Is your facility and its electrical infrastructure prepared?

As electric vehicles (EVs) become more prevalent, they present a challenge for institutional-type facilities that have significant on-site parking, in terms of how to address the charging requirements of EV owners. Toronto’s Sunnybrook Health Sciences Centre (SHSC) is one such facility. With a three million ft2 campus and 4,535 parking spots, vehicular traffic exceeds 10,000 cars per day.

In 2018, SHSC was experiencing power outages in parking lots due to EV owners using adapters and extension cords to charge their vehicles from housekeeping receptacles. Recognizing the growing demand for on-site charging and wishing to promote green initiatives, SHSC investigated available incentive programs for an EV charging project.

HH Angus was engaged to assist SHSC in delivering this project. The first decision was to identify the type and number of charging stations that would best meet the needs within the established budget. One of the first decisions was which charging level to provide of the three levels available. Level 2 was selected, offering a full charge in four to six hours.

Key considerations for the supply of EV charging stations included physical construction and design features (for example, retractable charging cords were an important feature); service agreements; built-in wireless connectivity; and warranty coverage. It was also necessary to address the increased electrical load for the parking lots through power distribution upgrades and modifications to existing switchgear.

An important decision with direct impact on the installation design was the selection of dual-head EV charging stations, which allow two adjacent vehicles to be serviced by a single charging station. SHSC eventually installed 20 dedicated EV charging stations.

The entire project was successfully completed in approximately four months. By undertaking the necessary project planning, institutional facilities can help ensure their parking areas are ready to meet the requirements of EV owners and further support of green initiatives.

Philip Chow, P.Eng., P.E., was the lead engineer on the project and is a senior project manager at H.H. Angus & Associates Ltd. He specializes in electrical projects and construction in critical facilities and can be reached at philip.chow@hhangus.com.

Bavan Poologarajah,EIT., was the senior electrical designer on the project and worked on the project from initial concept design to final commissioning. Bavan has worked on a number of electrical projects in critical facilities and can be reached at Bavan.Poologarajah@hhangus.com.

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Sending you our very best wishes for a healthy and happy holiday season!

From your friends at HH Angus

This year we turned our card into a delightful set of DIY desk decorations with special holiday messages.

Some assembly required.
(Because we’re engineers and you know how much we like that!)

Click here to download DIY desk decorations

As another year draws to a close, we particularly want to thank you – our clients, project partners and industry friends – for your role in helping HH Angus achieve the milestone of 100 years in business, which we celebrated this year. We’re grateful for the opportunity to build long-standing relationships and to deliver the kind of dedicated client service that builds trust and respect.  

Over this holiday season, we wish you and yours the very best, and look forward to another great year ahead as we begin our second century – Happy Holidays! 

Guest Speakers:  Michael Hyatt | Dr. Rueben Devlin | Andrew Day

 

Across the board disruption, led by the rapid advance of technology, is changing everything about the delivery of healthcare, from how we think about healthcare, and how we plan tools and strategies for the future and implement these, to what hospitals, primary care, and long term care facilities are going to look like and how they will function in the coming decades.

On October 29th, HH Angus invited leaders from Ontario’s healthcare sector, as well as the financial, real estate, architecture, engineering and construction industries who focus on healthcare, to join us for our Ideation: Healthcare Reimagined. The conference explored how delivery of care will evolve and benefit from the digital transformation disrupting nearly every industry today.

We’re sharing a few of the many fascinating insights from this event to help frame the degree of disruption ahead and the change that will be necessary to successfully deliver better healthcare.  We’d like to thank our speakers for their insights into the impact of technology disruption, the evolution of change in the healthcare industry, and for allowing us to share highlights from their presentations.

Technology Disruption

Michael Hyatt is one of Canada’s top entrepreneurs, and a Founding Partner and Fellow at the Rotman School of Management’s Creative Destruction Lab. He examined the larger view of how disruption is both prevalent and good, and how we must embrace it to create positive change.

