Health Infrastructure NSW pushes for digital hospitals

Health Infrastructure NSW is pushing to ensure that major hospitals and facilities are digitally modelled to ensure that they can use future technology.

Health Infrastructure NSW CEO Robert Rust has said that it's time to mandate the use of IT when developing health infrastructure in order to build the healthcare system of the next decade.

Speaking at the Digital Hospital Design conference in Sydney yesterday, Rust said that the use of Building Information Modelling (BIM) when building hospitals and other medical facilities will be instrumental in creating better healthcare facilities.

BIM allows hospitals to be built and modelled in a virtual environment, providing stakeholders with better information for decision making. It has been used in the past to model and simulate patient inflow and movement throughout a building, helping designers to optimise the location of building features, such as corridor widths, during the planning phase, rather than dealing with the issue once the facility is built.

Rust said that when traditional drawings are used, they often require all stakeholders to be trained in how to read them, and, even then, some are surprised by the scale of the end result, or that the finishes aren't as they expected. A building designed through BIM, however, allows stakeholders to fly through the design for themselves, and allows the project team to communicate more effectively with the community by providing imagery of the building at any point of the construction process.

Such modelling is referred to as 4D BIM, due to the ability to represent a building in an additional time dimension, but it also allows project teams to schedule costs in 5D BIM (time plus budget) at any time in the construction of the facility.

A sixth dimension can also be added by including all 3D models with relevant asset-management information and/or documentation, allowing facility managers to completely manage the building for years after it has been completed.

Having a completely digital plan also allows for integration with new technologies. Rust pointed to the "TransCars" that are being deployed in the Royal North Shore hospital in Sydney. These automated guided vehicles look like low-profile platforms on wheels, moving medical trolleys and other goods throughout the hospital. By communicating with the hospital's building-management system, they can potentially operate doors, or optimise their route to take elevators that are not in use. By comparing their laser "vision" to the building's digital plans, they are also able to create optimised routes, free of any guide rails.

However, there are obstacles to the implementation of BIM. The construction of a building requires many trades and professions, and Rust said that not all of them are up to speed with the use of BIM, making widespread acceptance an issue. He also said that there are significant hurdles in terms of interoperability and standards, which would make it difficult to work with multiple organisations, either on a single project in the present or in the future, when technology will undoubtedly advance.

"Issues such as backward compatibility continue to cause me concern [because] when you build, or when you design in BIM, subsequently you need to continue to maintain those models to try to keep it in place with technology as it moves."

Despite this, Health Infrastructure NSW is pushing ahead to make BIM mandatory on its projects, but in order to ensure that the industry isn't left behind, it has set some limitations. When Health Infrastructure makes BIM mandatory, it will only apply to projects above AU$50 million in value.

"We've got to make sure we don't push too hard, given the sheer number of projects we have on our agenda [and make] sure we have an industry that's comfortable with what we're doing and comfortable with the risk profile," he said.

"As we are building, we are more and more seeing what it's cost us to build somewhere else and [we] try to justify why there's a difference in cost. To do that, you need to be very, very clear in how you can describe components of the project."