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: drnanliu@163.com

123

Cell Biochem Biophys (2014) 70:1741–1748

DOI 10.1007/s12013-014-0123-1

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

1742 Cell Biochem Biophys (2014) 70:1741–1748

123

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

Cell Biochem Biophys (2014) 70:1741–1748 1743

123

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]

Cell Biochem Biophys (2014) 70:1741–1748 1745

123

Fig. 5 Paradigm shift

Fig. 6 Medical building network under the emerging infectious disease

1746 Cell Biochem Biophys (2014) 70:1741–1748

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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.

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