The Overlooked Price of Healthcare Digitalisation

The Overlooked Price of Healthcare Digitalisation Power management continuing to be a big challenge Technologies such as analytics and advanced diagnostic machines have accelerated advances in care and treatment while emphasising the central role of power management and quality. Now with the need to be able to scale operations in a matter of days, there is increased pressure on connected, always-on hospitals and clinics to get this right and avoid catastrophic downtimes.

Rich Farrell, Director, Cloud & Data Centre Segment, Electrical Sector, APAC, Eaton

The hospital environment today has changed significantly in the last two decades with research and technological innovations advancing patient care and treatment. However, the perennial expectation of doing more with less remains, exacerbated by a myriad of challenges faced by today’s healthcare systems. Even before the emergence of COVID-19, the rapidly ageing populations1 in many developed economies and a crippling healthcare worker shortage2 were already creating big challenges for hospitals worldwide.

To address these difficulties, hospitals have turned to digitalisation to identify a range of feasible solutions with technology and data being applied across an array of functions to support hospital operations and cope with

1 https://www.who.int/news-room/fact-sheets/detail/ageingand-health 2 https://www.who.int/health-topics/healthworkforce#tab=tab_1 today’s challenges. For example, the use of analytics in diagnostics and wearables for remote patient monitoring helps augment healthcare workers’ capabilities and reduce hospitals’ reliance on manpower to complete manual tasks. However, this growing adoption and reliance on data, connectivity and critical machines comes at an oftenoverlooked cost-an increasing energy demand.

The modern hospital is already notorious for consuming significantly higher amounts of energy compared to other building types due to their diverse needs. On top of the lighting, cooling, ventilation and heating needed to support hospital operations, the constant movement of thousands of staff, patients and visitors, and the need to remain open 24X7, all make it challenging to keep energy consumption levels low. What will a comprehensive power management approach look like for tomorrow’s hospitals?

What are some of the new factors influencing energy demand, and what will their impact be on an already crowded power grid?

More critical technologies mean more critical power is needed

Hospitals are a key component in the fabric of every community and are typically regarded as places of safety, especially in times of disaster or emergency. It is thus unthinkable to imagine a hospital without power, especially one that relies on a multitude of machines, sensors and systems to meet patient needs. Yet, it is the constant addition of such equipment and services to accommodate new patient needs and increasing dependence on modern technology that adds complexity, difficulty and cost to building a stable, reliable power system.

No matter the duration, it will be devastating if ventilators, surgery room equipment and intelligent monitoring equipment were to experience a power outage. To support critical life safety equipment, healthcare facilities need to be prepared with solutions that can navigate unavoidable outages, both temporary and extended. Not doing so would force them to make painful decisions about which systems to keep online and which to let go in times of power outages. Even extremely short power outages of a few seconds can compromise the health of individual patients and damage sensitive medical equipment and IT systems. For example, expensive hardware such as Magnetic Resonance Imaging (MRI) and Computer Tomography (CT) scanning equipment, are particularly sensitive to small disruptions in power quality which can trigger malfunctions that might even pose a danger to both staff and patients. With this heightened sensitivity to electrical disruptions, hospitals need to take extra precautions to protect modern IT equipment to avoid unnecessary safety risks.

At the same time, critical IT systems responsible for access and sharing of data also require critical power to keep running. Should the system fail, the inability to access test results or digitalised patient records can lead to an incomplete diagnosis or gaps in treatment. On the administrative end of hospital operations, limited connectivity to cloud-based platforms such as insurance policy databases or billing systems can slow down processes significantly.

These increasingly complex power demands, together with the volatility of power grids and the growing frequency of weather-related power blackouts3 are emphasising the importance of investing in the right infrastructure to keep many of these mission-critical systems up and running.

Hospitals and the Internet of Everything

While critical power may be key to keeping important machines and systems up and running, their heavy reliance on connectivity and networking adds another layer to the complicated power puzzle. Smart hospitals4 today run on the free-flow of data and interconnectivity of networks and devices, which help enhance patient care and streamline operations. For instance, Thailand’s Ministry of Digital Economy and Society is trailing 5G technology at Bangkok’s Siriraj Public Hospital to relieve network congestion5 and deploy unmanned vehicles6 for the contactless distribution of medical supplies within the hospital. Meanwhile, machine

3 https://www.climatecentral.org/news/weather-relatedblackouts-doubled-since-2003-report-17281 4 https://www.enisa.europa.eu/publications/cyber-securityand-resilience-for-smart-hospitals/at_download/fullReport# :~:text=%25E2%2580%259CA%2520smart%2520hosp ital%2520is%2520a,procedures%2520and%2520introd uce%2520new%2520capabilities%25E2%2580%259D 5 https://www.khaosodenglish.com/news/2020/04/16/ siriraj-hospital-teams-up-with-huawei-adopts-5g-tech-tofight-covid-19/ 6 https://www.bangkokpost.com/thailand/pr/1941024/ nbtc-joins-forces-with-siriraj-hospital-and-huawei learning algorithms around the world are helping doctors analyse thousands of medical images7 to identify patterns and abnormalities faster and more accurately than ever.

