Few sectors are more competitive than healthcare. Even in countries with nationalised health services, the rising cost of lifestyle changes and expensive new drugs are testing the system to its limits. Competition between private services is fierce, and expectations for care have risen with access to online diagnoses. From online booking to e-therapy, the mechanisms of care are increasingly being digitised, requiring changes to infrastructure and beckoning in more new services. In this environment the push to reduce costs is central, and facilities managers play a major role in the identification of inefficiencies and delivery of improvements. Here are five ways in which the FM’s role has gone from fixing facades to saving lives. Wireless In an age of ubiquitous wifi, it almost seems a bit old hat to talk about wireless technology. But thanks to concerns about signal conflicts, structural barriers and a relative lack of networked devices, hospitals have been slower on the uptake. Now technology is being renewed with a focus on flexibility, and patients’ expectations of hospital services are changing. Wireless equipment allows for more dynamic use of spaces, allowing rooms to be customised to the needs of the patient rather than moving them to the equipment. Conversely wireless tracking can allow for greater patient mobility, enabling remote assessments and monitoring off patients when they leave their rooms. With the ubiquity of smart mobile devices, there is also an expectations on the part of patients and visitors that internet access will be provided. The new 802.11ad wireless standard provides enormous bandwidth at shorter range than conventional wifi, meaning that a greater number of wired access points may be required in future. But by running copper lines through walls and ceilings to provide power over ethernet (PoE), the complete adoption of wireless internet can cut down considerably on visible cabling, reducing trip hazards in the process. The cheaper and more reliable use of VoIP services like Skype and messaging to talk between departments could be the final step in this all-online future. Space optimisation The use of BIM systems is crucial for efficient and accurate space management, and this is applied broadly across hospital facilities. Reimbursements from government schemes and research grants require specific details of space allocation, which can comprise as much as 12% of a facility’s income. Space management is also naturally important for patients and staff, with a delicate balance to be struck between comfort and maximising the available facilities. BIM allows for intelligent floor planning, calculating space more intelligently than traditional CAD programs. This can be combined with the tracking of a hospital’s assets to micro-manage available floor space, with simulations testing potential conflicts and usability issues. Similarly, detailed building designs can be used to simulate the spread of infection based on numerous intangible factors, combining elements such as predicted humidity and airflow. Increasingly potent computers and augmented/virtual reality solutions will only enhance these capabilities, potentially projecting the data onto real environments to highlight solutions in a physical space. User experience Little is more important in the outward facing hospital environment than the experience of patients and visitors. Hospitals can often be seen as intimidating by visitors, and all efforts should be to make the experience as pleasant as possible. Once indulgent services such as free wifi are now all but mandatory, while more advanced tech is making its way into patients’ rooms. Voice recognition is allowing occupants to change the temperature or lighting of a room from their bed, offering a degree of control, comfort and independence. Video calls meanwhile could allow patients and families to stay in touch more easily, reducing the need for expensive regular visits. For visitors, sensors can alleviate the stress of parking by tracking capacity, as well as allowing for reservations ahead of time online. Once you’ve arrived, intelligent wayfinding could point you in the right direction through digital signage, or via a companion ‘map app’. For a less sci-fi solution, data on footfall and feedback about layouts allows FMs to tweak static signage, making a hospital’s web of corridors easier to navigate. Live tracking of patient occupancy could even keep their family up-to-date on where they are in the hospital, reducing the burden on receptionists and automating another element of data collection. Telehealth Telehealth or telecare refers to the provision of remote support, diagnosis and care through internet enabled devices. With the move away from home visits by doctors, some patients’ ability to access health services has been compromised. Being able to not just book appointments online but conduct them via video has massive benefits, and not just for those who are unable to travel. With missed appointments a major source of wasted resources, remote appointments could eliminate travel problems and provide greater convenience. Reduced footfall in hospitals could also reduce costs and waiting times, as well as eliminating infection vectors for those with contagious diseases. Perhaps more pertinently, remote monitoring of patients could reduce emergency admissions and mortality rates by addressing problems more quickly. For more mobile patients with long-term conditions, wearables linked to a mobile internet connection could provide live updates on a patient, monitoring vital signs and providing GPS coordinates should they experience a problem. So-called ‘smart shirts’ are already in development, offering a health monitoring package similar to that installed in space suits. Throw AI into the mix, and this incoming data could eventually be sorted automatically, with ambulances dispatched to individuals automatically when a problem is detected. Preventative maintenance If there’s a future in automatically checking patient vitals, there’s a present implementation of this for machinery. Data logging the frequency of uses of medical equipment and any errors or hiccups can enhance maintenance routines, addressing problems before they occur. This has the obvious potential to reduce issues that could endanger lives, but also offers an efficiency saving in maintenance and the premature scrapping of equipment. The same process can be applied to cleaning and even construction. Routines can be intelligently altered by a BMS based on sensor data such as