Introducing Building Informatics

Introducing Building Informatics

PUBLICATION ARRAY-ADVISORS.COM

Table of Contents

Advisors Approach to Building Informatics . . . . . . . . . . . . . . . . . . . . 3 Improved Design and Construction Outcomes . . . . . . . . . . . . . . . . 4 Improved Repairs and Maintenance Outcomes . . . . . . . . . . . . . . . 6 Improved Healthcare Outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Array Informatics Extends CapEx and Improves OpEx . . . . . . . . . 13

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Advisors Approach to Building Informatics Building Information Model (BIM) management is a true enabler and enhancer of most other technology trends in the Architecture, Engineering, Construction, Operations (AECO) industry. This is important to the healthcare industry because facilities management-related operating expenses represent as much as 50% of all healthcare system costs. Embracing BIM represents a significant opportunity given that US hospitals own and operate more than six billion square feet of space with a replacement value of more than $1 trillion dollars.

As of 2017, most organizations have a fragmented and reactive approach to building management, rather than a holistic and proactive one. Therefore, nonBIM-based workflows result in unnecessarily high capital expenditures (CapEx).

Much more significant however, is that non-BIM based workflows also result in unnecessarily high operational expenses (OpEx). BIM can be a key contributor to facility management (FM) cost efficiencies and many value propositions become available when organizations carefully consider and implement BIM as a workflow enhancer and integrator across the entire system for the lifecycle of facilities.

BIM-enabled workflows provide significant opportunities to improve overall health system bottom-line outcomes.

ARRAY INFORMATICS Array is a healthcare-only architectural design, consulting and technology firm.

Delivering hundreds of healthcare projects each year, we have utilized BIM workflows on all of our architecture projects for more than a decade. In every current project, we now also require our engineering consultants to use standard BIM workflows. We do this because we have discovered tremendous value in use of BIM during design and construction. It is based on this deep knowledge and experience that we have started to promote using BIM workflows in support of facility repairs and maintenance. We see very few clients requesting BIM as part of their design and construction deliverables; and even when requests are made, they are at a very low level of detail. Array sees significant opportunity to improve organizational value by establishing and driving new BIM workflows. It is within this context that Array Advisors developed its Informatics service line—to help healthcare systems leverage additional value from design and construction projects by integrating BIM workflows through repairs and maintenance without creating additional operational expenses for facilities management.

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Improved Design and Construction Outcomes ORGANIZATIONAL TRANSFORMATION One major tipping point all health systems experience is the growing momentum in the healthcare market to make intelligent real estate portfolio management decisions by leveraging new, but proven, technology solutions. FM trends show that portfolio owners of all sizes who implement technology solutions that integrate across their entire business consistently realize significant business value improvements. While there are many such solutions to choose from, Array has found that most FM technologies are in some way accurately informed, or precisely augmented, by BIM. So prioritizing BIM will inevitably enable or enhance those other technologies in whatever state they have been considered or deployed thus far.

The data that design and construction teams provide hospital facilities management departments needs to be available, accessible and interoperable to assist repairs and maintenance staff in making better informed decisions more quickly. This will raise campus buildings’ performance effectiveness and efficiency, as well as improve the ROI on both CapEx and OpEx spend.

EMS = ENERGY

EQUIPMENT = EAS/AIM

LCA = LIGHT/GREEN

SITES = GIS

BMS/BAS = SYSTEMS

SPACES = CAFM/IWMS VIRTUAL HOSPITAL

DMS = DOCUMENTS

CAD/P&ID = LOCATIONS

MODELS = 3D/BIM

PRODUCTS = CMMS

PROJECT EXECUTION = PMIS/PIM Page 4 | Introducing Building Informatics

While this is currently achievable, it is simply not happening in practice today. This is due, in part,

Project Milestones Requirements

to the misconception that the costs to implement this strategy are too high while the return too low.

