Building Smart: A Process-Oriented Approach to Healthcare Facilities

As the healthcare industry evolves, the need for intelligent, adaptable, and resilient healthcare facilities has never been greater. However, truly smart healthcare buildings are not defined merely by advanced technology or automation but by a well-integrated process that meets the specific needs of its operator, prioritizing efficiency, sustainability, and, most importantly, patient care. The architecture, engineering, and construction (AEC) industry must shift its focus from isolated technological implementations to a holistic, process-driven approach that ensures healthcare facilities remain resilient, adaptable, and future-ready. 

One of the greatest challenges in healthcare facility design is the long lifespan of buildings and the difficulty of renovation. Unlike commercial or residential spaces, hospitals and clinics must operate continuously, often making extensive retrofits impractical or disruptive to patient care. Smart healthcare buildings leverage a converged infrastructure where operational technology (OT) and information technology (IT) work together to create an environment that is not only efficient but also adaptable to future advancements. Terms such as “single pane of glass,” “digital twin,” and “fault detection and diagnostics” should be understood not as standalone features but as essential components of an integrated system that improves operational efficiency and patient outcomes, but questions often arise as to who is actually responsible for implementing them. 

The design phase is critical in determining whether a facility will ultimately function as intended. Smart building consultants help owners develop and define their vision for a project, working closely with stakeholders to establish use cases, operational goals, and system expectations. They ensure that technology decisions align with long-term objectives and strategic planning. Master System Planners (MSPs), on the other hand, are responsible for translating this vision into the actual technical requirements of the project. This role is a relatively new concept designed to address the scope gap between the C-suite, their consultants, and the design team. By coordinating across engineering disciplines, master system planners ensure that various building systems—such as HVAC, lighting, and security—are designed to be fully integrated and capable of supporting long-term efficiency and adaptability. While this role is particularly valuable in complex environments like healthcare, where uninterrupted service and strict regulatory requirements are crucial, it is essential in any project seeking to implement smart building solutions effectively. 

Despite best efforts in design, many challenges arise during construction, often due to procurement practices that prioritize cost over functionality. General contractors frequently seek the lowest-cost solution that meets performance-based specifications, which can result in minimum viable products that fail to deliver on integration and long-term usability. In a healthcare setting, where reliability and redundancy are paramount, such compromises can have serious consequences. The introduction of a Master System Integrator (MSI) working with the general contractor can help mitigate these issues by overseeing the implementation of smart systems, ensuring that design intent is preserved through installation and commissioning. 

For healthcare facilities to meet the growing demands of the industry, the AEC sector must embrace a paradigm shift—one that moves beyond fragmented solutions and acknowledges the need for structured coordination among stakeholders. By establishing clear roles, fostering collaboration across disciplines, and prioritizing process over products, we can create healthcare buildings that are not only technologically advanced but also resilient, adaptable, and truly smart, ensuring they continue to serve patients and healthcare professionals effectively for decades to come.