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Cameron Archer
June 03, 2020

Downtime Is Not An Option: Helping Healthcare Facilities Keep Critical Infrastructure Online

Downtime is not an option in healthcare. 


Patients, physicians, and institutions depend on critical infrastructure remaining online at all times. Because of the high-stakes nature of the industry, equipment and system failures can be absolutely catastrophic. Facility leads and technicians must be aware of how every machine is operating at any given moment.


In the medical field, “critical infrastructure” consists of two main types of heavy equipment: biomedical equipment and facilities equipment. 

Biomedical equipment describes the flashy, well-known machines and systems that serve on the front lines of patient care. Medical imaging, lab work, surgery, and patient monitoring all rely in some form or fashion on biomedical equipment. 

Every year, healthcare organizations invest enormous capital in this area. According to a 2017 study, the U.S. spends nearly $20B annually on medical technology R&D. Consequently, we tend to hear about the latest and greatest innovations related to MRI machines, X-rays, or other diagnostic tools in the press. 


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On the other hand, facilities equipment is often overlooked, though it is just as important as biomedical equipment. Facilities equipment is the infrastructure that enables all daily operations in a healthcare building. Power generation, lighting, HVAC, plumbing, electricity, and medical-quality air, gas, and water are all examples of facilities equipment infrastructure. 

Facilities equipment may not be nearly as flashy as biomedical equipment. However, these machines and systems are the foundation of a healthy healthcare institution. Think: 

  • What would happen if backup generators didn’t come on during a power outage?
  • What if lighting failed throughout an entire medical building?
  • What if the entire oxygen delivery system went down?

The consequences of facility equipment failures are significant. On top of that, without a secure foundation of facilities infrastructure, biomedical equipment is useless -- CAT scans don’t work if the power supply is gone. 

According to Modern Healthcare, hospitals are spending $93 billion per year on medical equipment lifecycle costs. A Becker CFO report estimates that hospitals are losing up to 12 to 16 percent of savings due to a “lack of accurate information, internal resources, bandwidth, and specialized expertise.” Preventing downtime for facilities equipment is crucial for providing quality patient care, maintaining stable revenues, and reducing costs. As we’ll discuss below, it’s also necessary for physicians to do their jobs well and for institutions to stay afloat financially.

The Consequences of Downtime

If facilities equipment goes down, the consequences can be devastating on multiple fronts. Patient care, safety, and financial performance are all at risk during unanticipated downtimes. 

Protecting Patient Care

The primary goal of any healthcare facility is quality patient care. Achieving this goal is challenging if critical infrastructure is unreliable.

For example, HVAC failures can cause air quality issues, which can compound problems for patients who are already high risk. In Seattle, one hospital admitted to six unnecessary deaths that occurred as a result of mold growth in air-handling units. 

Power outages can take out biomedical equipment and impact many hospital functions, from surgical procedures to imaging. According to Electrical Business, 40% of global health organizations experienced unplanned outages in 2015. More recently, a hospital in India lost power for 12 hours, putting at least 12 COVID patients on ventilator support in danger.

Failures can also interfere with electronic health records (EHR). In Northern California, one hospital lost access to its EHR system for an entire week after the data center HVAC system overheated.

Beyond these examples, there are many other ways that facilities equipment can directly impact patient care. Preserving facilities infrastructure should be a top priority for operators who want to support their care teams and patients as effectively as possible. 

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Mitigating Safety Incidents

Safety incidents are every VP of Facilities’ worst nightmare.

Hospital staff members are already prone to develop illnesses and injuries due to the exposed and stressful nature of their jobs. Facilities equipment failures can lead to poor workplace conditions that make life even harder for caregivers. 

For example, HVAC failures can cause overheating or air-quality issues that prevent healthcare workers from performing to the best of their abilities. More serious infrastructure issues can cause leaks or explosions that put lives at immediate risk. 

To mitigate safety incidents, facility leads must consider how their teams are affected by critical infrastructure day in and day out.

Minimizing Lost Revenue

Healthcare institutions have a lot to lose on the financial side when facilities equipment fails. 