This might have been the case just a few years ago, but it is not so today.

To implement this strategy, design and construction teams must be supported by Informatics specialists who understand not only design and construction BIM workflows, but can also navigate the complexities of

Specified Products Attributes

Stakeholders Contributions & Needs

collecting and integrating this data with repairs and maintenance BIM workflows. Project-level execution plans must roll up to portfolio-level specifications. The requirements of maintaining space, mechanical systems and managed equipment inventories are distinctly different from requirements for documenting walls, windows, doors, ducts, pipes and conduits.

More than a decade of industry trial and error has revealed that it is unfair and unrealistic to expect either the design and construction team or the repairs and maintenance team to become fully-knowledgeable in the other team’s language.

This is at the root of why FM handover of useful information by design and construction teams is not standard practice today. In today’s market, it is very reasonable to expect a workflow, which integrates the two, to be part of all design and construction projects, and that this workflow provide additional value to the enterprise. Array Advisors’ Informatics team is well positioned to be the catalyst for this initiative.

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Improved Repairs and Maintenance Outcomes Having a building informatics strategy in place makes delpoying new internet of things solutions much more efficient and effective.

Ubiquitous demand for facilities information should be considered mission critical for today’s healthcare service delivery. However, most decision-making stakeholders, including CEO, CFO, CTO, service line directors, and facilities managers, are initially uncomfortable applying departmental resources to learn new, complicated BIM workflow information classifications and software to take advantage of this. They are also typically not tasked with supporting other corporate resources they do not manage personally.

These valid concerns are reactive in nature. A more proactive approach to BIM workflows is that all stakeholders benefit from gaining more access to the structured information that the organization already pays for, and therefore already owns! By seeking new, actionable business insights around facilities-related assets, utilization, equipment operations and safety hazards, organizational outcomes are immediately advanced and improved. With modern solutions, it is now possible to quickly introduce new, user-friendly, browser-based solutions that provide excellent asset awareness using BIM-viewer technology

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Click here to read more about BIM.

MAINTAINING EXISTING CONDITIONS The next challenge is establishing a well-defined procedure to initially capture the current conditions of site layouts and mechanical status, as well as asset identification, assignment and work order histories. Maintaining the relevancy of facility information over time is key to delivering ongoing success using BIM workflows. A hospital is a dynamic environment. Changes to a facility’s physical and non-tangible characteristics are inevitable and ongoing. It requires much less effort to maintain a repository of facilities information than it does to initially create one. Maintaining relevance is more useful, so it is often practical to handle capture as an independent effort from maintain in most working environments.

CAPTURING EXISTING CONDITIONS Capturing the initial building components and attributes necessary to take advantage of BIM can be a very daunting task. This heavy lift is probably why most organizations don’t do it. But the task does not have to be an arduous one, nor does it need to happen all at one time.

Knowing where to start is half the battle. Knowing when to collect what is necessary is the other half. Working the initial BIM capture task backwards is always the best course of action. Defining BIM Use Cases for a target business environment tied to specific FM enterprise software solution functions can very quickly reveal portfolio-level specification requirements that should be included in appropriate site survey project executions.

Whether in-house or outsourced, there are many options for doing site surveys and the newest technologies provide amazing graphics results within weeks.

Adding intelligence to raw data, however, is an esoteric concern often best left to the appropriate experts. Array Advisors will always provide expert guidance when approaching these important concerns.

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Improved Healthcare Outcomes When hospitals optimize the way they structure, capture, use and revise their facility information, they realize more mature business outcomes including improved revenue, spending control, risk reduction and service stability.

Accessible Facility Information

Improved Revenue Generation

Improved Cost Control

Improved Risk Reduction

Improved Service Stability

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Building Informatics Outcomes

REVENUE ENABLED: ONLINE INDOOR MAPPING Brand and reputation have become very serious issues for health systems.

