Ahead of its time: the rise of the all-electric hospital

This article introduces the concept of an all-electric hospital, highlighting the pivotal role of electrification and digitisation in revolutionising healthcare infrastructure, with an emphasis on the challenges and opportunities associated with replacing traditional energy sources with electric alternatives. Electrification and digitisation play a crucial role in achieving these objectives by reducing emissions, optimising energy usage, and promoting environmentally friendly practices. However, there are challenges to overcome, such as initial capital investment, regulatory compliance, and the reliability of newer technologies. Implementing an all-electric hospital requires careful planning, including conducting energy audits, researching suitable electric alternatives, analysing the grid energy mix, and redefining asset management strategies.

The transition to all-electric hospitals can significantly impact power demand, requiring the redesign of electrical infrastructure, the installation of EV chargers and solar PV generation, and the replacement of back-up diesel generators with greener alternatives such as hydrogen fuel cells. While there are challenges to address, designing all-electric hospitals is certainly feasible given the coordination of multiple stakeholders and a commitment to sustainable practices.

A key decarbonisation factor

Electrification of healthcare facilities is now recognised as a key decarbonisation vector. By integrating electrification with digitalisation, healthcare facilities can manage complex electrical solutions efficiently, creating a sustainable and self-sufficient environment. Transitioning to an all-electric estate is complex, and presents several challenges. It requires careful planning, including energy audits, research on suitable electric alternatives, analysis of the grid energy mix, and redefined asset management strategies. Common challenges include capital investment, regulatory compliance, facility lifecycle and asset management, adoption and reliability of new technologies, and energy supply management.

To advance their infrastructure through electrification and digitalisation, NHS Trusts are looking to partner with experienced technology providers like us who are already guiding clients through this transformation. We recommend focusing on three critical areas to accelerate progress:

• Replacing infrastructure dependent on fossil fuels with electric alternatives to effectively shift direct, Scope 1 emissions into indirect, Scope 2 emissions.
• Implementing effective metering and monitoring technologies to optimise energy usage and reduce consumption.
• Integrating renewable energy into the power mix to further decarbonise supply and transform healthcare providers from power consumers to prosumers by introducing microgrid solutions.

Our analysis reveals that this all-electric design requires 2 to 2.25 times more electrical power capacity than the original design, highlighting the need for robust planning and an innovative approach to healthcare facility infrastructure.

Grid capacity challenges

The limitations of the national grid’s ability to meet increased demand pose challenges, but also opportunities for growth in local renewable energy generation and decentralised electricity methods.

Future electrical supply scenarios will shift from a linear, one-directional supply, to a bi-directional model. In a one-directional system, energy flows from power generation to the consumer. In a bi-directional system, energy can flow into an organisation and back onto the grid. We envision a future with distributed power and a bi-directional system, where local renewable generation is managed through microgrid arrangements, supplementing traditional methods. Our ETAP digital twin technology assists in future planning, using digital solutions to provide accurate scenario planning for potential changes. For example, if a new wing is added to an existing hospital, data can predict its impact on patient flow and electrical demand.

Local generation and distributed power supply models address infrastructure challenges, and create a sustainable and self-sufficient energy model, benefiting not just the NHS, but the entire country.

Digitalisation for visibility across your estate

The increasing trend toward electrification is adding complexity to healthcare operations, and — like many organisations — the NHS will need to adopt technologies such as machine learning and artificial intelligence (AI) to support and enhance existing staffing and solutions. Aligning digitalisation efforts across the hospital infrastructure with broader healthcare developments is crucial, and applies to both legacy systems and new constructions. This shift affects everyone involved — from patients and visitors to staff and suppliers, and positively impacts decarbonisation, sustainability goals, and overall efficiency, by providing insights through data measurement and collection.

Connecting various data sources, and establishing digital infrastructure, opens opportunities for improved efficiency and operational insight — including into how the facility is managed by the Facilities Management team, logistics, internal transport of goods, and scheduling of assets and activities. It also influences future adaptability. For example, if a new treatment requires redesigning pathways, using a digital twin or AI for scenario planning can help the key parties involved understand the impact of changes to the system.

Digitalisation offers visibility into assets, people, activities, and pathways, improving understanding, and highlighting areas for potential improvement. However, a shortage of digital expertise within NHS Trusts presents a challenge. Our Connected Services Hub addresses this by providing 24/7 remote monitoring. We transform raw data and information from organisations lacking in-house expertise into intelligent insights using nearly 500 AI-powered algorithms. Automating tasks that previously needed human intervention frees up valuable resources for other areas, and supports data-driven investment decisions, ensuring that limited capital is used where it is most needed. This digitalisation enhances estate operations through a better understanding of equipment performance and condition, as well as future planning. While challenges exist, designing all-electric hospitals is achievable with the collaboration of various stakeholders and a commitment to sustainable practices.