As we have observed in the current pandemic, surgeries, particularly elective surgeries, are a crucial source of income for hospitals. Specialty surgeons generate tremendous revenue for their institutional employers, and surgery patients contribute much more revenue than other types of patients. 

Many procedures net tens of thousands of dollars in revenue for hospitals. Even a few hours of downtime can cause cancellations or delays that represent hundreds of thousands of dollars in revenue. And this revenue cannot be “made up.” It’s simply lost.

Similarly, imaging services, which rely on expensive diagnostic equipment, generate substantial profit for hospitals -- 37% of total profits according to The Advisory Board. Facilities equipment is essential for keeping these machines online and ensuring they function properly.

Preventing Bill-Above Events

Finally, facilities equipment downtime can result in bill-above events -- issues that occur outside of regularly scheduled maintenance work. These events can blow maintenance budgets out of the water and cause healthcare facilities to spend far more than anticipated to fix broken infrastructure.

By monitoring facilities equipment, leaders can avoid costly maintenance problems and keep systems up and running. 

Why BMS and BAS Don’t Solve the Problem

Building management systems (BMS) and/or building automation systems (BAS) have yet to solve the downtime challenge for healthcare facilities. Even though these real-time monitoring solutions are capable of 24/7 observation, there are still major gaps.

Many institutions use machinery from multiple original equipment manufacturers (OEMs) that each have unique protocols and controls. OEMs also tend to design after-market services around software and monitoring, rather than hardware upgrades. Naturally, this creates interoperability issues between different types of facilities equipment. 

Those who want to upgrade BAS capabilities to accommodate equipment from various OEMs face huge cost barriers (in the six to seven-figure range, even for a smaller facility!). Regardless, BAS tends to be over-designed and expensive relative to its value. 

Most facilities managers only use a fraction of available features, and many do not take advantage of predictive maintenance capabilities. One hospital that our team recently interviewed only had 50% of facilities equipment connected to the BAS system.

Further complicating this reality, many facilities managers are overly confident in their BAS to identify potential issues. Another hospital we interviewed had a chiller explode near an employee walking path. Fortunately, no one was harmed, but the event serves as a powerful example of what can happen when only a portion of infrastructure is monitored by BAS. 

IoT Also Falls Short

The Internet of Things (IoT) has also failed to plug gaps in healthcare facility equipment upkeep. 

Most IoT vendors are focused on full-stack solutions for certain kinds of infrastructure. For example, a company that designs sensors to monitor backup generators might not do the same for HVAC systems. 

Consequently, healthcare institutions have to use multiple vendors to cover every component across their facilities infrastructure. Again, this creates integration problems and adds unnecessary complexity. While they might offer some of the vertical integration that equipment OEMs lack, they can’t offer the same horizontal breadth of solution across multiple equipment types, and they rarely offer the support and services required to help their customers make good use of the data being collected.

So, what is the ideal solution?

Prevent Downtime with WellAware’s Managed Facilities Monitoring and Control Services

To optimize equipment monitoring and performance, healthcare institutions need a comprehensive facilities management system that can support and optimize any type of equipment. WellAware’s Managed Healthcare Facilities Monitoring and Control System is designed for this exact purpose. 

Our team addresses every layer of infrastructure and service to establish full monitoring uptime on all facilities equipment. We provide core infrastructure consisting of both hardware and secure network connectivity. We deliver an integrated, user-friendly software experience through a single pane of glass, both web and mobile, for all equipment and machinery. We also offer continuous upgrades and support on all elements of the solution. With this cutting-edge technology stack, we are able to generate higher quality monitoring data than legacy BMS or BAS software at a fraction of the cost.

Learn more about how WellAware partners with healthcare companies by visiting our Healthcare Industry page. 

We also provide labor for installation and ongoing maintenance, which is highly unusual amongst traditional BMS and BAS providers. In addition, we offer data insight services informed by predictive maintenance to help facility leads identify catastrophic failure events before they happen. Everything we do is covered under a level subscription plan with no upfront capital expenses. 

By partnering with WellAware, healthcare organizations have everything they need to preserve critical facilities equipment, protect patients and caregivers, and enhance financial performance. 

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