such as the Mayo Clinic have dedicated functions focused on “commercialization of ideas” and have achieved great success in “spinning out companies that actually solve real medical problems,” Simmers said.

“So if a really creative, advanced researcher has a choice of where to go, why do they end up at Mayo?” he said. “They end up at Mayo because of all these supports around them. So we want to be the Mayo of the North.”

This sector is increasingly important to the province.

At a time when B.C.’s overall economy is struggling — with real GDP per capita falling by 1.8 per cent last year, the second-worst performance among all Canadian provinces — the life sciences sector is a rare bright spot.

B.C.’s life sciences sector contributed $3.1 billion to the provincial GDP in 2022, a 27 per cent increase from three years earlier, according to industry association Life Sciences B.C.

Some Canadian companies working with PHC Ventures have global ambitions.

In October, PHC Ventures announced a partnership with Ventripoint Diagnostics, a company working to bring high-accuracy cardiac diagnostics to patients in small, rural, and Indigenous communities, through artificial intelligence-enhanced imaging that can be conducted remotely, reducing the need for MRIs.

This partnership is expected to provide access to Providence’s network of specialists and patients, thereby helping the company scale up, said Ventripoint CEO Hugh MacNaught.

“This is exactly what we need to get real-life evidence and validation of the product, and we believe that if it’s executed properly, this will scale nationally, and then eventually internationally.”

Ventripoint intends to eventually work in other First Nations communities across Canada, the Arctic, and parts of South America, Africa and Asia where access to MRIs is limited.

Ventripoint’s partnership with the Nisga’a Valley Health Authority, announced this month, is expected to be the first of many such efforts, MacNaught said. “What we’re wanting to see is a better way to support patients everywhere, through a faster and far more accessible service, for a 10th of the price of an MRI.”

Nisga’a Valley Health Authority CEO Corinne McKay said she is optimistic this technology can reduce the need for expensive, arduous, and time-consuming trips by ambulance or helicopter from Nisga’a Valley communities to hospitals in cities.

McKay’s husband had to take a two-hour ambulance ride this past spring from their village of Laxgalts’ap to the nearest hospital, in Terrace, for medical assessment. Fortunately, he was OK, and was discharged from hospital.

But the whole experience took considerable time, expense, and hardship that could have been avoided, in theory, if he had been assessed remotely at his home by a specialist far away.

“That’s something other remote First Nations can benefit from,” McKay said. “There’s a need for us to be as efficient and effective as possible in providing health services.”

PHC Ventures also invests in early-stage startups, like MyTrials.ai, a Vancouver-based artificial intelligence platform that helps people find and connect with clinical trials all over the world, at no cost to the user.

MyTrials.ai was co-founded by Dr. Zachary Laksman, a cardiologist who has worked at St. Paul’s for the past 10 years, and Omar Asaker and Tyler Connelly, a pair of 24-year-olds who just last year were in the same biomedical engineering class at the University of B.C.

Meanwhile, Thrive Health is a software platform for use by both patients and their doctors that co-founder and board chair David Helliwell compares to “a concierge for people going through the health-care system.”

Providence has made a small equity investment in Thrive, but Helliwell says the largest benefit of the partnership is that St. Paul’s is a customer of the platform. In 2017, a surgeon at St. Paul’s started piloting Thrive with a couple of patients a week, Helliwell said, and the platform is now being used in more than 50 clinics with hundreds of thousands of patients.

“Providence was Customer Zero for us,” said Helliwell, whose company has a workforce that has grown from about five staffers to around 40 full-time employees. “They were the first ones to buy in.”

dfumano@postmedia.com

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