How digital twin technology is informing NHS projects

The healthcare sector has experienced many challenges that have strained its ability to deliver the most efficient and timely care. One issue is the increasing pressure on resources, as hospitals grapple with surges in patient numbers, particularly during peak periods of infection. This has manifested itself in often overwhelmed intensive care units, shortages of essential medical supplies, and exhaustion among frontline healthcare workers.

Increasing patient numbers, and disruptions caused by global events such as the COVID-19 pandemic, have led to delays in elective procedures, routine check-ups, and diagnostic tests. As of December 2023, more than 337,000 patients had been waiting over a year for treatment, with 3.3 million waiting over 18 weeks — the maximum wait time for an outpatient appointment to be allotted. Staff shortages worsen the demand on healthcare professionals. The disruption and subsequent backlog caused by the pandemic, combined with an ageing population requiring increased medical attention, have created a formidable workforce challenge. The lack of skilled healthcare personnel not only contributes to prolonged waiting times, but can also jeopardise the quality of patient care.

Given these issues, healthcare leaders must act to employ strategies to bolster the workforce, improve efficiency, and navigate the complexities posed by the ageing population and staff shortages. Improving operations through innovative technology has become a viable means to support the healthcare sector against multifaceted challenges.

Milton Keynes University Hospital

Like many NHS hospitals, Milton Keynes University Hospital (MKUH) works hard to combat a myriad of challenges faced in managing an acute healthcare estate. While ensuring excellent patient care remains its fundamental priority, ageing infrastructure, population growth, and increasing energy costs, pose operational challenges that the Trust is committed to confronting head on. Renowned for its ability to embrace digital innovation, MKUH is working with Trend Controls, AES, and Haltian, to understand the benefits of deploying one of the first digital twin systems in an NHS healthcare setting.

MKUH is among the 40 hospitals selected to receive funding as part of the Government’s New Hospital Programme (NHP), and will deliver a new Women’s and Children’s Hospital facility by 2030. This substantial investment in the hospital’s estate has provided an opportunity for the Trust to consider the ways in which it sees and treats patients to ensure that their needs are met, now and in the future. The use of digital technology is one way the hospital is finding solutions to deliver service efficiencies and provide additional support for its workforce.

Digitising the ward

In 2020, MKUH opened its new cancer centre. The purpose-built facility’s modern design features a high percentage of single patient rooms, plus several open-plan clinical assessment areas. It is argued that single-patient rooms provide a better patient experience, with increased privacy, and the ability to personalise the care environment. Due to their benefits, single-room wards are beginning to become commonplace in new hospital builds, and will be a key feature within the NHP, where the Government’s intent is to build new healthcare facilities fit for the future.

Despite their advantages, single-room wards have uncovered some new operational challenges. “In wards where we have single patient rooms, nurses have told us they find themselves spending significantly more time trying to locate other members of staff and equipment,” explains Rebecca Grindley, NHP Programme Director at MKUH. “They have also identified how this was causing a high number of non-clinical disturbances in patient rooms, and an increase in noise levels across the ward, as nurses need to call out to find other staff. We know single patient rooms will be incorporated as part of our new Women’s and Children’s Hospital; therefore we were keen to see how digital twin technology could help solve these challenges and support us in providing the best possible care for patients.”

It was identified that digital twins could create a digitised representation of the ward as a map, with real-time data allowing for an immediate overview of staff, equipment, and room occupancy. Key to this was the technology that could deliver the required data. MKUH engaged Haltian, a global Internet of Things (IoT) specialist, to help develop and trial the Digital Twin concept for a hospital setting. Haltian had already previously developed a platform called Empathic Building for visualising digital representation of office spaces and monitoring occupancy. Working together, the Empathic Building platform was developed to provide a digital representation of the MKUH cancer centre inpatient ward using Haltian Thingsee IoT sensors and a Real-Time Locating System (RTLS) to provide a real-time digital view of what was happening on the ward.

