Healthcare lags behind other industries when it comes to the implementation of information technology. The WHO estimates that 20-40% of resources spent on healthcare are wasted. However, new advances in technology make it possible to integrate previously separate facility systems to form an “intelligent” hospital infrastructure. As a result, significant improvements in patient care and reductions in operational costs are possible.

One of the main challenges facing healthcare organisations around the world today is that of an ageing population. The United Nations (UN) predicts that by the year 2100, the number of persons aged over 60 is expected to more than triple, increasing from 841 million in 2013 to 2 billion in 2050 and close to 3 billion in 2100. The UN goes on to state that “66% of the world’s older persons live in the less developed regions and by 2050, 79% will do so. By 2100, this figure will reach 85%.” In addition, population ageing will bring on a dramatic increase in illnesses which have age as a dominant risk factor, such as cardiovascular disease, cancer, diabetes and chronic respiratory disease. Healthcare costs will continue to rise as treatment and care costs are high for these diseases. According to WHO, the promotion of efficiency and the elimination of waste are major initiatives that should be launched in order for healthcare providers to address this challenge. WHO is recommending a focus on the following areas:

Performance of healthcare workers; Improvements in hospital efficiency and quality of care; Reduction of medical errors and redundant processes; and Analysis of population health needs and identification of appropriate services.

Intelligent infrastructure
Healthcare providers will require tools to help them cope with these new challenges. An intelligent technology infrastructure (ITI) is one such tool that stems from the progressive development of Information Communication Technology (ICT) and other emerging wireless and mobile communications protocols. Acting as a central nervous system for the hospital, an intelligent technology infrastructure integrates traditionally disparate systems, such as power, building management, security, and IT to enable communication across systems, as well as real-time monitoring, optimisation, and automation. When a hospital’s systems can “talk” with each other, the infrastructure as a whole is strengthened and builds intelligence, leading to more effective use of all resources. With an ITI, hospitals can: Improve patient and staff well-being with staff safety and patient clinical monitoring systems; Enhance the patient’s experience with nurse call services, and control of their own lighting, temperature, window blinds, and more; and Promote energy efficiency with the control and monitoring of energy sources.

Intelligent infrastructure benefits
An ITI improves each patient’s journey through the healthcare process. In many areas of the world, patients now have more choices for where they receive their healthcare, placing additional pressure on hospitals to stay competitive. Good or bad, the experience a patient has while in a hospital will likely impact their decision to return when they next need care.

The journey a patient experiences will be affected by a variety of factors including clinicians, catering, cleaning, and the healthcare facility itself. By connecting medical and facility of hardware, software and enabling wireless communication, medical staff can access the info they need, any time, anywhere in order to keep patients safe, satisfied with their overall experience.

Mobile solutions allow practitioners to stay in continuous contact, whether at the patient’s bedside, in examination rooms, emergency treatment centres to effectively deliver patient assessments, and make more informed care decisions based on collaborative treatment plans.

An intelligent hospital infrastructure also provides maximum 'uptime' of systems through a resilient design that incorporates sophisticated power management techniques. This results in higher availability of systems and services than was previously possible through conventional, separate discrete systems. The architecture allows all the systems to interoperate and for users within different departments to access the information they need to better service their patients. A hospital that is always “on”, from the power in the operating room to availability of electronic records, will provide the safest possible environment for patients, staff and visitors.

The design of the infrastructure facilitates a distributed intelligence. This implies that systems interoperate in different ways across multiple departments of the facility. The architecture will allow for operational gains such as reductions in energy consumption though active monitoring of energy resources, improvement of patient and staff safety though intelligent access control systems, and improved environmental control (lighting, temperature, humidity) in patient rooms. The infrastructure is designed to allow interoperability of all services across the healthcare facility.

The infrastructure is also built to easily adapt to expansion and change. Using open protocol technologies, the infrastructure integrates new technologies or a new wing to the facility in a rapid and cost effective manner. The efficiencies gained from an intelligent hospital infrastructure helps to reduce that waste.

Capital expense benefits
By integrating the various facility systems into a single network, healthcare organisations can realise the following capital expense benefits.  Reduction of wiring and associated installation costs that would be traditionally dedicated to individual subsystems. Both the number of cables and the average length of cables are reduced; Less time spent on commissioning the systems, which leads to cost reductions in construction labour;  and Reduction in the number of active network devices required to run the ICT network.

The principle of intelligent infrastructure and distribution of that infrastructure can be applied to many hospital environments and situations. Consider the example of ventilation and power systems in new hospital construction. Delays in new construction can potentially affect the project's gross margin. Typically, the preceding contractor needs to complete their own work before installation and commissioning for the HVAC system can be started. If the preceding contractor fails to complete their work in accordance with the construction program, inevitably the time allowed for commissioning and installation is reduced, and can result in increased project risks, such as inefficient work, safety hazards, delays, and added cost.

Operating expense benefits
Network availability can be bolstered when an intelligent infrastructure is enabled. This results in operating expense benefits that save the hospital time and money in the following ways: Resiliency and high availability can be better managed in a single network than in many separate networks; Network management and diagnostics can be integrated into the systems to indicate whether the point of failure is in the network or in the equipment, which leads to better failure detection and shorter reaction time; Openness and flexibility allows future technological developments to be easily adapted to standard Ethernet/IP communications; Power over Ethernet techniques reduce maintenance and reconfiguration costs; and A collective integrated dashboard offers views specific to the job role of the individual staff member.

Patient satisfaction and safety
Communication and response time with the staff is improved. Patients can use information displays to communicate different needs directly with nurses instead of just calling a nurse via a nurse call button.

Access to the Internet allows patients to communicate with friends and family via web, email, or other social services.

Information can be delivered to a patient interface in case of a fire or other threats. For example, exit routes can be shown in three dimensional patient displays and information screens along the way.

A new approach is required when planning future investments in healthcare to achieve the stated aim of “getting the most out of technologies and health services” and deliver better value to both the healthcare organisation and the patient. Recommendations to further the development and adoption of an intelligent infrastructure and the associated benefits include: Greater focus on an intelligent infrastructure and technology pathways from central governance bodies to inform and encourage greater uptake of new technologies;  Development of new standards for healthcare ICT infrastructures, including all sub-categories for better management of patient flows and outcomes; More attention and value placed on technology infrastructure and pathways by national or regional healthcare organisations to stimulate further development and innovation from the private sector; and Broader recognition for the role of engineers and ICT professionals in the future of efficient healthcare delivery.