In a rapidly evolving world, healthcare is not immune to transformation. Edward McCluskey explores the first of a series of healthcare insights reshaping the landscape of hospital facilities. With patient-centric technology and advanced building services, next-generation hospitals require next-generation MEP designs – and the power to run them.
With growing populations and longer life expectancies, there is a greater emphasis on preventative measures in healthcare and on technology that aids self-diagnosis and treatment. Against that backdrop, hospitals become ever more specialist, deploying technology, data and artificial intelligence (AI) to improve efficiencies and deliver a more user-centric approach.
That transformation to high-tech facilities brings implications for equipment, power demand and building services. And like their cousins in the high-tech sector, healthcare buildings face the challenge of increasing energy demands – at a time when operators are under pressure from governments and shareholders to slash their carbon footprints.
The design of mechanical, electrical, plumbing and heating (MEPH) packages becomes central and crucial to the overall design. Currently, MEPH packages account for around 40% of a hospital build cost but that is set to rise. For inspiration, we can look to builds such as data centres where MEPH can account for up to 70% of the construction cost.
Hospitals and healthcare facilities will look and feel very different to those of today, with a remit to calm and heal through their environments. Patients will access information about their medication and treatment, order meals or change the temperature of their room via handheld devices. Nurses will monitor patients remotely with automatic alerts set up according to medical needs and conditions.
Lighting will be adaptive, perhaps mimicking circadian rhythms to aid healing. Heating and ventilation systems will be automated and reactive too. The more sophisticated hospitals become, the cleverer the building management systems must be.
The greater demand on building services and increased use of specialist equipment and technology will drive higher energy consumption. And hospitals are already heavy users. In the US, healthcare buildings account for 8.5% of carbon emissions, while in the UK public sector National Health Service (NHS) buildings account for 4% of the country’s carbon emissions.
This rising demand for energy comes at a time when governments are targeting the healthcare sector to cut carbon emissions. The US’s Health Sector Climate Pledge asks healthcare providers to sign up to achieving a 50% cut in carbon by 2030 compared to a 2008 baseline and net zero by 2050. In the UK, the NHS has committed to reaching net zero for emissions it directly controls by 2040 and for all emissions it can influence by 2045.
Power, or rather the lack of it, is driving development decisions in many areas of the world. Just as burgeoning data centre markets – such as Querétaro, Frankfurt or Northern Virginia – are being constrained by a lack of power, so hospitals in some parts of the world are facing the same hurdles.
To tackle both power shortages and the need to decarbonise, some hospital operators are already looking to renewable energy, with measures such as photovoltaic panels, and combined heat and power plants. But there are limits as to how much energy can be generated on site, since electricity networks are not yet set up to provide the required capacity for storage and redistribution.
In moves that mirror similar ones in the data centre sector, some hospitals are deploying power purchase agreements (PPA) where energy suppliers set up renewable energy generation on the healthcare facility site, with the healthcare providers agreeing to buy energy from that provider for a set number of years. For instance, in Australia Nexus Hospitals is part of a consortium which has signed a PPA with Origin Energy which will see its New South Wales and Victoria hospitals 100% powered by renewable energy. Signature Healthcare signed a 25-year PPA with Siemens for a hospital in Massachusetts, US, which will see Siemens install and operate an energy system comprising solar panels, a battery energy storage system (BESS) and microgrid control.
Standardisation and flexibility?
With demand for hospitals and healthcare facilities ramping up fast, standardisation has a role to play, whether that is through a toolbox of products and details or through pre-designed components such as treatment areas, operating theatres or wards.
Hand-in-hand with component-led design – or design for manufacture – comes the need for building information modelling (BIM) so that healthcare facilities can be virtually assembled earlier in the design process. Given the growing complexity of MEP services, the ability to accurately plot out positions and runs and to avoid clashes in 3D becomes ever more vital. BIM could have an important role to play in refurbishment projects too, not only in designing and locating new building services but in effectively reconfiguring the space to suit new service delivery models and equipment.
Looking further ahead, next-dimension digital twins will help to map out how both healthcare services and the buildings involved in those services could work together, focusing on the needs and experiences of the user. Digital twins can also be a powerful tool for reducing carbon emissions and operating costs. For instance, Soben, in partnership with IES, is deploying digital twin technology to help customers in the data centre, healthcare and other sectors map out the roads to net zero. By using data from its real-world twin, the digital version can help uncover new operational and procurement strategies to reduce carbon emissions.
One certainty for next-generation healthcare design is the uncertainty of technological progress. Just as in the high-tech sector, the ability to reconfigure spaces and swap in new equipment as technology evolves will be vital. Standardisation of components or units so that they can be assembled off-site and more quickly installed in the place of older ones can also be useful – an approach currently being deployed by some data centres operators to upgrade processing performance to meet increased demand.
The flip side is that building in space for flexibility means building in cost. And here, there is a balance to be achieved. With so many healthcare facilities required, there can be a temptation to reduce the size of spaces due to budgetary constraints. But a longer-term view might find that adding cost now to enable flexibility later is a better approach.
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To find out more about Soben’s specialist services in EMEA you can contact Edward on the details below:
Director – EMEA