Michael shone a spotlight on the sheer unlikeliness of most disruptive changes, which explains the tendency of human beings to not see these big changes coming. Disruption isn’t new; it has been changing the nature of work since the Industrial Revolution, leading to better and more productive work than ever. The explosion of computing power is increasing predictive capacity, with far-reaching consequences and untold benefits. Knowledge is compounding exponentially and the growth in machine learning will bring myriad new opportunities and make obsolete low value, repetitive work. Which is good, Michael said, because studies show that autonomy and a sense of purpose mean more to employees than money when it comes to job satisfaction. Sponsoring creativity, invention and random thinking days in your organization will bring unexpected positive results. Despite the public spotlight on technology, innovation is still about people, and leaders need to focus on keeping staff engaged if they want their organizations to innovate. 

The Future of Healthcare in Ontario

Dr. Rueben Devlin is an orthopedic surgeon and an experienced health care executive with demonstrated success working in hospitals and the health care industry. The former CEO of Humber River Regional Hospital, North America’s first fully digital hospital, Dr. Devlin is currently Special Advisor and Chair of the Premier’s Council on Improving Healthcare and Ending Hallway Medicine in Ontario, and is well positioned to influence the future of health care delivery in Ontario.

Dr. Devlin highlighted the need to take action with a long-term view in mind, in order to significantly improve health outcomes—to plan for services and the facilities that will be needed ten to fifteen years from now, not just next year.  The Council’s second report identified a roadmap for the future of healthcare delivery, outlined under four headings:  integration, innovation, efficiency/alignments, and capacity. Enabling all of these are digital supports, the tools that replace processes and tools now at the end of their useful life, such as outdated fax technology. Digital supports enable improvements in service delivery and make interactions with the health care system more effective for patients and providers.

Integration

Patient-centric health care systems allow medical staff to connect easily with patients and to share information safely and securely among the health care team to the benefit of each patient. He noted that we need to improve patients’ ability to navigate the health care system, ensuring primary care is the foundation of an integrated health care system. We need to connect multiple health care providers to ensure better integration and a simpler, smoother patient/caregiver experience.

Innovation

Improved options for health care delivery include increasing the availability and use of virtual care options, both synchronously and asynchronously. The latter allows patient/practitioner to interface at times that are convenient for both. Patients and providers should be able to use technology to access health services in the most efficient way possible. For example, Ontario has the opportunity to modernize home care, and provide better alternatives in the community for patients who require a flexible mix of health care and other supports.

Efficiency and Alignment

Improvements happen by doing things differently. Data should be strategically designed, open and transparent, and actively used throughout the healthcare system to drive greater accountability and to improve healthcare outcomes. Two examples are:

  1. Ensure Ontarians receive coordinated support by strengthening partnerships between health and social services, which are known to impact the social determinants of health.

     

  2. As the healthcare system transforms, design financial incentives to promote improved health care outcomes for communities and increase value for taxpayers.

Capacity

This includes bricks and mortar, human resources and collaborative inter-professional leadership. We need strong leadership throughout the system—we can’t just simply be caretakers of the current system, because if you are caretakers of the system, you continue to get what you’ve already got.

What could be achieved if we made bold changes?

  • Imagine a health care system where patients can conveniently and securely access their own personal health care information and make healthy choices by accessing preventive services in the community after talking with their primary care provider.

     

  • Imagine a system where providers are working in a team environment and have access to a full continuum of care for their patients, in addition to digital tools and professional development support and resources.

Moving Forward

Dr. Devlin describes one of his main tasks as the identification of barriers in order to make the system work more effectively.

“What are we going to look for? More virtual options for patients and providers. Data used as a management tool—how do we exchange it, how do we share it across the province, and how do we start using it for predictive analytics so it works for us?  We need to think about coordinated treatment plans, designed and delivered by integrated and inter-professional teams as well as upstream interventions, how to modernize our funding system and use Predictive intelligence and predictive analytics. When data is used strategically, information becomes relevant for decision making and we will be better positioned to connect patients to the right care at the right time.”

The Health System of the Future 

Andrew Day is a Principal with GE Healthcare Partners where he leads their global analytic consulting team and the design of GE’s real-time data analytics for hospital command centres. He has extensive experience in the US, Canada, UK, Asia and Australia, working with clients to focus on the future of healthcare facility design to improve operational efficiencies and deliver better health outcomes.