Traditional marketing message mediums are only half the battle though. Content used off-site and first impressions on-site are equally important. Providing potential patients with context for the care environment can do wonders to help the public feel comfortable coming to your healthcare facility and increase your traffic. Once there, finding a service department, staff member or patient family/ friend can all be a bit intimidating. Online indoor mapping can help make these experiences more user-friendly.

For instance, providing department navigation routes and publicly-accessible room floorplan layouts in a mobile application is a good and easy place to start.

REVENUE ENHANCED: CMS REPORT AREAS AND INVENTORIES Annual reimbursement provided by Centers for Medicare and Medicaid Services (CMS) for services rendered has become a significant issue for ambulatory services with Business occupancies. While 75% of billing accounts for which healthcare procedures were approved, the other 25% of billing is based entirely on where those procedures were provided.

The Federal government requires detailed reporting of room square footages and equipment expenses, both of which need to be categorized by recommended cost center codes. The challenge here is that hospitals are constantly under renovation, and equipment inventory is constantly being repaired or replaced.

Documenting precise floorplans with room identifications (according to industryaccepted standards, such as ANSI/BOMA), and documenting accurate managed equipment inventories is a good and easy place to start.

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SPENDING CONTROL ENABLED: PREPARE PROPER FM HANDOVER Although design and construction projects are large capital expenses (CapEx), they only represent 25% of the total cost of ownership (TCO) of a facility when looking across the entire lifecycle of a building. Operational expenses (OpEx) account for 75% of cost, and it is important to keep this in proper perspective when looking for efficiency gains. A very small percentage of improvement in the OpEx phase will far eclipse value-added of a similar percentage gain achieved during the CapEx phase.

The number one building informatics strategy that can be implemented is preparing the structured information necessary for FM Handover throughout the design and construction process. Waiting until the end of construction is problematic at best and, at worst, results in not implementing a BIM for FM solution.

An easy way to do this is by establishing governance standards and protocols for properly structuring and collecting facilities management information throughout design and construction. This ensures it is present and ready for delivery as FM Handover at or near occupancy.

SPENDING CONTROL ENHANCED: BIM VIEWER FOR CAFM AND CMMS During the OpEx phase, there are many BIM Use Cases that can be implemented individually or in combination. For instance, all managed equipment inventory should, at minimum, be classified by space assignment. Ideally, you want to capture, present and maintain space definitions, including geometry boundaries, constraining elements such as walls and openings, and assignment of managed equipment.

Doing so non-graphically with tables or databases only provides limited benefit.

Implementing BIM allows organizations the opportunity to do so in 3D rather than 2D. Regardless of how a health system chooses to capture and maintain its information, giving geospatial context to real estate assets has far-reaching benefits throughout the entire organization.

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• Structure Assemblers • Equipment Installers

CONSTRUCTORS

• Architects & Interiors • Engineering Disciplines

DESIGNERS

OWNER/OPERATOR

• Building Maintenance • Facility Planners

RISK REDUCTION ENABLED: CONTEXT FOR INFECTION CONTROL When dealing with Hospital Acquired Infection control compliance, it is not enough to simply react to an emergency. Health systems must also carefully consider prevention throughout a building’s lifecycle. Taking time to carefully consider which building components and attributes, such as volumes, surface materials, room adjacencies and connected ventilation distribution systems, are involved in a health risk situation is always done better without an emergent deadline.

RISK REDUCTION ENHANCED: 3D INTERFACE TO WARRANTIES AND MANUALS It can be cumbersome to keep track of equipment type service requirements, even when being proactive with preventative maintenance, such as maintaining warranty compliance. Utilizing individual asset work order history and mapping these instances to other metrics, such as actual usage, connected system history and even local weather history, can add new layers of intelligence. This enables facilities management staff to make better-informed decisions at an equipment-instance level rather than at an equipment type level.

