Photo: Ivan Brodey
23.01.2018 / Alvin Wehn
Large data algorithms are seeking to solve the cancer conundrum and doctors and nurses are abandoning paperwork in favour of smart tablets. With the help of new technology, societies are setting new goals as to how they plan and build the future of health care. So what is the key to the future of hospitals?
Entering the doors of one of Norway's newest hospitals, Nye Østfold Sykehus, you might think for a moment that you are entering an airport.
Before you "depart" to your doctor's appointment, you register at the digital check-in counter where you receive detailed information about where to go and how to get there.
When your appointment is finalised, the doctor updates your digital medical record, allowing you to get a full overview of your available health data, as well as information about who has been accessing your information.
It was not always like this.
Many of today's hospitals were built in the 50's and 60's, long before our smartphones assisted us throughout the day.
At the same time, the population is growing older; in 2016, the Business Insider reported that globally by 2020, adults over the age of 65 will outnumber children under the age of 5.
This shift in age demographics drives the need to invest in more efficient and reliable health care.
Norway is among the countries aiming to meet these needs, with 750 million NOK being invested in hospitals every month until 2020. The ambition is to meet the needs of digitalisation, modernisation and increasing the capacity.
Health care is changing, and so are our hospitals. So how does this rapid pace of digitalisation effect the way we plan and build our hospitals?
Looking at the planning and building process, digital collaboration tools, such as advanced use of Building Information Modeling (BIM) and Virtual Design Construction (VDC), have become the keys to success.
The BIM models for hospitals have evolved into complex tools managing costs, products, fire safety and logistics together with all building disciplines.
After completion in 2015, the Østfold Hospital, was awarded for best use of open BIM by buildingSMART International.
Digital collaboration tools have become the keys to success.
Pushing the limits continues to be the key to innovate and succeed.
At the hospital in Stavanger, they are building a dedicated Virtual Reality room.This allows the stakeholders of the hospital to gain a user experience more true-to-life and give detailed feedback in the early stages of the planning process.
The purpose is to reduce misunderstandings and errors, and provide a more efficient building process.
On the west coast of Norway, in Bergen, COWI is involved in designing a new paediatrics hospital. This project is pushing the limits even further.
The hospital will use a revolutionary technology; more than 1,000 m2 of windows with transparent solar cells and might also become the first hospital in the world to have a digital planning and design process – totally free of paper.
Entrepreneurs use the BIM models actively on the construction sites. "BIM kiosks" and smart tablets make sure they always have up-to-date project details.
4D planning allow you to add tasks to the objects in the model and to the project's resources, equipment and materials.
This makes it possible to track materials and ensure that all components are delivered to the right place at the right time.
The complexity of modern hospitals is evident, but it can be hard to grasp just how complex they are when only looking at the big picture.
So let's take another look at Norway's wireless frontrunner, Østfold Hospital.
The 3,664 rooms covers an area of 85,500 square metres; 480 of these are technical rooms, which require complex electrical and technical solutions.
In the olden days, hospitals were built without computers in mind. Later, the hospitals' wireless solutions were redesigned for the use of stationary computers.
The client for the Østfold Hospital had much bigger digital aspirations; they wanted the entire patient monitoring system to run wirelessly and on mobile devices. The staff's daily routines are also aided by smart and wireless units, making a reliable Wi-Fi a must.
The technical engineers had to plan a way for higher numbers of access points for the wireless network, while at the same time making sure that the frequencies do not disturb each other.
Climate friendly, BREEAM classified hospitals make this even more complex; the environmental friendly buildings' walls are thicker to avoid losing heat, but they also block the wireless signals. The same goes for the window panes.
Still, it worked out. The final solutions at the Østfold Hospital enabled digital interaction between staff and patients; nurses and doctors now receive patient news and information on their touch screens through a RPSM system.
A patient with a health risk can wear a digital monitor that will send an alert to a monitoring system, if it recognises any disturbances, for example an abnormal heart rhythm.
The hospital staff are then able to track the patient down with devices, which give a position accuracy of between 5-10 metres inside the building.
Photo: Ivan Brodey
While engineering and construction projects keep evolving, the technology companies are also increasing the pace for the future of digitalised health care.
One such company is IBM, who are helping doctors to find the most effective treatment for each patient, using large amounts of data and complex algorithms.
Their programme 'Watson' is able to read 200 million pages of text in 3 seconds, covering more than the average doctor can manage in a lifetime of work.
The collected data can offer a diagnosis for difficult cancer cases at a speed a doctor cannot compete with, and it is always up-to-date with the newest research.
Several companies have also tested algorithms that has proved to be just as good as doctors at identifying cancer from X-rays and MR scans, making them the perfect assistant.
In scarcely populated areas in the middle of Norway, they have introduced a pilot project with virtual examination rooms.
These enable nurses and general practitioners to assist with decisions and the seamless sharing of health data with central hospitals, facilitating decentralisation of medical expertise.
These technologies could be among the answers to labour shortage in the future, while helping the elderly stay in their homes and be healthy longer.
'Watson' is able to read 200 million pages of text in 3 seconds - more than an average doctor can manage in a lifetime.
While the digital decision assistants continue to improve their algorithms, and artificial intelligence become mainstream in the health care sector, it is obvious that we will become even more dependent on IT.
Avoiding downtime in the data systems becomes a question of life and death. Thorough IT engineering and analysis on the data centers' independency, security and redundancy is crucial.
Our hospitals digitalise at an unprecedented pace. But luckily, so do our engineers.
In close collaboration with the most ambitious clients and hospital developers, who push the limits to what is possible, this is the key to the future of hospitals.
I am a Civil Engineer in construction and an expert within hospitals and health buildings.
In 2003, we won the competition of designing the clinical building of 100,000 m² at St. Olav's hospital in Norway.
This sparked my inquisitive nature; I found it very interesting to work with so many experts with such a wide range of competencies on extremely complex projects.
Hospitals are some of the most complex land based projects you can possibly design.
Buildings Central North, Norway