By Michael C. Skurla, Chief Technology Officer, BitBox USA (now Radix IoT)

Most use cases of IoT (Internet of Things) in healthcare fall into clinical applications—from medical devices to procedures to records. However, digital technologies extend beyond clinical settings within healthcare facilities, clinics, and hospitals.

The unique physical infrastructure of healthcare facilities has led medical enterprises to embrace various IoT capabilities. These applications range from improving patient experience and comfort to lowering utility costs, fostering security measures, and implementing preventative facility operations and maintenance.

The VA Hospital system’s Orlando VA Medical Center at Lake Nona exemplifies this approach. This 1.2 million-square-foot facility, designated as an “Emerging Center of Innovation,” represents the first VA hospital built in the United States since 1995. The Center includes a multi-specialty outpatient clinic, 134-inpatient beds, a 120-bed community living center, a 60-bed domiciliary, and administrative support services. The facility operates seven hospitals across the southeast, providing acute care, complex specialty care, and advanced diagnostic services.

The campus houses the Simulation Learning, Education and Research Network (SimLEARN), which provides simulation-based healthcare training. This facility uses replicas of hospital environments for clinical staff training in innovative technologies.

Managing Complex Systems

According to Greg Merrill, responsible for IT project management at the Orlando VA Medical Center, the facility’s digital infrastructure currently operates in silos. Merrill explains: “Our digital infrastructure at this point has multiple siloed trades–what we are working to achieve is a horizontal network, one pane of glass dashboard to centrally monitor our entire Center.”

Merrill, a Navy electrician with a State Master Electrician License, previously worked as a process analyst at Lucent Technologies before joining the VA in 2012 as a program analyst.

The Center’s siloed systems manage network operations, power plants, HVAC, water systems, and switch gear—presenting significant challenges for consolidated management. While older buildings undergo modernization through electrical switchboard replacements and automated breaker controls, the facility houses multiple generations of equipment that prove difficult to consolidate, despite the building’s relative youth.

Healthcare facilities require standards for HVAC, boilers, power distribution, lighting, security, and elevators. Additional systems operating in tandem include PA systems, tube systems, water treatment, and chlorination—each running separate software and management applications. This fragmentation excludes emerging technologies like indoor navigation, public Wi-Fi, and asset tracking.

The Orlando VA Medical Center uses a JCI solution for central management of boilers, chilled water, steam, and HVAC controls. However, a separate SCADA system manages Schneider substations and the energy plant down to individual breakers and meters for Joint Commission reporting. This approach leaves numerous infrastructure systems operating independently, complicating consolidated management and maintenance views.

Merrill envisions a centralized monitoring dashboard providing actionable analytics for improved stewardship of taxpayer resources. Predictive maintenance, critical equipment trending, and proactive maintenance could save millions of dollars. One concrete example involves maintaining expensive reagents stored in the clinical laboratory worth approximately half a million dollars. Compressors must be closely monitored, and staff must receive immediate alerts if anything exceeds tolerance. Using IoT subsystem access point technology like Mist, Merrill monitors various points enabling rapid response.

Mist represents an AI-driven platform for wired and wireless networking. It combines data science, machine learning, and AI techniques to deliver reliable Wi-Fi access and indoor location services using virtual Bluetooth LE and intelligent IoT device connectivity. Merrill views this as “empowerment through data”—mixing control monitoring with previously orphaned monitoring technologies now integrated into a master platform enabling efficiency synergies.

The Mist platform exemplifies an IoT bridging solution, allowing wired IoT ports to aggregate data from legacy analog devices into larger data lakes. Wrapping entire third-party systems into a centralized dashboard and monitoring system enables refined reporting and alarming while simplifying management practices for building staff.

Optimizing Patient Experience

Beyond efficiency gains, system synergies offer growing conveniences and enhanced safety for patients, visitors, and staff. One example involves secured patient safety through location monitoring. Recently, the Center’s exterior doors were connected through Mist infrastructure to enable Bluetooth Low Energy (BLE) location monitoring. Patients wearing BLE ID bracelets can be monitored if they wander from clinical service zones.

BLE wayfinding via Mist provides monitoring accuracy within approximately two meters. Additionally, BLE asset tracking locates wheelchairs and helps facility staff navigate. The system sends patients cellphone notifications through virtual beacon zones, alerting them to clinical messages like flu-shot announcements. All this functionality stems from native Mist Virtual BLE technology for real-time indoor location services integrated within the Mist public Wi-Fi infrastructure.

Merrill plans to integrate IoT’s full potential to achieve shorter clinic wait times, asset location, increased automated door monitoring, and provide admissions offices with real-time room availability data. He also seeks to leverage real-time navigation for parking guidance, alerting veterans to available parking spots without requiring them to circle the facility.

This growing building and patient interconnectivity empowers both groups. It results from using infrastructure already in place while harnessing data in different and more creative ways.

Merrill states: “Having a holistic view of our entire multi-site systems is our mission for monitoring. We are hoping to gradually connect into a horizontal monitoring approach as our next step, instead of this vertical system silo model.”

Traditional systems were built around single-trade reporting and management—still vital as the VA requires compliance with Industrial Controls Standards (ICS), NIST, and VA standards. However, intelligently using system data creates actionable analytics often extending beyond the trade that generated the information.

Cloud Considerations

Currently, facility management data storage must remain on-premise per VA standards. Should standards evolve—as they have in commercial spaces and parts of federal government—Merrill might consider cloud migration. Cloud solutions offer greater manageability, scalability, and affordability compared to on-premise predecessors. Merrill emphasizes: “Shifting our on-premise infrastructure in the name of upgrades isn’t the best use of tax dollars.” Security and policy remain the biggest barriers to any transition.

With critical infrastructure using separate software packages for various systems, each with dedicated operational requirements and specialized understanding, the need for a unified platform becomes critical. The lack of unified monitoring remains a challenge, but that integrated view represents the target.

Merrill explains: “Our ultimate goal is to increase convenience for our visitors through a patient engagement network and make the healthcare facility and the hospital a better place to be if you have to be there.”

He concludes: “Ultimately, we want Veterans to start their experience with stress free services–from finding a parking space to knowing exactly what their wait time will be once they arrive at their destination. If we can help alleviate some stress through IoT technology usage, then we succeed.”

Originally published in Healthcare Facilities Today.