Andy explored the trend he is seeing towards localized community care.  Overwhelmed tertiary and large urban healthcare facilities can’t grow beds or services quickly enough to meet demand—budgets simply do not allow for this. Instead, they are partnering and trying to leverage other care settings (community care and outpatient strategies) as a matter of necessity, not as a matter of convenience. The focus is on how the acute care facilities and the community can work together to solve for the system-wide solution.

Digital Twinning

For new hospital development, digital twinning and simulation models provide the ability to test how systems and spaces will work together prior to construction. It’s vital to redesign the care delivery system itself—it’s not enough to simply digitize the status quo; the actual process of delivering care in the new setting has to change.  By changing the workflow, changing the dynamics and leveraging automation, delivery of care can be done better.

Command Centres

Command centres across a range of industries have common elements. The first is individual operators, individual experts from different functions, co-located, with their own transactional and operational systems in front of them. They also have a wall of analytics providing shared visibility to what’s going on across the system which alerts them to situations they need to act on. Key is that these alerts need to be in near real time and they need to be very specific. The best ones are about a specific patient that needs a specific action right now – or better yet, to forecast that it will be needed before it happens.

In designing a command centre, Andy recommends starting with the problem that needs to be solved, design the action, design the trigger for that action, and then make sure the right people are in the room and empowered with the right culture and the right tools to deliver care more effectively and at a higher utilization rate.

The analytics, or tiles, available in the command centre are also available on tablets as staff move around the hospital, and available on any terminal for staff to log in.

What’s Next for Command Centres?

Andy is looking ahead to broader adoption of command centres to ensure better integration between healthcare units.  Optimizing and connecting care across healthcare systems beyond single campuses. Leveraging AI/Machine Learning (ML) to forecast discharge date, likelihood of re-admission, etc. Guided ML being applied to limited but reliable variables is what is needed for using ML in real time. ML, neural networks, and simulation in the loop are useful forecasting tools and the basic building blocks of true AI, and they are already starting to quietly be applied in healthcare.

Key Take-aways From the Event

The pace of change is phenomenal. Humans initially tend to be afraid of change but time and again history has proven that change has improved our lives dramatically. We’re only seeing the opening act of what technologies like artificial intelligence will do. In healthcare, artificial intelligence will impact the role of health professionals and how they do their jobs, as well as the design of and access to healthcare facilities.


Currently, the hospital is seen as the epicenter for receiving healthcare. However, as demographics and technology changes, we will see a decentralization of healthcare. Healthcare will likely be distributed close to where it is needed – from clinics to homecare to even your phone. Hospitals will continue to be important, but their role will evolve to one more of facilitating and optimizing the system, as opposed to just focusing on the acute care piece of it.


Technology will be critical to the transformation of healthcare. The ability for patients to have access to their electronic health records and to easily transport this to the healthcare provider of their choice will significantly reduce friction in the system and lead to better care. As healthcare becomes decentralized, command centres will play a key role in integrating the various players.


The importance of change management cannot be overlooked. The transformation of healthcare will involve dramatic changes. Governments, healthcare professionals, patients and other stakeholders" need to be informed to the opportunities and buy into a collective vision for the future.

What Will Be the Role of Engineers?

Reflecting on the above highlights, Harry Angus (HH Angus’ CEO) foresees the use of current and foreseeable technology changing the face and means of healthcare delivery in profound ways and, if properly constructed, enabling far better knowledge and control for all patients.

Nice in theory but, practically, how can current leaders of healthcare effect the changes necessary at this point? Although the following is by no means comprehensive, here are some thoughts.

The formation of Ontario Health teams will mean that all health providers within a defined geographic district will need to agree how health care should be managed going forward, which institution or provider is to provide what service, how they will cooperate in creating comprehensive electronic health records and intra-communications systems, and who will assume the role of primary responsibility across a continuum of care.

