The world of health care is changing rapidly, and nowhere is that more apparent than in hospitals, which are tasked with providing critical patient care at lower costs while adhering to numerous and ever-changing state and federal regulations. In order to keep up with these changes, hospitals are relying heavily on their building automation systems (BAS) to do more than just control temperature, humidity, and IAQ.

Administrators are now looking to their BAS to identify opportunities to reduce energy consumption, as well as increase patient safety and satisfaction. As Jim Beam, controls leader, North America, Trane, an Ingersoll Rand brand, noted: “Hospitals need data to help them develop master facility plans that align with their core missions and ideals and help mitigate risk. With hospital administration teams being downsized and their scopes of responsibility being increased, administrators need more key metrics to run their businesses and meet their core mission goals.”

And, often, there is no better place to obtain those key metrics than the BAS.

Changing Needs

New federal regulations are one reason why hospital administrators are looking to their BAS for more help. As Carl Barnard, director of sales, Americas, Distech Controls, noted, regulations are having a significant impact on health care facilities, completely reshaping the way in which facilities receive financial support. “The Hospital Value-Based Purchasing (VBP) initiative rewards hospitals with incentive payments that extend beyond the amount of procedures performed to the actual quality of care they provide to those with Medicare. As a result, health care facilities are addressing the complaints and comfort of patients in order to improve their services, and, ultimately, ratings.”

The goal of the VBP initiative is to transform the quality of hospital care by realigning hospitals’ financial incentives to do so, said Mike Mattox, national account manager, health care, Schneider Electric. “Because of that, we are seeing an elevated focus around patient experience, reduction of health care-associated infections (HAIs), and the ultimate goal of bending the cost curve to provide patient care. These new requirements and goals should impact how we design and install systems and the data that are shared between traditionally disparate infrastructure systems.”

The BAS is the technology enabler that can help hospitals meet these goals, said Mattox. “Better patient experience can be achieved because the BAS allows patients and visitors access to temperature, lighting, entertainment, nurse call, and other low-voltage system settings using a hospital-provided device or patient app. With HAIs, the BAS can monitor the hand hygiene compliance of staff and guests by using inputs and outputs on a VAV [variable air volume] controller. It also has the ability to monitor and trend temperature, pressure, humidity, and air change rates in critical areas, and even tie those values to a specific surgery for data mining and trending of HAIs.”

As for bending the cost curve, “The BAS gives facility managers access to energy data to help establish benchmarks and proactively identify opportunities to reduce energy consumption without compromising IAQ. It also provides the toolset to implement energy-saving control strategies,” said Eugene Shedivy, product leader, BAS systems, Trane.

Implementing these energy management strategies allows administrators to reinvest the savings in the facility’s core mission, said Mattox. “Each dollar saved through energy-efficiency projects correlated to patient revenue is significant because of the thin profit margins for hospitals. On average, $1 saved is the equivalent of $20 in new revenues for hospitals.”

Looking Ahead

With administrators demanding more advanced analytics in order to track key performance indicators and deliver actionable information, it’s a safe bet BAS will continue to evolve to meet those needs.

“Health care administrators will increasingly need access to a specific subset of environmental data,” said Barnard. “In fact, raw data is no longer important, but, instead, intelligent, continuous, and real-time information matters most. BAS users have higher expectations and look for drilled-down details delivered via a dynamic visual representation.”

Barnard also believes health care facilities will start taking advantage of the convergence between building automation systems and IT infrastructure. “With this convergence, the bandwidth will greatly increase for health care facilities, meaning greater access to larger amounts of data. This data can in turn be used very effectively, ensuring health care facilities provide the best environmental experience possible for patients.”

Increased use of wireless solutions is also on the horizon, said Shedivy. “Wireless communication is being leveraged to simplify construction projects, especially when renovating or expanding existing sites. Wireless minimizes installation labor, speeds up construction time, and minimizes the amount of dust and debris created during construction projects. Since wireless solutions can easily be expanded one device at a time, upgrades to existing facilities can be more easily staged with less disruption of facility use. And, with standards from ZigBee Alliance, multiple wireless solutions can be used in the same environment without concern for wireless reliability or security.”

Data storage is another need that will continue to expand as medical providers have to be able to access patient medical history, and facility managers need to access historical building performance and energy data, said Shedivy. “This influx of information will force medical facilities to weigh the pros and cons of internal data storage versus leasing servers in the cloud and to balance security and privacy concerns.”

