WHITEPAPER: HEALTHCARE AND BUILDINGS

Accelerating the
digital transformation
of hospital​s
A fast-changing environment I Smart hospitals
1 World Health Organization, Health
workforce, accessed on Jun 13, 2022,
https://www.who.int/health-topics/
health-workforce#tab=tab_1
2 Centers for Medicare & Medicaid
Services, NHE Fact Sheet, accessed on
Jun 13, 2022, https://www.cms.gov/
Research-Statistics-Data-and-Systems/
Statistics-Trends-and-Reports/National-
HealthExpendData/
NHE-Fact-Sheet#:~:text=Historical%20
NHE%2C%202020%3A,20%20
percent%20of%20total%20NHE.
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A fast-changing
environment –
the perfect storm
An aging population is driving growth in demand for
healthcare services. This is being met by a shortage of
staff, with more people leaving the medical profession.
In addition, patients’ expectations have also increased.
The healthcare sector is caught in a perfect storm. An aging population is driving
exponential growth in demand for healthcare services. This trend is already well
underway and is expected to continue in the coming decades. Normally, a business
would increase its human and financial resources to deal with the increased
demand. However, for healthcare providers this is not an option. Regarding staff,
there is already a shortage, and the high workload from the pandemic has only
led to more professionals leaving the medical field. The World Health Organization
expects a staff shortfall of 18 million health workers by 20301. On the financial
side, increasing budgets is very challenging, since most developed countries
already spend more than 10% of their GDP on healthcare. For example, in the
United States 19.7% of GDP went to healthcare in 20202.
 Smart hospitals I A fast-changing environment

Beside higher demand, patients’ expectations have also increased. As consumers

we have become accustomed to using apps to find information, book travel,
buy things, and stay connected with friends and family. Patients have similar
expectations when it comes to healthcare, such as to schedule appointments and
get online consultation on a condition. In clinics and hospitals, they want to use
apps to provide food preferences, upgrade a room, obtain details of a treatment
schedule, and more.

A perfect storm: Challenges facing the healthcare sector

Staff shortage
Deficit of 18 million health
workers worldwide by 2030

Cost pressure
Developed 
countries spend
more than 10% 
of their GDP on
Aging population healthcare services
Exponential increase in Healthcare
demand for healthcare sector
services

Climate change
4.4% of worldwide CO²
emissions come from
the healthcare sector
Consumerism
Patients expect the
comfort and convenience
­digitalization can offer

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Doing more with less I Smart hospitals

Smart hospitals:
Doing more with less
The healthcare sector has to adapt quickly to a
fast-changing world. The need for smart hospitals
that can do more with fewer resources is evident.

The healthcare sector needs to adapt quickly to this fast-changing world. Facilities
have to do more with less. The key term here is resource efficiency. On the one
hand, this means focusing on building performance. In this regard it’s mostly about
reducing energy and maintenance costs, but also increasing the utilization of
available floorspace. On the other hand, staff must become more efficient. The
driving questions here are: How can clinical staff be supported to produce better
and faster outcomes? How can the administrative workload be reduced? What
steps can be taken to ensure that equipment can be found quickly? When it comes
to technical and facility staff, the focus is on reducing the time needed for repairs
and creating synergies when managing multiple buildings.

Efficiency

Building Risk Staff

efficiency mitigation efficiency

This emphasis on efficiency also puts the spotlight on mitigating risks that hinder
workflows. For instance, power outages, hospital-acquired infections, aggression
to staff, or falling patients.