To fund the changes necessary to address the above points, it will be necessary to create efficiencies out of a district’s cumulative budget, a goal made more difficult in light of the aging demographics of many areas and the fact that the many healthcare providers in the geographic region currently have their own priorities, management structures, and methodologies. It will be a huge change management task and a testament for the leaders who successfully take it on.

There are many areas for consideration; following are our thoughts in areas where we as engineers might be of assistance.

  1. Assessment of facilities located within a geographic region and evaluation of which are up to the task going forward; e.g., would it help to have sole practitioners be co-located, to move non-intensive activities to a different level of facility, or close down some facilities due to age/condition, operating costs, or inability to support on going medical procedures?

     

  2. As the combined vision of healthcare delivery is developed with the team, recommending strategies for how team members will share information, across which systems and infrastructure.

     

  3. Engage with healthcare facilities at the outset of strategic visioning to determine how hospital operations will be reimagined/modified to take advantage of current best practices.

     

  4. Understand how team members will take advantage of alternative technologies and delivery systems, such as virtual care and augmented reality; e.g., how a paramedic might quickly access enhanced medical expertise necessary to a patient.

     

  5. Consider and make recommendations on how remote monitoring may be utilized in proactive and beneficial ways.

The next ten years will witness rapid change in healthcare delivery, due in part to the advancement of technology. The scope and speed of change will be disconcerting to many, but welcome news to every patient who will have the opportunity to access their own comprehensive medical records, much as other industries have already converted their systems.

By proposing a model of healthcare delivery based on geography and a co-ordinated full continuum of care for every individual in that region, the province has served notice that the status quo will disappear. What the new model will look like, and how it will function, will likely vary between regions due to local needs. Technology will be the enabler to move the necessary changes forward.

A game-changer in the wireless communications industry, 5G represents the fifth generation of cellular connectivity and a significant leap forward in performance compared to 4G and LTE. However, in order to plan for its impact in industries such as healthcare, smart cities and commercial buildings, we have to understand its opportunities, limitations and design challenges.

 What is 5G?

First, it’s important to differentiate 5G from other wireless communication protocols such as Wi-Fi.

5G (along with previous standards like 3G, 4G and LTE) is a standard for wireless cellular communications, and uses licensed frequency bands which must be purchased by the carrier. Wi-Fi, on the other hand, refers to technologies commonly used for wireless local area networking – connecting users to a building or residential network which is often owned and operated by the building owner. Wi-Fi uses unlicensed frequency bands which are available for anyone to use, and which can result in an increased risk of signal interference. The new 5G standard augments existing Wi-Fi and LTE standards rather than replacing them – in fact, Wi-Fi 6 (802.11ax) is set to also dramatically change the performance of Wi-Fi communications.

With that in mind, let’s look at how 5G differs from previous generations of cellular technology:

  • Latency, or the amount of time it takes for information to travel from the sender to the receiver is reduced to a theoretical <1 millisecond end-to-end, which is on par with many wired networks. As a comparison, typical home Wi-Fi latency is 2-5 milliseconds, and cable/DSL connections can have latency up to 100 milliseconds. Reduced latency increases the responsiveness for applications like self-driving cars, and can help data speeds appear higher to the end user.
  • 5G supports a higher density of users (up to 1 million per square kilometre or 100 times the density of previous generations). This is a limitation of many existing networks and key to supporting the expansion of the Internet of Things (IoT) and the myriad connected devices carried by people all over the world.
  • Transmission speed, or the amount of data that can be sent in a given period of time, is increased from a maximum of 1Gbps with LTE to a theoretical limit of 10-100Gpbs with 5G. It is anticipated that actual speeds will be an estimated 200Mbps-1Gbps in the field, which is still significantly higher than what most users experience with LTE.
  • Ultra-high reliability of 99.999%, which translates into downtime of less than 5 minutes and 15 seconds per year, and meets the typical standard for mission-critical data centres and networks.
  • Reduced power consumption, which is key for extending the life of battery-powered field devices and IoT.