Screens at staff stations

Large screens installed at staff stations presented the mapped-out location of equipment and staff, as well as room occupancy. Staff voluntarily opted in to be traced via a personal location tag, which allowed their data to be visualised on the digital twin map. Greater numbers of staff opted in as the benefits of the project became noticeable, with recent staff surveys suggesting that 72% of the cancer ward had opted in.

“The impact was quickly noticeable,” says Rebecca Grindley. “A staff survey showed that 83% of staff on the ward felt they spent less time searching for their colleagues and medical equipment, allowing them to use the time more effectively caring for patients. Staff also reported a marked reduction in patient disturbances, particularly at night.”

The insight into staff and equipment location on a hospital ward was just the beginning for MKUH. The IoT sensors that had been fitted also gave insight into various environmental factors, such as temperature, lighting, CO2, and humidity. MKUH wanted to see if this information could be used to reduce energy consumption by integrating the ‘Empathic Building’ platform with its Building Management System (BMS).

MKUH approached a BMS specialist, AES Controls, to see if this was possible, which led to a new project trial within a newly renovated administration office at the hospital. AES Controls has been a long-time partner of Trend Controls, a Honeywell company and provider of BMS and building control systems, and was supported by the Trend team on the project.

AES first managed to use Haltian’s APIs to integrate the Digital Twin data into the Trend IQVISION supervisor system. Built on the powerful Niagara 4 platform, IQVISION can integrate Trend controllers, third-party devices, and internet protocols into a single, centralised software platform for managing buildings at an enterprise level.

Powerful control features

With the data now available within the IQ Vision, AES incrementally set up control features that could efficiently manage the office area’s heating, ventilation, and air-conditioning (HVAC) system. Just as the digital twin had given MKUH’s ward staff a clear picture of activity, the platform’s data was able to give AES and the hospital’s Estates & Facilities team visibility of building usage, and allow them to make changes to the BMS accordingly.

“The first step for us was to use the building’s occupancy data to understand how rooms and parts of the building were typically used,” explains Craig Mason, Account Manager — Support Services, at AES. “When we could see what times rooms would become unoccupied on a standard day, we integrated time clocks that would automatically shut off systems at those times. Just making this change led to immediate reductions in energy consumption on site.”

In addition, the local controllers on AC systems around the site were limited to +3 and -3 degrees Celsius from a setpoint temperature. Previously, this wasn’t possible, as the hospital lacked a central point of control for the AC systems. With data and control now readily available in the IQVISION BMS, MKUH could have greater control over AC-related energy consumption. Similarly, the humidity and CO2 data from the Haltian sensors were used to inform the ventilation control over specific rooms throughout the ward.

The impact on energy consumption across the site was striking. Within a few months of the project being completed, the site team at MKUH saw a consistent 40% reduction in energy consumption. This comes at a time when hospitals were braced for a 200% increase in energy costs.

“Knowing now how we can use digital technology to improve patient care and support effective estate management decision-making puts us in a good position ahead of the development of our new Women’s and Children Hospital,” concludes Rebecca Grindley. “There is still work to be done to ensure seamless integration is achieved and felt by occupying staff. However, we have been impressed with the progress, and believe the insight this collaborative piece of work has given us will play a huge part in how we use digital technology to improve our estate infrastructure and provide facilities fit for the future for both patients and staff.”

Further reading

BMA. NHS backlog data analysis. Published: 6 February 2024. https://tinyurl.com/3stzy4pw
Guy’s and St Thomas’ NHS Foundation Trust. Waiting for your appointment or procedure.
Davies J. Death of the traditional hospital ward? New NHS hospitals might have to be built for single patient rooms ONLY. Daily Mail Online. 30 September 2022. https://tinyurl.com/bdwbcecj
Energy reduction calculation based on a six-month (October 2022 — March 2023) base level data prior to site updates being implemented. Energy data provided by Milton Keynes University Hospital via its own reporting.