Intro: • Lance Roy started his career in plant maintenance and projects. He has been the technical manager at Mediclinic Victoria for the past 5 years. He is currently completing his

Masters’ degree in Engineering with the subject of his dissertation being: “Hospital Automated Building Management Systems and Alarms”.

• Technology is evolving and business systems and hospital operations in itself are becoming more dependent on computers and communication networks. Converged platforms, new systems and equipment are sold as BMS capable. IP protocol is now the market standard. The possibilities to harness data are endless; the requirement to unlock system efficiencies is no longer optional. Integrated systems are intended to improve optimization, unlock system synergies, reduce time wasted on gathering data, eliminate redundant tasks, improve system response times, reduce deviation (six sigma) and contribute to lean operations by reducing operational costs amongst other things.

• 1. Critical Alarms and risk management: Within this context we examine how a monitoring system and BMS systems are used to reduce risk by monitoring the critical alarm conditions. Examples of these being: electrical mains failure, UPS bypass, LIM faults, fire alarms, panic activation, water failures, low level alarms, transformer and generator parameters, reducing network failure, elevator alarms, medication fridges and cardiac alarms.

• 2. Security and access control Building security systems, access control systems, planning and integration can contribute to effective use of security personnel. We evaluate the functionality available in newer technologies these include: pan tilt and zoom (PTZ), Pixel density and the right application, biometric vs tag systems access codes and cost effective generic options.

• 3. Control system and feedback loops Integration allows a higher level of control leading to optimization of plant performance and improved COPs. A brief overview of a few modern buildings discussed in this paper will show how existing BMS systems harness this technology to minimize maximum demand and economize rejected energy in other building processes.

• 4. ICU and Operating Theatres Patient monitoring devices and traditional infrastructure alarms are rapidly being integrated into a single communication platform. A brief overview of existing technologies and their contribution to better patient care.

• Key Learning Messages/Benefits:

• Harnessing IP technology to contribute to operational success.

• A basic understanding of internet protocol.

• The basics of convergence, integrated platforms and building management systems

LANCE ROY

MEDICLINIC

Defining a Building Management System: A building management system (BMS) is a control system that can be used to monitor and manage the mechanical, electrical and electromechanical services in a facility. Such services can include power, heating, ventilation, air-conditioning, physical access control, pumping stations, elevators and lights. Supports Internet protocols and open standards such as DeviceNET, SOAP, XML, BAC net, Lon WORKS and Mod-

Bus

1. Convergence, Integrated Platforms and Building Management Systems:

A. IP Technology:

A. IP Technology benefits :

Unified / Converged Networks Why? → One platform for management. → Integration of technologies

What would this mean for hospital technology ? 1. IP MATV System: 2. Access Control: 3. IP – Video monitoring systems: 4. OM 4 fibre : ISO 11801 → Accessibility to info → Optimized info flow → Remove duplication → Lower operational costs: admin and TCO

Advantages of Digital Control Systems: 1. Availability of building Data.

2. Improved Control and management HVAC

3. Integration with maintenance schedules: Condition based monitoring.

Smart controllers and Feedback Loops on BMS systems:

Generators

Uninterrupted Power Supplies

Server Rooms, PBX, temperature controllers

Critical Airhandling Units and Fan coil units

Water management

3.Critical Alarms and Risk Management:

Defined Hospital Alarms Conventional Routing Possibilities Smart Alarms

1. Electrical Mains Failure 2. UPS Failure 3. Emergency generator

Alarms 4. Medical Gas 5. HVAC plant alarms 6. Fire detection and

protection systems 7. Cold Chain monitoring 8. Medical Devices

1. Display panels and alarm sounders.

2. GSM notification. 3. Changeover panels.

→ System intelligence → Hierarchical escalation → Smart control systems → Adapt to end users → AI to close the loop → Mobile device

integration: (IOS App specific person on duty)

Case Study: Providence St. Peter Hospital Recent Facility Achievements: 1. Puget Sound Energy granted Providence St. Peter Hospital an energy efficiency grant to recycle its boiler heat, reducing the hot air

released into the atmosphere by 250 degrees. 2. Practice Green health Partner Recognition Award is for health care facilities that have made environmental improvements, and

have a 10 percent recycling rate for their total waste stream. Providence St. Peter Hospital exceeds the benchmark with a 28 percent recycling rate.

3. Making Medicine Mercury Free Award recognizes facilities that have nearly eliminated mercury from their facilities and have made a commitment to continue to be “mercury free.”

4. Energy Star Certified buildings must achieve a rating of 75 or higher and meet current indoor environment standards. Providence St. Peter Hospital’s current rating of 81 ensures achievement of this certification six times running. It is one of seven hospitals in Washington to be granted this certification.

4.Security and Access Control Technology:

Benefits of an integrated solution (IP based systems): 1- Diagnostics and Fault finding 2- Management of Users 3- Integration with Video monitoring systems. 4- Integration with time and attendance devices

ALARM FATIGUE: "By trying to keep patients safe and alerting people to everything that could go wrong, we've actually created this problem," -Marilyn Flack Association for the Advancement of Medical Instrumentation Foundation,

5. Typical ICU and Operating Theatres Alarms: a. Central Station Patient Monitoring b. Gas Alarms c. Aircon System failures d. Pressure indicators for isolation rooms e. Electrical Reticulation line isolation transformers f. Medication cold chain alarms g. Medical Devices

4.Implementation Strategy and Costs:

4.Implementation Strategy and Costs:

Pre-Installation Criteria: Year 1: Year 2: Year 3:

1- Baseline energy evaluation for facility

2- Prioritising facility and business needs.

3- Prioritise facility critical alarms

4- Optimise High energy consumers

5-Network Infrastructure and Links

6- System Optimisation and remodelling to accepted infracture

7- Motivate additional equipment and calculated savings from Year 1 and 2

Rasperry Pi and Arduino Communities: Integrated Processing units WIFI Capable Processing Power Media capability Nurse Call Systems Lighting control Alarm monitors Information display VNC capable

Mobile and Media Interfaces

Building Management Systems: Open Source (Neutral ) VS Proprietary

1_ Local socio economic climate SA. 2_ Supplier dependency 3_ “specialised” provider rates

a) Independence from Specific service Provider. b) Limited only by your database. c) Freedom around your control philosophy. d) Compatibility with 3rd party products.

Summary

Building Management Systems: Integrated Mechanical, Electrical and Electromechanical systems Unified and converged communication platforms Consolidating Databases

Emerging Technologies: Internet Protocol Technolgies Smart and simplified controllers and processers Programming communities

Benefits to Hospital Operations: Instantaneous Data Better decision making criteria Energy efficiency and reliable control systems Advanced diagnostics Asset tracking and performance measurement

Thank You

lance.roy@mediclinic.co.za