Localized Battery Storage and Backup Systems Save Lives: Creating Outage Resilient Hospitals and Healthcare Facilities

Overview                                                                             

There are places where losing power is simply not an option. Hospitals and healthcare facilities rely on electricity to provide diagnostic and treatment services and keep people alive. In a natural disaster or extreme weather event, hospitals play an even more important role. They must not only carry on the day-to-day business of keeping people healthy, but they must also take on the role of first responder on the front lines of a disaster.

Unfortunately, even when emergency power supply systems or backup generators are employed, they may not always be reliable. It is estimated that 23 percent of generators fail when called upon in a power outage. New York City hospitals had backup generators in place during Hurricane Sandy but many failed because of storm related issues. Others simply did not have enough fuel to last through the sustained outage. Patients were moved, and the city was forced to face the disaster with dangerously reduced health care resources.

HIPAA rules on contingency planning state that healthcare organizations return to normal operations as quickly as possible and ensure that the confidentiality, integrity, and availability of ePHI is safeguarded. CFR-2007, Section 164.308(a)(7)(ii) Implementation Specifications, requires the implementation of an Emergency Mode Operation Plan-308(a)(7)(ii)(C) “Establish (and implement as needed) procedures to enable continuation of critical business processes for protection of the security of electronic protected health information whileoperating in emergency mode” to include emergency backup power systems. These systems need to be resilient and function independently of the utility grid during times of disaster to achieve the ultimate goal of reliable and continuous electrical power to maintain continuity of operations and patient care. (1

1) Mark Williams / Special to Healthcare Facilities Today June 6, 2016

Goal

This paper is designed to provide a guide to organizations developing or reviewing their emergency operations planning for backup power and for those considering the inclusion of a battery power system as a primary solution or an enhancement to an existing generator backup. The addendum includes a tear sheet checklist that may be used to support emergency operations planning decisions.

Key Electrical Backup Considerations

In addition to ensuring continuity of critical processes, a battery backup/power system must also fit within the financial and overall safe operations of a hospital or healthcare facility. Battery equipment must demonstrate:

• Long term cost savings with a return on investment (ROI) that covers the capital purchase, O&M and decommissioning costs, and;
• Ability to power hospital equipment safely and effectively.

A sufficiently engineered battery solution makes existing backup systems more reliable, highly resilient, less costly and pays for itself over the long term.

Durable Medical Equipment, ePHI and Other Critical Loads

A hospital’s continuity of operations relies on the consistent and uninterrupted operation of electrical equipment and systems. Inability to operate electricity-dependent Durable Medical Equipment (DME) and losing access to data processing systems such as Electronic Health Records (EHR) are examples of the disruptions that a hospital may experience during an outage. These systems may constitute approximately 50 percent or more of a hospital’s electrical load requirements but are not the only critical electrical loads that must continue operating during a prolonged power outage. Overall, a hospital or medical facility will experience the loss of availability or access in the following areas:

• HVAC systems that rely on electricity for heating, cooling, and ventilation.
• Respiratory devices and other critical equipment for intensive care, neonatal, or cardiac units.
• Emergency lighting and lighting for high-risk surgical procedures and potential black out of rooms without emergency lighting.
• Pressure in water distribution systems.
• Potential access to other hospitals and medical facilities.
• Access to ePHI such as electronic patient medical records and other hospital data.
• Inability to access and support electronics communications through internet-based network connectivity or radio access network equipment
• Patient signaling systems for assistance by medical and hospital staff.
• Potential loss of access to medication, vaccines, and other medical supplies requiring keyless entry.
• Vaccine refrigeration within the cold chain to keep vaccines and other medicines at temperature.

With a fully functioning diesel generator, a hospital or medical facility will experience continuous operations in most of the areas listed above. However, what is the facility contingency plan when a generator fails; when there’s loss of electricity dependent DME operations and systems; when the generator takes several minutes to bring electricity online; or when the generator runs out of fuel due to an extended duration grid power loss?

Enhancing Your Electrical Posture

Loss of electrical power affects a vast majority of systems within a hospital or medical facility. This adversely affects the hospital or medical facility’s ability to provide patient critical care and life support functions. On-site generators provide backup to the entire facility. However, upon a generator failure or loss of fuel, what measures are in place to ensure that the most critical systems continue to operate? Are the measures sufficient to ensure continuity of operations of DME and other systems so that contingencies such as individuals having to be evacuated or relocated from the hospital or medical facility are delayed or not necessary? Does the hospital or medical facility incorporate a tiered approach to ensuring electrical continuity of operations?