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 Smart hospitals I Doing more with less

The need for smart hospitals that can do more with fewer resources is evident.
More and more healthcare facilities are addressing these challenges with a culture
of data-driven decision-making. Digitalization is broadly accepted as the enabler to
tackle the challenges and stay competitive. For 75% of companies, digitalization is
viewed as a key driver of change processes in buildings3. But uncertainty and lagging 3 ZIA, ZIA-CREM-Studie 2020 - Die Rolle
der öffentlichen Hand in der immobilien-
experience are behind many requests for advice and simplified implementation. wirtschaftlichen Transformation
deutscher Unternehmen, accessed on
June 13, 2022, https://zia-deutschland.
A large number of different systems results in a major lack of useful and reliable de/wp-content/uploads/2021/
05/200924-WP40_ZIA-CREM-
information. OT and IT are often two different worlds, which are not or only very Studie-2020.pdf

limitedly connected with each other.

What are the hurdles?

• (Cyber)security concerns
• Lack of collaboration between OT and IT
• Complex, heterogeneous environments
• Old and unconnected infrastructure
• Many different facilities spread over a campus, region, or country
• Many stakeholders and the time required to assess their needs and use
cases and establish good cross-collaboration
• Tender processes that often split the scope of projects and consequently
make it difficult to keep the total cost of ownership in view
• Unfamiliarity with new technology and best practices from around the world

These hurdles often result in lower investments in smart solutions because it is

unclear how to implement them. In other cases, investments have a disappointing
return due to improper implementation. Furthermore, the infrastructure in many
new facilities is the same as in those that were built 10 to 15 years ago.

Even though healthcare facilities have a focus on

efficiency and becoming smart, many newly
constructed buildings are ‘copy-and-paste’ facilities
that have the same efficiency of those of the past.
Job Kamphuis, Global Head Healthcare Market

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Accelerating I Smart hospitals

Accelerating your smart hospital

What needs to change to make hospitals smarter?
To answer this question, it is important to understand the two main components of what
makes a hospital smart from a building-infrastructure perspective:

1. One common data environment (CDE) through the integration of systems and bringing
data from these systems together in a data lake

2. Ecosystem of applications tailored to different stakeholders to maximize data value

1. One common data environment

Regarding infrastructure, the main difference between smart hospitals and
conventional hospitals is the level of system integration. Most infrastructure
components (for example, HVAC, fire detection, elevators, medical gas systems,
tube mail systems, etc.) are already present in conventional hospitals. The
difference in a smart hospital is in how these systems are integrated and can
act as one. The following example shows why this makes a huge difference.

Code blue: Smart hospitals respond to events taking place

inside the facility. In many code blue situations, the patient
needs to be transported to the operating room as fast as
possible.

Emergency
department

1) Smart hospitals can track the location of the team transporting the patient,
for example, from the emergency department to the operation room (OR).
2) To save valuable time, doors that are normally locked open automatically
as the team approaches.
3) An elevator is automatically reserved and waits for the team. It then goes
without stopping to the floor where the OR is located; the elevator disregards
buttons being pressed by other people.
4) The OR is switched automatically to fully operational mode. This ensures that
the team can start the procedure right away without wasting time.

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 Smart hospitals I Accelerating

In this code blue use case, real-time location services (RTLS), access control, elevators,
lighting, and HVAC systems all work together. In a conventional hospital where
these systems are running in an isolated setup, this use case would not be possible.

This is just one example of an automated and optimized workflow. There are
numerous workflows where systems need to collaborate to ensure maximum
support and efficiency for patients and staff. This can be for use cases relating
to safety, security, power resiliency, and sustainability. Another example of an
optimized workflow is shown below:

Asset tracking: Nurses spend around 72 minutes per shift

looking for equipment. The utilization rate of mobile medical
equipment is less than 40%, and around 10% is lost or stolen.
To optimize the usage of medical equipment, smart hospitals
implement asset tracking.

Patient room Storage room Maintenance Used devices in

Storage
department the storage room
room

Broken

Storage
room

1) The nurse is at the patient’s bedside and sees that a monitor is needed.
The nurse’s tablet or smartphone shows where the nearest available monitor
is located.
2) When arriving in the storage room, the nurse sees that one of the four monitors
needs maintenance and triggers a work order in the computerized maintenance
management system (CCMS). The nurse takes another monitor and returns to
the patient.
3) The technical team knows the location of the broken device and has a short
description of what seems to not be working.
4) At this point there are only two functioning monitors in the storage room.
However, the department has specified that there should always be three
or more devices available. The real-time location services (RTLS) system detects
this and triggers an automatic work order to the facilities team to clean and
disinfect the monitor the nurse just used and return it to the storage room.