• The all-electric hospital: a case study

This section of the article presents a theoretical case study on how electrification affects the power needs of an 800-bed acute care hospital in a Mediterranean climate. The hospital, which serves 500,000 patients annually, initially relied on a combination of electrical and fossil fuel-dependent infrastructure. Our goal was to replace gas and diesel systems with electric alternatives, reducing the facility’s carbon footprint, and enhancing energy efficiency.

Initially, the hospital’s infrastructure included a 16 MVA electrical power capacity distributed across eight sub-stations, with back-up power from diesel generators, and gas-fired boilers for heating. The shift to electrification required a detailed analysis of the hospital’s energy needs. We focused on replacing the gas-fired heating and domestic hot water (DHW) boilers, which accounted for a significant portion of the hospital’s energy consumption.

To achieve this, we introduced a combination of water-to-water (WTW) heat pumps, air-to-water (ATW) heat pumps, and electric boilers. This new system is designed to provide 10.5 MW of hot water for heating and 4 MW for DHW. The configuration includes heat pumps connected in series with electric boilers as a back-up, ensuring reliability during peak demand periods or emergencies.

In addition to heating, we addressed the electrification of kitchen and laundry services. This change required an estimated 2 MVA of additional power, acknowledging the enhanced efficiency of modern electric appliances. The transition supports the hospital’s efforts to reduce its reliance on fossil fuels and minimise carbon emissions.

Re-designing electrical infrastructure and integrating renewables

The electrification of gas-fired systems increased the hospital’s electrical power capacity needs to 27 MVA. Next, we redesigned the infrastructure to include electric vehicle (EV) charging stations, aligning with international directives for public buildings. With approximately 2,200 parking spaces, 15% are equipped with EV chargers, and an additional 10 EV chargers are dedicated exclusively to emergency response vehicles. A load management system is implemented to efficiently distribute power based on real-time demands. In total, the EV chargers added 8.7 MVA to the hospital’s power needs.

We also integrated renewable energy solutions by installing on-site rooftop solar photovoltaic (PV) generation, providing 2 MVA of power. This effort reduces grid dependency, and supports non-essential loads. Pairing the solar PV with a 16 MWh battery energy storage system (BESS) allows for peak load shaving, and acts as back-up power during outages, supplying an extra 4 MW when needed.

Traditionally, hospitals rely on diesel generators for back-up power. To reduce emissions, we explored hydrogen Proton Exchange Membrane Fuel Cell (PEMFC) technology. Initially, we retained the diesel generators to meet traditional demands while deploying a 9 MVA PEMFC power plant. As hydrogen technology becomes more available, the diesel generators can be progressively replaced by additional PEMFC modules, eventually achieving a zero-carbon backup solution.

Conclusion

Overall, after electrifying fossil fuel-dependent loads and upgrading the infrastructure to support EV chargers and solar PV generation, the total grid capacity demand of the electrified hospital has increased from the original 16 MVA to 32 MVA (a factor of 2), considering the grid demand reduction achieved via solar PV and the BESS. Without these considerations, the increase is from 16 MVA to 36 MVA (a factor of 2.25).

Our all-electric hospital architecture demonstrates a practical approach to decarbonisation in healthcare facilities. This transition supports healthcare facilities in meeting their Net Zero goals while maintaining reliability and cost-effectiveness. As we continue this journey, engagement with grid authorities and leveraging green technologies will be crucial in addressing the increased demand for electricity and ensuring sustainable healthcare infrastructure.

The rise of the all-electric hospital is no longer a distant aspiration, but an achievable reality, with the potential to deliver profound benefits. Arriving at that reality requires careful planning, capital investment, specialised expertise, alignment, and collaboration across multi-disciplinary stakeholders within the estate. Establishing a network of external experts and advisors is equally important to your pursuit. With specialised expertise in the healthcare sector, a best-in-class portfolio of software, and infrastructure solutions for all-electric hospitals, Schneider Electric is the proud partner of more than 6,500 healthcare sites worldwide. At Schneider Electric, we believe nothing should hold your healthcare facility behind. Join us today as we journey towards the healthcare facility ahead of its time.

•  To access and download the Schneider Electric white paper, The Rise of the All-Electric Hospital, visit https://www.se.com/ww/en/download/document/998-23682350/