Although most users won’t notice the difference, 5G also uses different radio frequencies from past standards. Current cellular protocols typically operate on radio frequencies between 1900MHz and 2700MHz; however, 5G uses two distinctly different frequency bands: below 6GHz, which supports standard cellular connectivity (600-700MHz and 3.5GHz in Canada), and above 6GHz, which is focused on point-to-point data transfer (millimetre wave or 28-35GHz) and can only be used for line-of-sight applications. This change has implications for existing infrastructure, as radio frequency communications are highly dependent on the hardware that supports them.

When is it coming?

Frequency auctions are already happening across North America and Europe. Canadian 600MHz frequencies were auctioned off in early 2019, and higher frequencies, including 3.5GHz, are expected to be auctioned in late 2020 and early 2021. Bell Media and Rogers Communications are expected to be the major players at the 3.5GHz auction in Canada, while Ericsson, Qualcomm and other major US cellular carriers indicate that they are ready with 5G infrastructure and can deploy as soon as they own the rights to the frequencies. Some carriers in the US have already launched 5G networks on the 3.5GHz frequency band, and some frequency bands above 6GHz have been auctioned off as well, with more to come later in 2021.

What is the potential impact of 5G on the design, construction and real estate industries?

5G has the potential to support radical advances in technology, and is anticipated to become the new standard for wireless mobile connectivity. However, it doesn’t replace wired networks which still set the standard on data transfer and latency, or Wi-Fi, which uses unlicensed frequency bands to distribute wireless connectivity throughout a building, often at a significantly lower cost per gigabyte.

So where is 5G anticipated to have the greatest impact?

While typical cellular users will experience enhanced performance, better connectivity and higher data speeds, the impact of 5G will mostly be experienced by devices rather than people. Devices such as self-driving cars and robotics which must be able to analyze and react quickly to situations will benefit from the low latency of new technology, and high-bandwidth mobile applications such as virtual reality (VR) and extended reality (XR) will make use of the increased data transmission speeds. 5G also has the capability to connect to a greater number of devices and use less power than previous generations, opening up a wealth of opportunity in the effortless deployment of battery-powered, highly mobile and flexible networks of 5G sensors and devices without the need for additional wiring.

Healthcare: the reliability of 5G connections is well suited to supporting critical healthcare applications, such as continuous monitoring. Higher data transmission speeds will be instrumental in facilitating high-mobility communications for telemedicine, data collection, predictive analytics, machine learning and artificial intelligence. The ultra-low latency wireless connections will also support applications like mobile robotic surgery and virtual reality.

Commercial and Smart Buildings: the explosion of connected devices within buildings will rely heavily on the increased density of connections available under the new 5G standard. Buildings are becoming more connected, IoT devices and sensors are becoming more ubiquitous, and occupants have higher expectations around connectivity and performance. The lower power requirements of 5G also makes it easier and more cost-effective to deploy highly mobile, battery-powered devices throughout the building without significant infrastructure costs. This, along with enhanced reliability, will also support mission-critical applications such as monitoring of building systems.

Smart Cities: navigation systems and self-driving cars will benefit significantly, as will increased density of sensors and users – particularly in areas like stadiums and transit terminals. However, higher frequencies necessitate high density of end-points compared to previous generations, which could have aesthetic implications as antennas move from towers to street level.

In all of these examples, properly designed distributed antenna systems (DAS) will become increasingly critical in the extension of 5G coverage throughout buildings and other areas with limited signal coverage; however, the building itself can have a significant impact on the operation of these systems and must be carefully considered in the early stages of design.

How  do we design differently for future technologies like 5G?

When technologies change every five to ten years but buildings can last anywhere from 30 to 50 years (or even more), designing infrastructure to adapt to evolving requirements is critical to ensuring the building will be able to meet the needs of its occupants both today and for decades to come. One of the key changes with the evolution to 5G is that the new standards rely heavily on optical fiber infrastructure to achieve the required data transmission speeds, rather than traditional copper infrastructure. This means that legacy buildings may need to replace their existing infrastructure in order to deploy 5G throughout their building, and new construction should not only plan for the latest fiber infrastructure, but also install spare capacity to accommodate future generations of technology. It also means that 5G networks are not able to take advantage of Power over Ethernet (PoE) which supplies both data and power over a single cable, since PoE requires copper cable in order to deliver the power component. That being said, there are significant opportunities for PoE and other types of low-voltage distribution to work in conjunction with 5G by powering end-use devices and sensors.

