Dr. Satish Kumar is the Executive Chairman of AEEE. He is an architect by training, with a PhD in building science from Carnegie Mellon University in the US. He has worked in three different sectors- Public sector, Private sector organizations and at present, he is with the nonprofit sector. He professional experience include working with organizations such as Lawrence Berkeley Lab in the US. He also worked on a USAID project in building energy sector. Prior to his current role, Dr. Satish lead the energy efficiency services for Schneider Electric in India.
In this interview, he talks about the significance of energy efficiency for the healthcare sector and gives recommendations to the hospital owners, administrators and facility managers to reduce the energy consumption in hospital buildings.
The below transcript was prepared from his Audio interview under the “Expert Interview” segment that is available on the AEEE website. To access audio recording, click here
Why is Energy Efficiency important in healthcare sector?
The main function of hospitals is to provide quality healthcare. But the equipment used by the hospitals for diagnostics in particular are consuming more and more energy. Hospitals fall under the commercial building segment. Other types of buildings in this segment are data centers, hotels, and office buildings. On a per square meter basis, hospital consume the highest energy on a per square meter basis among all the commercial buildings. The average energy consumption of a typical hospital building is 350-400 kWh per square meter per year. In relative terms, offices consume about half the amount of energy compared to hospitals. Hotels’ energy consumption is less than that of hospitals, at nearly 300 KwH per square meter per year.
What is the role of the government and regulators in reducing the energy consumption by hospitals?
Globally, governments and regulators are regulating the energy consumed by the healthcare facilities, particularly hospital buildings. For example. ECBC (Energy Conservation Building Code) and PAT (Perform, Achieve and Trade) are two such regulations in India. PAT currently is applicable for industrial consumers, but hospitals could very soon become designated consumers. Under a designated consumer status, any hospital building which has a connected load of 1 MW or more would be required to disclose their energy consumption and the energy efficiency measures the they have implemented. This should explain why hospitals should pay attention to their energy consumption.
What are some of the systems in a hospital that consume the highest energy?
Like most commercial buildings, plug load, lighting and HVAC consume a significant portion of energy in hospitals. But one very important component in hospitals are the medical imaging devices (MRI, X-Ray Machines, CAT scan machines, etc). In terms of figures, The HVAC equipment typically consumes 25 Watt/square meter. Plug load for all equipments in the hospitals consume another 15-18 watts/ square meter. Lighting load is a little lower, but hot water and steam generation consumes high amounts of energy.
What are the most common concerns that are faced by Hospital owners and administrators?
The question that is faced by most hospital owners, administrators and facility managers is, “How best can we manage the energy in the hospital?” There are many approaches that can be followed to answer this question. The first approach is to use technologies that are well proven where no justification or discussion is required. LED lamps are one such example. Compared to conventional lighting, the LED lamps are 2X or 3X efficiency, particularly for areas like operating theaters. The second area is air conditioning systems. A lot of hospitals do not have a central cooling plants, they use VRF or VRV or split AC units. Procuring 5-star AC units will help in significant cost savings in operating expenses over a five to seven year period. Hospitals should also explore incentives by government or utilities for using BEE 5-star rated appliances. For example, in New Delhi area, Tata Power is offering a financial incentive to consumers who use 5-star Air conditions.
For bigger hospitals, a structured approach to energy management is required. The first step for this is to collect data. A good metering or sensor infrastructure can help in collecting quality data. When we talk about other interventions such as retrofits, a prime candidate for energy retrofits is a central AC plant. Merely investing in an efficient chiller is not enough- it does not guarantee an efficiency Air Conditioning System. Auditors or HVC consultants can provide expert advise to test the effectiveness of the systems.
Third and most important component of hospital systems are the imaging systems. This is an area where a well defined procurement and operating strategy is required. For MRI and X-Ray machines, training of the operators by the OEM vendors is crucial for the efficient operations of the systems.
What are some of your recommendations for hospitals at an enterprise level? Say a municipal corporation with network of hospitals, or private sector hospital chains.
Let us take a look at MRI machines because they are some of the highest energy consuming devices. Most MRI machines in India are rated 1.5 Tesla to 3 Tesla, the state of the art machines have 7.0 Tesla. The procurement department can ask question such as, “We are buying a machine worth nearly million dollars or INR 5 to 6 Crores, what is the operating cost of this machine?” The number they need to look at is INR 20-25 lakh (USD 40,000) per year in India. This question does not get asked by most hospitals today. According to estimates, there are about 1,600 to 1,700 MRI machines in India, and between 30 to 50 MRI machines get added to India every year. We can estimate the total energy consumption of MRI machines.
MRI machines are very sophisticated machines, and they use cry cooling of the helium gas that helps in getting the imaging. It is crucial for the technicians to undergo rigorous training from the OEMs and they must follow the operating manuals diligently.
A MRI machine has 4 operating modes, and one needs to understand these modes: Off Mode, Low Power Mode, Ready to Scan Mode, and Scan mode. Low Power Mode consumes nearly had the amount of energy as a Ready for Scan mode. Similarly, if the MRI machine is put into “Off” mode during night times or times when there is no use foreseen, there can be significant energy savings, again to the extent of nearly 50 percent.
Can you talk about some of the research that is being carried out in the area of hospital energy efficiency
There is an organization called European Coordination Committee of the Radiological, Electromedical and healthcare IT industry (COCIR) which is doing a lot of work in collecting and publishing the data for operating the medical equipment. Medical device OEMs such as Siemens, Philips, GE and Hitachi are working with this organization by providing data and collaborating with this institute.
If we consider new hospitals, for example the new campuses for AIIMS, any recommendations at the design and construction phase?
It is important to hire a consultant or a MEP designer who is conversant with the latest technologies and trends in the world. For example, Scandinavian countries and Nordic regions have introduced features such as the design of building envelope that can reduce the hating that is required for buildings. In India’s case, we will require a reduction in cooling load, but similar design principles can be applicable to India. Adhering to ECBC or any green building ratings can help in designing the building appropriately is important.
We need to follow the approach that you cannot manage what you cannot measure. While designing the energy infrastructure for hospitals, it is important to run the electrical cabling in such a way that the lighting, electrical plug power and HVAC load can be measured separately. Installation of meters and sensors during the construction phase results in an small incremental cost but can result in significant savings, because the cost incurred in energy audits is avoided. Similarly, interventions can be carried out at a granular level. Identifying problem areas and troubleshooting becomes predictive rather than reactive.
Where can hospital facility managers, administrators and owners learn more about this subject?