The adoption of such technologies helps address many hospitals’ overarching challenge of maximising available resources while simultaneously reducing the workload on an already overstretched workforce. Yet many of these capabilities will no longer be available without a resilient power infrastructure to keep networking and communications equipment, and data centres up and running. The growing dependence on power to ensure constant interconnectivity reflects the growing prominence of the data centre as the hospital’s ‘traffic control’ centre. Even the slightest outage can cause the complex, highly-integrated machine that is the modern digital hospital to fall into disarray.

Scalability in the new VUCA normal

One of the many major lessons learnt from COVID-19 is the need for hospitals to be able to scale up and down quickly to meet the demands posed by such health crises, especially as hospitals around the world brace for the multiple waves of infections in the coming weeks. With Volatility, Uncertainty, Complexity and Ambiguity (VUCA) becoming the new, everyday state of play and pandemics such as COVID-19 likely to happen more frequently8, hospitals will need to have the right infrastructure in place to be able to respond swiftly and effectively. The challenge is a complex one, requiring many moving parts and supply chains to be carefully coordinated, and any delays could result in serious consequences.

From a power management perspective, hospitals will need to cater to a sudden increase in power load

7 https://www.zdnet.com/article/fujitsu-and-tokyo-shinagawa-hospital-to-develop-ai-for-covid-19-pneumoniadiagnosis/ 8 https://www.bbc.com/news/science-environment-52775386

for additional monitoring devices, diagnostic machines, connectivity, and other equipment that is needed to manage a sudden influx of patients. In our recent experience with setting up field hospitals in Wuhan earlier this year, establishing a fast and stable connection to utility power is the key to getting things up and running in a matter of days. With more than 20,000 infections in Wuhan9, hospitals had to scramble to set up makeshift facilities to treat patients. Just as in regular hospitals, field operations also need to rely on the same critical equipment and reliable networking communications to coordinate information sharing and respond effectively. CT scanners and other diagnostic imaging equipment still require the same circuit protection and downtime needs to be avoided at all cost.

With COVID-19 and other potential pandemics being increasingly difficult to predict and manage, this ability to deliver the same standard of comprehensive care regardless of location will be important in slowing down the spread of diseases and delivering effective treatment. Moving forward, power management and infrastructure will be a critical component of every hospital’s emergency and pandemic preparedness plans.

Getting the strategy right

While there is no panacea for hospitals’ power management woes, many of these challenges can be managed effectively with the right technology, maintenance strategy and a good understanding of local regulations.

Start by assessing your current power management infrastructure and back-up power resources to determine if sufficient resources are in place to support your existing IT load. If blackouts or disruptions are unavoidable, check your current Uninterruptible Power Supply

9 https://www.theguardian.com/world/2020/feb/04/ new-1000-bed-wuhan-hospital-takes-its-first-coronaviruspatients (UPS) solution to determine if it meets your back-up power requirements. A UPS is essential to keep data centres up and running, by adding a layer of protection to shield critical loads from power supply issues. Consider looking into newer battery technologies for your UPS, such as lithium-ion systems, which not only offer longer life cycles and better reliability but are also smaller and lighter. Having a robust back-up power strategy in place will protect highly sensitive medical equipment and critical networks, giving you sufficient time to quickly address any issues or power downtime safely. Other longer-term solutions such as microgrids can play an even bigger role in keeping hospitals functioning in the event of severe natural disasters while also helping to manage fluctuations that come with adopting renewables. Even then, IT teams should always have data backed up in an off-site location to ensure critical information is never lost as an added level of insurance.

Once the right technology is in place, maintenance has to take on a more preventative and collaborative approach as well. Working closely with trusted suppliers and communicating openly about requirements is critical as no two set-ups are identical. As a start, hospitals should set up a regular service arrangement that focuses on keeping power management equipment running at its best, and not simply as needed. Testing, while sometimes a hassle, should also be done regularly to ensure systems work as they should when activated. If available, leverage predictive analytics solutions to identify issues before they become problems to help save additional maintenance costs and enable you to optimise your set-up.

Finally, hospitals should always ensure that local regulations are adhered to when it comes to configuring your power management infrastructure. Such requirements are not just for ticking boxes off a compliance checklist but are also in place to ensure the safety of staff and patients. Doing so not just requires procuring the right technologies, but also making sure that the technical teams within the hospital receive the right training and can deal with issues promptly when they arise. Guidelines and regulations for power management sometimes also set benchmarks for sustainability, which can be useful references for hospitals looking to achieve emissions or renewables targets.

Looking ahead

Hospitals need to recognise that power management is an ongoing journey and one which constantly requires regular reassessment and adjustments. To tap on the full potential of emerging technologies, networking and data, a comprehensive foundation in power management must first be laid to avoid any dangerous missteps. If these technologies and systems are not integrated or supported well, they may start to compete for bandwidth and increase the volatility of the grid. Intermittent power disruptions may then become a regular challenge, hindering day-to-day operations and possibly impacting patient care. Thus, the value of investing in reliable power protection to support healthcare digitalisation cannot be understated. Hospitals, now more than ever, will have to take stock of their power management tools and be mindful of these additional factors in the rush to embrace digitalisation.

AUTHOR BIO

Rich is a technology evangelist, strategist & consultant with over 20 years of experience in the IT, Data Centre, and Hyperscale Cloud space. In his current role at Eaton, he collaborates with customers across the Asia-Pacific region to shape their cloud strategy and advises on data centre build best practice and industry innovations.