HOW CAN WE MAKE THE WORLD MORE RESILIENT? 7

Accelerating I Smart hospitals

Smart hospital

In this example, multiple systems also work together to provide a seamless

MED
workflow for different staff members. Data from medical, IT, and OT systems
is combined. Next-generation smart hospitals will include all three technology
OT IT
components (medical, IT, and OT) into one platform to address complex use
cases with a high return on investment.

By combining these data sources, conventional hospitals will evolve into

self-adaptive smart hospitals.

The path to becoming a Traditional Automated Smart Self-adaptive

self-adaptive smart hospital hospital hospital hospital smart hospital

The Ankara City Hospital in Turkey is proof that this approach to integration is
scalable for very large facilities. The impressive hospital campus covers a floor
area of 1.3 million square meters and currently has more than 4,000 beds and
131 operating rooms. All infrastructure systems are integrated into one common
data environment as shown on the next page.

In the Ankara City Hospital one single management platform, Desigo CC, monitors
and controls 22 hospital subsystems with more than 800,000 data points coming
from among others energy supply, fire protection, HVAC, lightning, access control,
and CCTV. This approach to integration is scalable from small facilities to very large
ones – as well as to facilities spread out over a region.

2. Ecosystem of applications tailored to different stakeholders to

maximize data value

When data is collected in a common data environment (CDE), it is important

to leverage as much value out of that data as possible. How? By providing an
ecosystem of applications tailored to the needs of different hospital stakeholders.

No organization can offer know-how and applications for all stakeholders.

For that reason, a successful ecosystem includes applications from different
providers. Should hospital staff want to build their own applications or dashboards,
it is important to have a low-code environment that enables them to do so.

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 Desigo CC

HVAC Access HIMS SCADA Parking

Energy
H
Help desk billing Helipad
Lighting Fuel tank

Emergency
Surgery Tube mail Telemedicine Generator lighting
control panel master panel

Infant
CCTV protection Trigen Medical gas
Isolation master panel
transformation

Network Energy NTP server

analyzer
PBX

Elevators Jet fan

RTU
Medical gas

Fire
Operation
lamp PLC

Announce
Circuit
breaker

Integration of all Nurse call

infrastructure systems Relays
on one platform at the
Ankara City Hospital

PBX
Integration effort

Traditional monolithic
Solution 1 Solution 2 Solution 3 Solution 4
software architecture

Cloud-based SaaS with

Effort

modularized functionality
3rd
party and APIs

Micro services

Holistic cybersecurity concept

Often software applications are large and operate on a standalone basis. Many
features go unused. Smart hospitals use micro services that offer tailored solutions
for different stakeholders. This way, only applications that have a clear return
on investment are being used. Also, third-party applications run in the same
cloud-based environment and use or share data from the common data environment.

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Siemens Xcelerator I Smart hospitals
With Siemens Xcelerator,
hospital staff is able to easily
create their own applications
or dashboards.
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Siemens Xcelerator
Siemens Xcelerator provides the perfect environment
to create smart hospitals. It is characterized by the
following principles:
• Easy: It is easy to integrate different systems into one common data
environment. Integration in the past could be difficult and costly. But with
Siemens Xcelerator, system integration is greatly simplified. When data is
brought together in a common data environment, it can be used in different
applications and in low-code environments. Hospital staff is able to easily create
their own applications or dashboards.
• Open: Siemens Xcelerator is an open environment that enables the integration
of systems from other vendors and from different generations. This is crucial for
any hospital that operates equipment from a range of vendors and time periods.
The data from all these systems belongs to the hospital. Siemens Xcelerator
draws value from this data to be used in any application – either by the hospital
itself or by appointed organizations.
• Flexible: Technology keeps evolving and the systems that are state of the art
today will be replaced by newer technology just a few years down the road. To
make sure that investments in infrastructure pay off, it is important to have a
flexible approach by which new and existing technologies can work together
seamlessly. Whether applications are used by medical or technical staff, they
should offer a seamless experience. Users should not notice any differences in
the data source, for example, if it is from older or newer technology. Further-
more, the applications should work together and be modular. This eliminates the
need to buy large software packages consisting of many features that are hardly
used. Smaller applications or micro services are available in the cloud and users
can easily subscribe and unsubscribe according to their needs.
 Smart hospitals I Siemens Xcelerator

