Keeping the Bottom Line Healthy: How Smart Buildings are Changing Healthcare
It’s no secret that technology’s role in healthcare is increasing and evolving with every passing day. From lighting and security systems to patient telemetry and wireless connectivity, low-voltage systems are becoming an integral part of hospital design. Ensuring these systems not only work seamlessly but also integrate at all layers is the key to making buildings smart—for today’s needs and for future advancements.
Healthcare organizations are investing less in mega projects and more on infrastructure and technology (as well as outpatient and physician integration) due to the new requirements of the Affordable Care Act. Many new renovation and expansion projects are experiencing the challenges of interfacing with existing low-voltage infrastructure or implementing entirely new infrastructure. A healthcare provider must consider the cost-benefit analysis of salvaging existing infrastructure or building new infrastructure to accommodate the rapidly advancing technology systems.
Historically, low-voltage systems have been provided by specialty subcontractors that work underneath electrical, mechanical, security, and door subcontractors. These scopes of work are often executed in a silo. However, if these systems are not carefully integrated from the beginning of the project, an influx of low-voltage coordination and clash issues will surface. These late coordination issues typically increase project cost and schedule during installation, commissioning, and turnover. Considering all systems in an MEP-T approach can minimize these clashes and avoid a potential problem later.
Often times, low-voltage subcontractors are interfacing with existing facilities that embody various digital and physical challenges. The digital challenges can be attributed to disparate networks being managed on multiple servers. This inefficient redundancy creates a ripple effect of additional operations cost associated with heating/cooling of extra network gear, numerous software licenses, and maintenance contracts for equipment. Multiple control networks might also exist that are proprietary and thus difficult, if not impossible, to interface new programming. This results in the sub-optimal use of collected information due to multiple sources and management efforts. The physical challenges are typically comprised of accessibility, unorganized, and unmarked cables and outdated technology gear.
Through our project results, we have found that having a smart building low-voltage integrated approach to delivering CSI division 25, 27, and 28 trades can save roughly 8-27 percent, depending on project complexity. Low-voltage systems are becoming an increasingly valuable portion of the overall project budget. Based on 10 healthcare projects across the country, low-voltage accounted for roughly 5-10 percent of the overall budget, so savings are significant.
How to Approach Low-voltage Scopes
For all healthcare organizations beginning new projects, the technology scope should be just as much of a discussion topic in the schematic design phase as the structure and envelope. Facility operators will need time to thoroughly assess their infrastructures, understand evolving and available medical technologies, review technology matrix dependencies, and predict future growth of the facilities.
JE Dunn Smart Building Solutions (SBS) group has taken a fully integrated self-perform approach to incorporating network systems prior to construction commencing. This approach has worked well for Banner Harmony Hospital in Ft. Collins, CO; St. Joseph Catholic Health Initiative Replacement Hospital in Dickinson, ND; Seton Dell Hospital, Austin, TX; CHI/BCM St Luke’s Hospital Houston, TX; and on new projects including UCHealth Hospital, Greeley, CO. All these projects are large-scale hospitals and saw the value in approaching all low-voltage systems in a comprehensive approach.
The project team should properly account for these technology considerations early in the budgeting and construction planning. Early emphasis placed on technology will help vet coordination challenges up front and reduce downstream issues and increased costs. Project teams should also be asking questions related to interoperability for central monitoring and control. It is critical to ensure new technology is both efficient and scalable. By striving for convergence in technology systems, it will generate a lower total cost of ownership for the technology investment. This will ultimately maximize the return on that investment.
Organizations should ensure that construction managers have the proper expertise on technology systems. Extensive expertise and management will better orchestrate this process. Consider integrating all technology scopes under one management source to ensure all systems are being considered throughout each subcontractor scopes of work to eliminate silos. This integrated approach will reduce challenges for both organizations and project teams as well as provide a central point of accountability for the entire technology system.
SIS Case Study: CHI/BCM/ St. Luke’s Hospital – Houston, TX
The CHI/BCM/St. Luke’s hospital is a $93 million hospital buildout of a shelled building, comprising approximately 300,000 square feet of hospital space. The JE Dunn SBS team provided single point of responsibility for preconstruction, installation, project management, integration, and commissioning of tele-data, wireless, building automation system (BAS), fire alarm, security access control, security CCTV, nurse call, and distributed antennae system (DAS) valued at approximately $2.8 million.
On this project, JE Dunn SIS project manager Karl Surdyke identified over (10) items during preconstruction phases in BAS and fire alarm design and changes to the nurse call design, which resulted in savings of more than $340,000, or 12% of the low-voltage contract value. Thanks to this design approach, the team has already identified ways to save $1.3 million of savings when the future Tower #2 is built.