Seeing Beyond the Map

Population Growth Numbers Weren’t the Whole Story

A regional health system was facing a familiar question: should it expand outpatient capacity to meet anticipated growth across its service area? With more than 60% of gross revenues generated from outpatient care, the competition heating up in the region, it was crucial to invest wisely. 

At first, the quantitative data argued for caution. Population growth projections were modest, and travel times appeared manageable. On paper, the existing footprint seemed sufficient. The numbers implied that new facilities might create excess capacity and strain capital budgets.

But something about that conclusion didn’t sit right. Competitive pressure on the outskirts of the service area was increasing, and while the community was growing, volume was flat. Leaders sensed there was more to the story than the spreadsheets showed.

A Literal Bridge to Strategic Insight

To validate their assumptions, the leadership team went beyond reports and GIS maps. They held town halls, visited neighborhoods, and — perhaps most revealing — drove the routes themselves.

What they discovered changed everything. A single two-lane bridge divided the southern region into two distinct communities. East of the bridge, along the coast, residents were more affluent, many having moved from outside the area. They commuted north on major highways and were oriented toward larger coastal towns. West of the bridge, the community was more rural, lower income, and largely self-contained.

Though the two sides were only a few miles apart, they lived in separate worlds—socially, economically, and behaviorally. Few people crossed the bridge for groceries, restaurants, or healthcare.

No dataset or heat map could have revealed that. Only human observation and conversation uncovered the invisible barrier shaping real behavior.

Merging Data with Lived Experience

Armed with new understanding, the planning team reframed the problem. Instead of asking “Where is the population growing fastest?” they asked, “Where and how do different communities actually access goods and services?”

They used the same data — population density, utilization patterns, drive times — but now interpreted it through the lens of community insight. Through several facilitated workshops, the numerical and narrative data were synthesized.  The result was a capital strategy that balanced analytical precision with human relevance. It acknowledged both the physical geography and the social geography of the region. And it led to a strategy that reached beyond this one example to every small town in the region. 

Designing for Real Lives, Not Averages

The original plan had called for a single outpatient hub east of the bridge, near the denser population. The revised plan recognized that such a site would not effectively serve both sides.

Instead, leadership approved a two-site solution:

• A larger regional hub positioned as far west as feasible to attract patients from both communities.
• A smaller access point farther west to serve the rural population more conveniently.

The overall capital strategy for the market changed to address the small town dynamics. A standard three-tiered framework of outpatient facilities was articulated and over the course of the next ten years, more than $240 million of capital dollars were invested in outpatient expansion. 

The new design aligned physical infrastructure with human behavior, improving access and equity while optimizing investment.