Having plans and measures in place that further protect critical systems and electrically dependent DME with battery storage systems can add hours or days of electrical power to the existing electrical infrastructure to operate critical care, life support, emergency lighting, EHR, Laboratory Information Systems (LIS), vaccine storage and security systems.

Hospital Applications for Battery Backup

Battery energy storage and electrical power systems provide enhanced protection as a continual electricity source for uninterrupted power through outages(2 . These include battery powered uninterruptible power supplies (UPS) for short term transition power of 30 minutes or less and emergency power systems to provide longer term power. Smaller versions can be co-located with electricity-dependent equipment in areas such as a patient room, surgical theater, server room or vaccine refrigerator room. Due to their mobility and size, a portable battery power system can be plugged into a wall outlet while the DME or other critical care equipment is plugged into the battery system. This can serve as either a short-term or long-term solution for maintaining electrical power to equipment. Additional batteries may be added or swapped out as needed to extend capacity without shutting down equipment. These systems can also be tied directly into electrical wiring to provide power to a limited number of circuits, for example. Lastly, these devices have the capability to recharge from renewable sources such as solar or wind power during prolonged outages.

2) https://en.wikipedia.org/wiki/Continual_power_system

Categories for Enhanced Protection The following DME, critical care, lighting, security, and data processing equipment would benefit from battery backup support. The power consumption requirements of the equipment types listed below is standard 15A/20A hospital plug outlet, 115VAC/120VAC at 50Hz/60Hz.

• Oxygen, Respiratory and Cardiac Devices: Respiratory therapy equipment that provides treatment of breathing disorders and other cardiopulmonary needs.
• Infusion/Intravenous, Anesthesia and Feeding Equipment: Equipment/devices that deliver fluids, nutrients, and medications into an individual’s body in controlled amounts.
• Mobility Assistive Equipment: Equipment that performs one or more mobility-related activities of daily living (ADL) or instrumental activities of daily living (IADL) in or out of the home, including access to the community.
• Vital Signs/Patient Monitoring Equipment: Temperature, pulse rate, respiration rate, blood pressure and other specialized, in-room, vital signs monitoring equipment.
• Pathological Laboratory, Radiology & Diagnostic Equipment: LIS, portable X-Ray and ultrasound machines.
• Emergency and Surgical Suite Lighting and Surgical Displays: Tripod lighting, surgical suite LED, fluorescent lighting, and HD LED and OLED display monitors.
• Data Processing, EHR and Accounting/Billing Systems: Access terminals, data carts, server equipment, printers, and network connectivity equipment.
• Refrigeration: Medical refrigerators for vaccine and cold medicine storage.
• Security: Access doors, camera systems, video servers and computers, and.
• Communications Equipment: Radios, phones, WiFi and cell repeaters, concentrators, battery chargers, and patient signaling systems.

Backup Power and Shelter Operations(3

Certain emergencies or disasters require individuals who rely on electricity-dependent DME to evacuate, leaving them inadvertently separated from their critical electricity supplies. In addition to going to healthcare facilities, electricity-dependent people will also seek support at community-based shelters. Emergency managers and public health providers should plan to ensure that these community shelters will be able to access electricity and power sources to support DME equipment. If electricity is available, priority should be given to individuals who rely on electricity dependent DME such as life-sustaining (respiratory, cardiac) medical equipment. Those who depend on electricity-powered wheelchairs and scooters for mobility must also be able to frequently recharge equipment to ensure they are able to move about and participate in services offered by the shelter. A battery backup can effectively provide the energy needed to power electrically dependent DME when an evacuation is inevitable or unavoidable.

3) TRACIE HEALTHCARE EMERGENCY PREPAREDNESS INFORMATION GATEWAY

Key Battery System Feature Considerations

Unlike commercial or residential installations of battery energy storage devices hospitals and healthcare facilities must consider additional requirements due to the criticality of the equipment that must remain operational during power outages. For example, they must consider conditions such as whether equipment must remain powered in the case of an evacuation, the level of portability to support mobile DME and the output power stability of the battery power equipment. Several points of consideration are:

• Transportability: How easy is the equipment to carry and transport. What are the lift requirements? Is it wheel transportable?
• Battery Capacity: What’s the operating capacity in minutes, hours, or days?
• Hot Swap Capability: Can batteries be added and removed without powering down the equipment? If so, what is the process for accomplishing a battery swap? What are the technical staff qualifications for accomplishing a battery swap?
• Sufficient Equipment Operating Power: Can the device power nominal loads continuously without overheating or shutting down prematurely? What is the rated surge wattage and duration?
• Clean Power Output: Is the output power utility grade pure sine wave and not modified sine wave to ensure DME and critical care equipment is not damaged?
• High Fault Tolerance: Can the device self-correct operational faults and restart automatically after a fault condition? If so, what are the conditions that are covered by automatic fault restarts?
• Ease of Use: Can the device be operated without programming? Are there clear operation indicators? Are there power lockouts to prevent inadvertent power shutdowns?

