POWAY -- Architects on Tuesday led Palomar Pomerado Health officials through a virtual tour of the Palomar Medical Center West planned for western Escondido.

The designs they presented to the hospital district's board of directors and Strategic Planning Committee at Pomerado Hospital combined elements of a resort hotel, a conservatory garden and a modern, 453-bed hospital.

"From the beginning, this has been about creating a garden hospital out of a vertical building," said Dennis McFadden of CO Architects, the San Francisco firm that is working with the district to design the $691 million medical center.

Palomar Pomerado officials said they are planning to begin moving dirt in April at the 52-acre Escondido Research and Technology Center site near Vineyard Avenue.

Construction of the foundations could begin by January, if the district's cooperation with the state agency that reviews hospital plans goes smoothly, they said.

Voters endorsed the project in 2004 when they passed a bond measure that raises $496 million for a master plan that also includes an expansion of Pomerado Hospital and several new satellite medical centers.

The Office of Statewide Health Planning and Development agreed last week to use Palomar Medical Center West as a test case for a new process that could shave several months off the usual two-year approval time for hospital plans.

"Instead of being nose to tail, we will be working side by side," said the district's head of facilities planning, Mike Shanahan.

He proudly announced that the computer-aided design firm Autodesk recently gave the Palomar Medical Center West project an innovation award, apparently beating out New York City's Freedom Tower to be built at the site of the former World Trade Center.

The basic structural designs of the hospital are almost complete, Shanahan said.

He said the firms that will supply the steel, electrical wiring and plumbing have been selected after a bidding process: Herrick Steel, Berg Electric and University Mechanical, respectively.

But Palomar Pomerado officials continued Tuesday to discuss furniture, shelves and lighting in patient rooms and hallways and signs around the campus.

Presenting the latest designs to the board, architect McFadden said the lines of the two rectangles making up the hospital's main building will be softened by cascading gardens and metal sunscreens.

Nurses and doctors could confer at desk areas at each end of the main building that would be surrounded by glass walls allowing natural light.

Upon entering, visitors could encounter touch screens and computer stations that will print out directions to the appropriate part of the hospital, sign and navigation consultant Bob Guerin said.

Guerin proposed that the buildings have simple number-letter designations such as 1E rather than long names.

He showed a video of a man controlling a wall-sized graphic screen with hand gestures and suggested that patients or their relatives could use the screens to learn more about their treatments at the hospital library.

"This is great, if it works," said board President Marcelo Rivera, who asked his colleagues if they were comfortable with possible costly proposals to have such advanced technology rather than more utilitarian designs.

Board member Alan Larson said some patients may find computers "scary" and could want more of a human touch.

Members debated the color scheme, which some said they thought looked too grey or could give neighbors a headache.

Rivera said he wanted an architectural "signature" that could define the skyline of North County and be visible from an airplane.

"I'm not seeing it yet," he said.

Contact staff writer Quinn Eastman at (760) 740-5412 or qeastman@nctimes.com. Comment at nctimes.com.