In addition to its attractive design, the building also demonstrated examples of modernized engineering (for the time). For instance, pile foundations comprised of steel and concrete footings were driven well below the waterline of the Providence River. As well, the building including an elaborate ventilation system, which drew in fresh air from the roof of the building, filtered it through a spray chamber to remove dust, dried it chemically and then sent it through the heating stack.
Along with its novel, historic architecture, its original tenant enjoys historical value, too. Providence recognized during the late 1850s a need for a large, well-staffed hospital. As a result, the town chartered the Rhode Island Hospital in 1863, partially funded by local donations dating back to 1857. And, despite the U.S. Civil War forcing delays in construction, the hospital opened its doors in 1868. During the lengthy construction process, it became increasingly apparent that there was a need for proper administration and financial management. Thus, in 1867, the Rhode Island Hospital Trust Company was organized.
The Trust company started small, operating in rented rooms, but gradually took on other commercial banking functions as a way to aid the hospital and to invite citizen depositors and shareholders. As the company grew, a building became necessary (and desired), which resulted in the eventual construction of the now-historic Rhode Island Hospital Trust Building.
In 2004, the Rhode Island School of Design (RISD) purchased the building and began a renovation project that finished in 2005. Ten floors are used for student housing, dining, and activities while the lower levels are home to the RISD Fleet Library.