From a building perspective, DAS that supports 5G requires a different topology from previous generations (known as a centralized radio access network or C-RAN topology), which may require changes to pathways and spaces compared to traditional DAS infrastructure. When designing 5G systems, it is also important to consider that higher frequencies do not penetrate buildings or obstructions as well as lower frequencies due to the inherent nature of the electromagnetic signal. Past generations such as 3G, 4G and LTE have used frequencies in the range of 1.9 to 2.6GHZ which had reasonable penetration, but the proposed 5G bands in Canada are significantly higher at 3.5GHz. While 3.5GHz provides better bandwidth and data transmission speeds than lower frequencies, it will also experience higher signal degradation and will require a higher density of antennas. This, along with the requirement for the latest fibre optic infrastructure, can create some unique challenges when performing upgrades in existing buildings which weren’t originally designed to accommodate 5G infrastructure. There are a number of solutions on the market to help ease the transition – and, in some cases, it is worth evaluating whether there are other technologies which could serve the same purpose with a lower capital investment.

Finally, the move towards more energy-efficient buildings can have a significant impact on deployment of wireless technologies of all types, and must be addressed early on in the design of the system. Many modern building materials have a negative effect on wireless signal penetration, meaning that a higher density of antennas is required to provide sufficient coverage. Additional testing may also be required after installation to optimize the system for the unique building environment.

Leveraging 5G in a Data-Connected World

5G has the potential to radically change our experience of connectivity and how we design the built environment. From smart cities to virtual reality, the world is becoming more connected every day – and technologies like 5G are playing a key part in the evolution of our environment. Designing buildings and systems to support these changing technologies in the decades to come will be critical as users increasingly expect a seamless integrated experience, no matter where they are.

Author:

Kim Osborne Rodriguez,P.Eng., RCDD

kim.osbornerodriguez@hhangus.com

We’ve grown significantly since we announced the opening of our Vancouver office. Click here for more current information.

We’re delighted to announce our expansion into British Columbia with the opening of our new Vancouver office.    

While our office may be new, HH Angus is no stranger to working in BC.  We’ve been successfully delivering projects in Vancouver and across the province for over a decade. Completed projects include Penticton Regional Hospital David Kampe Tower Phase I, commissioning of the TELUS Kamloops Data Centre, Royal Jubilee Hospital Patient Care Centre, and Fort St. John Hospital & Peace Villa.

Current local projects include the Royal Inland Hospital New Patient Care Tower, Royal Columbian Hospital Redevelopment Phases 1 through 3, Lions Gate Hospital power plant replacement, and ongoing mission critical facilities work in the Greater Vancouver Area. We’re also excited to be on one of the pre-qualified teams for the new St. Paul’s Hospital P3 project.   

– Top left & right: Royal Jubilee Hospital, Patient Care Centre - Victoria, BC
– Botton left: Penticton Regional Hospital, David E. Kampe Patient Care Tower - Penticton , BC  
– Bottom right: Royal Inland Hospital New Patient Care Tower - Kamloops, BC

Expanding our presence in Vancouver allows us to better serve our clients on their BC projects. With over 100 years in business, we bring deep expertise in a range of sectors including healthcare, commercial, education, hospitality, mission critical and research facilities, industrial, sports and recreation, and transportation.

 The services we offer include Mechanical and Electrical Engineering, Sustainability (LEED, WELL, Net-Zero, Living Building Challenge, low carbon district energy, energy modeling and CFD analysis), Lighting Design, Information and Communications Technology, Smart Buildings, Vertical Transportation, Tenant Improvements, Commissioning and BIM Development. BC’s progressive attitude towards sustainability aligns well with HH Angus’ approach to sustainable design, particularly when it comes to incorporating high performance, low carbon building design and energy solutions. 

“Our Vancouver office is the next logical step in growing our capabilities beyond the large projects we have successfully completed in the province over the years,“We’re looking forward to collaborating even more closely with our current clients and partners while also creating new relationships.”

- Nick Stark, Vice President, HH Angus