The trend of doing more with less and driving down operating costs will continue to be a concern going forward, and the BAS can offer solutions, noted Mattox. “A recent energy study by the American Society for Healthcare Engineering (ASHE) found that mechanical systems make up more than 70 percent of energy use in hospitals, with mechanical reheat and cooling consuming more than half. The BAS can help lower energy costs by reducing air changes, fan speeds, and heating and cooling requirements during unoccupied hours, which can play a large role as more procedures are being conducted in an outpatient setting. There are a lot of changes going on in the health care marketplace today, and it’s an exciting time to make a positive impact on health care employees and the patients they care for.”

SIDEBAR: BAS Solutions Fill Health Care Needs

With the growing demand for more data collection in health care facilities, vendors are offering comprehensive building automation systems (BAS) solutions to meet those needs.

Distech Controls offers a completely unified building management system that integrates every building function, ranging from HVAC (mechanical and electrical) to lighting, security, access control, and advanced applications. This unified system allows for improved control and monitoring of health care facilities and enables stakeholders to take action based on concrete real-time information, which leads to improved energy efficiency and reduced operating expenses, said Carl Barnard, director of sales, Americas.

“Our BAS ensures indoor environmental quality (temperature, humidity, pressurization, and air changes) regardless of building, room, or space type, which impacts both clinical outcomes and patient experience. In situations of post-acute treatment, the BAS also offers the option for a personalized patient experience. User-friendly interfaces in private rooms allow additional control over certain parameters such as temperature and lighting, thereby increasing comfort levels.”

The BAS also allows health care facility administrators to manage all of their buildings via one seamless, centralized interface with global and building-functional capabilities, said Barnard. “A unified, personalized energy management dashboard improves visualization of vital building metrics through an easy-to-use application that can be accessible via a browser or a mobile device. In addition, our powerful, real-time reporting and analytics are easily tailored for specific operational and functional needs.”

Schneider Electric’s EcoStruxure Solution for Health Care lowers operating expenses, reduces risk, improves clinical outcomes, and increases patient satisfaction, said Mike Mattox, national account manager, health care. “EcoStruxure is flexible and scalable and uses the latest Web technology and open protocols so it works in all health care facilities. SmartStruxure Lite is a lower-cost solution and is great for retrofit and new outpatient clinics and medical office buildings. SmartStruxure Lite is open and scalable and can integrate HVAC, lighting, and metering, and it can be wired or wireless.”

EcoStruxure’s integrated control platform creates a fully integrated health care facilities infrastructure focused around mechanical systems, electrical systems, information and communications technology systems, and security systems. For larger inpatient hospitals, there are “use cases” in which the infrastructure integration is tied to five key priorities for health care facilities: improved financial performance; improved safety and security for patients, visitors, and staff; simplified regulatory compliance; increased patient satisfaction; and improved staff productivity.

“An example of a use case is integrating the BAS into the hospital’s admission, discharge, and transfer (ADT) system. The business value for this was to improve financial performance using a patient room energy-savings-setback strategy during unoccupied periods,” said Mattox. “After interviewing health care facilities staff we uncovered additional benefits related to improved staff productivity by being able to schedule room maintenance during unoccupied times through a dashboard of available rooms. It also helped increase patient satisfaction because patients were not interrupted while the maintenance team looked for available rooms.”

Trane’s Tracer™ scalable BAS solution provides local control, from the smallest facility to the largest hospital. “Health care system personnel need to manage a variety of building types in diverse locations,” said Eugene Shedivy, product leader, BAS systems, Trane. “There is value in central monitoring and management of these facilities. At the same time, there is a need for local staff interaction and management of smaller remote facilities along with the reliability and simplicity of stand-alone systems in these facilities. These systems can be connected to a central server for monitoring, data gathering, and centralized management while also being accessed locally or remotely with a variety of mobile and other user devices.”

Trane’s BAS reliably maintains environmental conditions for patient and staff comfort and safety and helps lower energy costs without sacrificing performance. “We have been introducing energy-saving strategies — such as partial occupancy and fan optimization in VAV systems, as well as solutions to maintain challenging environmental conditions in surgery suites — with better performance and lower energy costs,” said Shedivy.

The BAS also offers several options to meter energy usage and track performance. “Meter technology is improving, and energy usage — electricity, gas, steam, etc. — as well as water consumption and other critical building performance parameters can be monitored,” said Shedivy. “The cost of energy can be normalized against building parameters and key performance indicators (KPIs) such as energy dollars per registered patient can be calculated and tracked. Just as importantly, critical environment conditions can be monitored, displayed, tracked, and recorded for future validation needs.”

Publication date: 11/3/2014 

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