By Joseph Armas, President, Otis U.S. and Canada

The State of the U.S. Health System

The U.S. healthcare system stands at a critical inflection point. For the past decade, hospitals and health systems have invested heavily in digital infrastructure – from electronic health records to telemedicine platforms and AI-driven analytics. These advancements have modernized patient care and transformed the way clinicians and administrators work.

Yet the healthcare industry faces a challenge that technology alone cannot solve: We’re running out of physical space. A recent study led by UCLA and published in JAMA Network Open warns that by 2032, U.S. hospitals could reach 85% occupancy – a level that strains operations and patient care. This is especially concerning as our rapidly aging population needs more frequent medical attention. Already, health systems are grappling with crowded emergency departments, delayed admissions, and the pressure to do more with limited space and less resources.

The Forgotten Half of Healthcare Infrastructure

While digital transformation has rightfully been a priority, the physical side of healthcare infrastructure has not received the same attention. Yet, the reality is that most patient care does not happen in the cloud; it happens inside hospital and clinic walls. The ability to move patients, staff, and critical supplies safely and efficiently is a cornerstone of healthcare operations. That means elevators are mission-critical assets, but they are often aging and overlooked – especially when compared to other physical building systems such as HVAC and access control.

We often refer to elevators as the spine of a building, and the analogy holds true for hospitals and healthcare facilities. Elevators support the movement of patients to surgical floors, enable medical staff to reach their destinations quickly, and ensure timely delivery of medications and equipment. Just as the spine supports the body’s health, function and mobility, elevators uphold the flow and efficiency of care. When they fail, slow down, or can’t meet demand, the entire system feels the strain – impacting workflows, safety and patient outcomes. Modernizing these systems is not just about convenience; it’s about strengthening the backbone of healthcare delivery.

Physical Infrastructure 911

As more Americans live longer, healthcare facilities will face increased strain not just on the availability of open beds but also on mobility infrastructure. Consider these statistics:

• One in five Americans – more than 71 million people – will be 65 or older by 2030.
• Adults aged 65 and older are expected to outnumber children under 18 in the U.S. by 2034.
• The number of Americans aged 85 and older, who often require the most intensive care, are projected to nearly triple to 18.6 million by 2050.

Investments in physical infrastructure – including modernized elevator systems – are essential to hospital readiness and resiliency. Additionally, new healthcare facilities must be built in suburban areas, often closer to the homes and retirement communities where older Americans live. With 80% of U.S. commercial buildings standing eight stories or fewer, including hospitals and clinics, today’s modern, digitally native elevator systems designed for these low-to-mid-rise environments are well-suited to meet the mobility needs of our aging population.

A Blended Approach to Modernization

The future of healthcare demands a dual strategy: one that marries digital innovation with physical modernization. A truly future-ready health system doesn’t just invest in AI and telehealth; it also ensures that core infrastructure like elevators, escalators, HVAC, and power systems are up to date. Overlooking either side risks creating gaps in care delivery.

While elevators and escalators may not generate the same buzz as robotics or precision medicine, they are essential enablers of those technologies. For example, as hospitals adopt delivery robots to enhance staff efficiency and improve patient care, integrating them with existing elevator systems often requires upgrades. This highlights the broader issue: While healthcare technology is advancing rapidly, much of the physical infrastructure – like elevators – must be modernized to keep pace.

A Defining Moment

Healthcare is not alone in this challenge. Across the world, 8 million of the 22 million installed elevators are at or approaching an age where modernization is recommended, and this number is expected to more than double by the next decade. In the U.S. alone, it would take 40 to 50 years to modernize all elevators in need across the country at our current pace.

While this issue spans industries and global mobility depends on widespread infrastructure transformation, healthcare has one powerful differentiator – modernization of vertical mobility systems can mean the difference between life and death. Digital transformation must be matched by physical upgrades. Preparing for the future means addressing both the rise of technologies and the growing infrastructure demands of an aging population. Ignoring either side puts access to care at risk. Elevators, as vital components of healthcare infrastructure, must be part of the strategy, ensuring that when patients need support, modern elevator systems can keep care moving forward – safely, efficiently and without delay.