This article is co-authored by Mark Latz.

When a healthcare provider adds a new building to an existing hospital, integrating the new building’s technology systems with the existing buildings’ systems presents a complex set of challenges, decisions, and sequences. The systems that must be integrated can include nurse call, security, distributed antenna (DAS), Wi-Fi, data network, voice, real-time location services (RTLS), wireless personal communications, patient entertainment and education, and more. A coordinated systems integration approach will include assessment of existing systems, pilot projects (if possible), early identification of make-ready work, and an optimal systems transition and continuity strategy.

Healthcare providers are often wary of adding costs to their new construction project with additional work on their existing systems. A lack of integration, however, requires staff to learn proficiency in separate sets of systems and transition between them as they move from building to building. This fatigues staff more quickly and carries greater risk of human error. Integration can be accomplished in the most appropriate manner to avoid unnecessary costs. Staff can have the opportunity to learn the new systems in time to use the integrated set of systems when the project is completed.

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Existing Systems Assessment

The first step is to assess existing systems that will need to connect or interface with the new building. An assessment of each system addresses the following aspects:

• Product life cycle — how far into the future will the system’s manufacturer provide support, such as spare parts and firmware updates?
• Relevance to current technologies — have the existing systems fallen behind the rapidly-moving curve of technological advancement?
• Ability to support the clinical workflows — can the existing systems keep pace with improvements in caregiving processes?
• Compatibility to future systems — do the feature sets and software integrations exist to integrate existing systems with those being considered for the new building?

The outcome of the assessment sets the stage for the design phases, influencing decisions about which systems to implement in the new building as well as decisions about existing systems. Without the assessment, the design could proceed in the wrong direction, wasting time and money.

Pilot Projects

Pilot projects are an excellent means to support decision making. They can be installed into existing hospitals or into mock-up spaces. Real users can get hands-on experience and provide meaningful feedback to the IT department. Within controlled environments, new systems can even be connected to old systems to find and fix problems.

On a larger scale, pilot projects can involve multiple systems simultaneously to demonstrate how they work when integrated. User groups can tweak system behavior and optimize workflows.

To execute pilot projects requires time, funding, staffing, and space, all of which are not always available. However, trying out new systems, either at a vendor’s showroom or in a fully built out mock-up space, will be quite revealing.

Make-Ready Work

A common example of make-ready work is replacing an outdated system in an older building with a new system that will match the system to be implemented in the new building. Alternatively, an existing system may be upgraded to a greater or lesser extent, rather than replaced, so it will be compatible with the system implemented in the new building.

The upgrades or replacement could happen while the older buildings are still functional, or this could happen simultaneously with space renovations. Regardless, such make-ready work requires careful planning and a very sharp eye toward sequencing to reduce the risk of system downtime.

Presumably, the budget for the new building will include costs for make-ready projects. However, not all of the make-ready projects will be known while establishing the project’s budget. Ensuring that make-ready projects are defined, estimated, and submitted as early as possible prevents schedule and budget from being negatively impacted.

System Transitioning and Continuity

At some point during construction of the new building, the new systems will either fully connect into the old systems or replace the old systems. Getting to this point takes quite a bit of planning and coordination. While the new and old systems overlap, the old systems must remain operational. Some systems, such as nurse call, require a strategy for transitioning with no downtime. This may mean designing, installing, and commissioning the new system and making it fully operational before the old system is decommissioned. Other strategies may include updating the system in chunks, by floors, or by patient rooms to slowly make the cutover. This cutover approach can save some costs but may require caregivers to interface with two systems in the same building during the transition period.

Continue the Conversation

There is no one-size-fits-all approach to systems integration. In each case, the best approach depends on a variety of factors. Each project requires a systems integration strategy to ensure that selection of systems for the new building, decisions about systems in the old building, make-ready work, and systems transitioning all contribute to completing the project on time and on budget and best equipping caregivers to provide the highest level of care.

TEECOM has more than 20 years of experience designing technology systems within existing and new hospitals, including the Lucile Packard Children’s Hospital, Santa Clara Valley Medical Center, Highland Hospital, and Laguna Honda Hospital Replacement. Use the below Contact TEECOM form to continue the conversation with one of our healthcare experts.