Digital world (IT) Digital

services

Asset Analytics 130+

management use cases

With
API API Siemens
"Today" Xcelerator

Real world (OT)

Data from medical, IT, and OT
systems is brought together
and employed to optimize the
patient's journey.

Data from medical, IT, and OT is brought together and employed to optimize the
patient’s journey, staff efficiency, and other workflows in hospitals. An approach
that focuses on ease, openness, and flexibility allows smart hospitals to connect
applications in such a way that the patient, visitor, or staff member has a seamless
experience.

The effect of consolidating data can be compared to the seamless user experience
with smartphones.

An integrated device Less integration effort and the

like a smartphone paves convergence of OT and IT open the
the way for additional door to digital services that address
services and is less the challenges of today and tomorrow.
expensive.

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Siemens Xcelerator I Smart hospitals

The smart hospital approach focuses

on ease, openness, and flexibility for
a seamless experience.

Smart hospitals value the easy, open, and flexible

approach that Siemens Xcelerator offers them.
Siemens Xcelerator enables us to deliver:
• More efficient hospitals: Hospitals are more intelligent and better able to
manage their resources and how they are used. The effect is an environment
that makes life better for staff and patients.
• Spaces that maximize productivity: Spaces are created where data provides
insights that help adjust conditions and operations, thereby allowing people to
work more effectively.
• Flexible spaces: Sensors monitor room usage and automation to ensure every
building can adapt to the changing needs of operations, staff, and patients.
• Transparent operations: Data provides transparency in costs, building
­performance, and delivered services.
• Compliant spaces: Hospitals meet regulations set out by the government and
authorities.
• Safe places: Systems help to prevent unauthorized access, track at-risk patients,
and prevent and manage dangerous situations. The effect is improved security
for staff, patients, buildings, and property.
• Environments that support healing: Environments where optimal conditions
are maintained in critical treatment areas provide patients with the best possible
opportunity to heal.
• More sustainable energy: Systems help hospitals to maximize the use of
energy from renewable and local sources. This brings benefits for the
­environment as well as significant cost savings.
• Reliable energy: Hospitals receive the reliable energy supply they need to run
effectively and best support patient recovery.

Our vision is for an effortless, human-centric experience that drives patient outcomes
and staff productivity by enabling enhanced interactions between staff, patients,
visitors, and healthcare facilities. At the same time, we help increase revenues with
efficient space and energy management. Siemens Xcelerator delivers that vision by
accelerating your hospital's digital transformation.

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 Smart hospitals I Siemens Xcelerator

Our vision is for an effortless,

human-centric experience that drives
patient outcomes and staff productivity.

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Published by
Siemens Switzerland Ltd.
Smart Infrastructure
Global Headquarters
Theilerstrasse 1a
6300 Zug
Switzerland
Tel +41 58 724 24 24
For the U.S. published by
Siemens Industry Inc.
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Suite 450
Alpharetta, GA 30005
United States

Subject to changes and errors. The information given in this docu-

ment only contains general descriptions and/or performance features
which may not always specifically reflect those described, or which
may undergo modification in the course of further development of
the products. The requested performance features are binding only
when they are expressly agreed upon in the concluded contract.
© Siemens 2022