The combination of people, processes and places require an interdisciplinary approach between medical sciences, information technology, and architecture. The goal is to (re)design and to simulate clinical processes and hospital architecture in a virtual environment (Building Information Model) to increase professionals’ productivity but also the way patients experience the quality of care.

Achieving Smart Hospital Designation

Achieving “smart hospital” status or designation is a high priority, long term goal for new as well as existing hospitals. Naturally, recently completed facilities enjoy a substantial head start and will show the way for their older, peer institutions. However, existing hospitals may also attain a reasonable level of compliance through the purchase and installation of advanced technologies ranging from hard-wired and wireless networks to web-based systems run on personal telephones and hand held devices. Manufacturers will soon conclude that the market for upgrading existing hospitals will be larger than the one for new facilities, and they will quickly reconfigure systems to fill the void for apparatus capable for retrofitting older facilities.

Consequently, the question at hand is two-fold; how to plan and design new facilities having maximum flexibility to incorporate future advances in technologies, but also to find ways to retrofit existing hospitals to become smart hospitals, for the least possible capital cost for new infrastructure and innovative technologies.

Elements of an intelligent hospital

From the viewpoint of planning and design there are three principal physical elements that comprise a smart hospital:

1. Habitable spaces such as waiting areas, examination rooms, and inpatient care bedrooms, interventional rooms and surgeries,

2. the infrastructure of engineering systems, including medical gases, electrical capacity and distribution, as well as heating, ventilation and air conditioning systems (HVAC), and

3. The informational technology architecture or backbone, like secure hard-wired connectivity, wireless intercommunication (Wi-Fi) and “cloud” based storage for easily retrievable data.

The fourth critical component consists of the operational systems, which includes patient registration, billing and communications systems, electronic medical patient records, building information systems and controls, as well as more advanced equipment such as robotic carts for the delivery of linens, supplies and medications.

1. Habitable Spaces

Smart hospital’s purpose is to provide the spaces, systems and resources within which staff may tend to patients, and patients are empowered to participate actively in their recovery, personal care and well-being.

Healthcare providers must improve the patient experience inside their facilities and out through a focus on connectivity, communication and access to information. Architects and designers can create settings that cater to the individualized needs of patients and identify opportunities for staff and administrators that broaden treatment options.

 1.1. Smart Lobby and Information at Intelligent Hospitals

Evidence of a smart hospital may begin at a lobby kiosk where an arriving visitor may be guided to his destination, and an outpatient may register, make clinic appointments, receive messages from care givers, examine his/her electronic medical record and make any

necessary copayments for clinic visits or medications

through a secure information network capable of accessing all hospital systems and departments and extending outward through web-based health care applications to patient telephones and medical devices placed within the home.

1.2. Smart Waiting Areas in Intelligent Hospitals

Waiting areas can also be wired so that patients and visitors may make better use of their time for relaxing programs of choice and/or educational programs about home care and healthier lifestyles. Patients may also tap into Wi-Fi networks and the Internet on their own portable computers or smart phones.

Examination and consultation rooms are outfitted with a large, wall mounted screen to be shared by patients, family and care givers for immediate access to the patient electronic medical record, recent diagnostic tests, explanations about impending procedures and/or educational materials for aftercare.

1.3. Smart Imaging Service Room in an Intelligent Hospital

The most wired area of the hospital, requiring the greatest band width and capacity is the imaging service, within which exists a plethora of diagnostic data to be stored, interpreted and communicated to primary care physicians and specialists (perhaps located miles away), nursing staff and patients, whether at the hospital or home. Augmented reality is a trend across all industries, but it is especially powerful in the healthcare field and can be an outcome of intelligent hospitals.

Operating theaters are the most complex spaces within a hospital, and each should be designed and planned as a “plug and play” element, having the capacity to be taken out of service for repairs or modifications without affecting adjacent operating rooms or the interventional suite as a whole. Such rooms of smart hospitals usually include medical gases, electric power, HVAC and informational technology

2. Engineering Systems and Information Technology Infrastructure:

New hospital facilities must maximize the value of every investment for infrastructural capacity in order to ascertain the selection of state of the art systems throughout the hospital, especially those exhibiting the greatest resiliency for change and capacity to confront unknown future needs.

can you turn your hospital into a smart one?

The initial steps to determine if an existing hospital can support smart technologies and how best to upgrade the hospital consist of an exhaustive, detailed evaluation of current patient care technologies, beginning with the telephone system, nurse call, monitoring equipment and existing technologies to determine their current state of obsolescence as well as their ability to be integrated into a new informational architecture sufficiently robust to integrate an electronic medical record, as well as technologies already in wide use by peer hospitals.

A subsequent step is to evaluate the physical obsolescence of the hospital itself, as to its capacity to deliver a high standard of patient care, ascertain compliance with basic building codes and ensure patient and staff safety, which can be seen in pioneer smart hospitals like the University of Missouri smart health care hospital.

Once a facility is deemed to be reasonably compliant for years or decades to come, only then should the facility be evaluated in detail to accommodate and integrate informational systems improvements necessary for consideration as a smart hospital. Subsequently the two major aspects of cost and feasibility may be reconciled through development of a long range master plan for capital investments for informational technology and infrastructure improvements leading to the status and designation as a smart hospital.