By using equipment instances – location, access boundary, warranties, owner’s manual and building anatomy system assignment – BIM provides systems with the ability to manage important documents as attributes of virtual building components, rather than storing them elsewhere as separate, abstract artifacts.

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SERVICE STABILITY ENABLED: BASIC BIM STANDARDS Emergent break/fix resolution delays will always result in a temporary productivity loss. This does not always equate to a negative impact on overall revenue income. Real-time awareness of existing conditions for the whole portfolio can certainly help mitigate the impact of losing one mechanical system or some space by providing information related to potential solutions, which already exist and may provide assistance or options for quicker mitigation.

Knowing available equipment replacement requirements and currently available spaces is often all that is needed.

Maintaining the basic BIM of a facility—technology requirements checklists, user skills training and an introductory process to keep the building information model relevant—is a good and easy place to start.

SERVICE STABILITY ENHANCED: MINIMUM BIM MODELS An institutional, centralized repository of historical asset inventories, locations and requirements is much more valuable than individual staff members’ personal knowledge of a particular facility’s layout and equipment needs. This is due to staff turnover, as well as combinations of ongoing rotation of in-house staff, embedded subcontractors and outsourced personnel across various responsibilities. BIM is meant for all stakeholders, and each has potential for use of some minimum BIM, including: foundation, structural columns, building envelope, core, floors, roof and egress elements.

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Array Informatics Extends CapEx and Improves OpEx Array Informatics provides new visible and interoperable solutions for health systems to discover inherent value within their existing FM investments.

Introducing BIM workflows will benefit designers through design and construction projects and, more importantly, benefit operators across repairing and maintaining portfolios. Linking these two initiatives together is where even greater gains can be found.

The AECO industry has recognized for many years that repairs and maintenance service providers that participate early, and prioritize visibility and interoperability during any given design and construction project, will provide facility owners the following benefits: • Gain actionable data more efficiently • Identify problems sooner • Deliver higher levels of effective building performance longer Array believes that there is demonstrated value enhancement for facility owners who seek higher ROI by introducing new BIM workflows based on visibility and interoperability across their entire enterprise, stakeholders, workflows and technology deployments.

We briefly introduced how Array Informatics can partner with healthcare facility owners to develop eight basic BIM workflows, and we are confident that pursuing these virtual hospital solutions will provide value not achievable otherwise.

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Discovering Your Healthcare Solutions Together We are innovators who specialize in the areas your system seeks out to leverage its valuable operational and facility resources. Array Advisors has the expertise and skills to reach beyond your milestones and provide you with the decision support you need.

OUR PURPOSE We are Array Advisors, your trusted partners in Strategy Development, Organizational Transformation, and Facility Informatics. The challenges you face are not unique, but your solutions should be. Through a partnership of Strategy and Transformation we help you achieve and sustain. Our process begins by understanding your current operations and clearly defining your system’s goals before generating options. We employ a variety of integrated methods tailored to your strategic challenges, such as process mapping; operational planning; and healthcare real estate portfolio optimization, to help position your organization for future success.

INFORMATICS: Building Information Model management (BIM) is an enabler of most other technology trends in the Architecture, Engineering, Construction, Operations industry, including but not limited to: sustainable design, offsite fabrication, LEAN construction, and energy efficient operations. Carefully considering how best to leverage virtual/digital representations of physical buildings can provide significant returns on innovation throughout the entire lifecycle of your facilities.

Click here to learn more about our Informatics services.

STRATEGY: The need for healthcare real estate portfolio optimization has never been greater. With the acceleration in mergers and acquisitions, as well as the evolution of clinical models, healthcare organizations must continuously evaluate their physical assets and maximize the value they derive from them.

Click here to learn more about our Strategy services.

TRANSFORMATION: Transformation and lean methods are very useful when focusing on operational process improvement. By bringing all constituents together and giving them the tools to experiment and test new ideas, current state barriers can be identified and transcended.

Click here to learn more about our Transformation services.

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