Key Battery System Cost Considerations

In order to be of value to a hospital or healthcare facility, a properly engineered battery solution must not only make existing backup systems more reliable and highly resilient but help to make them less costly and pay for itself in the long term in order to show a positive ROI.

The system must be such that the total ROI covers the capital purchase, O&M and decommissioning costs. Battery systems must demonstrate the ability to protect sensitive equipment from failures and malfunctions that may be caused from conditions such as voltage sag, surges and power failures. Ultimately, a battery system must demonstrate that its introduction into the electricity path provides cost savings as well as supporting electrical resilience and patient safety.

Sol Donum™ Products for Electrical Resilience, Safety and Preparedness

Sol Donum™ offers a range of durable energy solutions that feature safe, efficient, and non-toxic lithium iron phosphate (LiFePo4/LFP) batteries and industrial components. These are designed to provide long term backup power for hours or days, unlike a traditional UPS. However, they can work in conjunction with a UPS to transition ePHI systems when the battery SoC is low. swappable with short circuit and overload protections, which makes them suitable for fixed or mobile hospital and healthcare facility applications.

Hospital Devices that Vulcan Can Power

Vulcan can help you achieve your electrical resilience and preparedness goals by providing clean and stable energy when needed most to power critical loads for hours or days. The following medical devices can be safely powered by Vulcan:

• Oxygen, Respiratory and Cardiac Devices.
• Infusion/Intravenous, Anesthesia and Feeding Equipment.
• Mobility Assistive Equipment.
• Vital Signs and Patient Monitoring Equipment.
• Pathological Laboratory, Radiology & Diagnostic Equipment.
• Emergency and Surgical Suite Lighting and Surgical Displays.
• ePHI Data Processing, EHR and Accounting and Billing Systems.
• Vaccine and Cold Storage Medicine Refrigerators.
• Security Systems, and.
• Communications Equipment.

Vulcan Cost Savings and Features Benefits

Vulcan provides long term cost-effectiveness and cost savings with the following features and benefits:

• Pure sine wave output power protects sensitive IT and medical equipment and reduces equipment failure.
• Voltage sag and low grid voltage protection keeps IT and sensitive equipment from shutting down.
• Reduces maintenance and device re-coding needs. Thus lowering overtime labor costs.
• High 92% energy conversion efficiency reduces electricity costs.
• Safe battery technology does not overheat, is fire safe and lasts for 10 years at over 5000 cycles - reduces the overall battery decommissioning, maintenance hours and personnel costs.
• Field maintainable with spare parts keeps units in inventory longer.
• High capacity battery storage up to 100kWh allows Vulcan units to power devices for hours or days.
• Automatic transfer switch keeps devices powered in the event of a power outage or diesel generator startup with a low 5W of standby power (equivalent to an iPhone charger). This means lower electricity costs to maintain the battery system SoC.

Conclusion

We all rely on hospitals and healthcare facilities for care of life and life safety needs. A hospital’s ability to provide the highest levels of care must be constant even when the electrical grid is not available for power. On October 29, 2012, Hurricane Sandy caused massive power outages and property damage in New Jersey and New York and affected 24 states in all. The result for hospitals was a 23% failure of all backup generators leaving facilities with no electrical power. Having a resiliency plan with suitable battery backup power supports HIPAA requirements and lowers overall equipment and labor costs. The savings can be used to cover battery system capital costs and O&M expenses, and, most importantly, ensure that a hospital’s patient care continues when grid and generator power does not.

About Sol Donum™

Sol Donum™ (www.soldonum.com) is a U.S. domiciled power technology developer and integrator founded in 2019. Our products are built for robust operation in the toughest environments and our professional services arm provides engineering and technical support for contingency planning, and battery storage and power solutions around our products.

The company was founded by electrical and software engineers and information technology entrepreneurs who built their careers within the U.S. Federal Government, U.S. DoD, U.S. Intelligence Agencies and the telecom industry. We welcome your call to discuss how we may provide battery storage for your organization sales@soldonum.com.

Addendum

Power Loss Protection Checklist

Hospital executives can provide enhanced protection for local hospital facilities against grid power loss through a variety of means. Below is a summary of key areas of consideration when mapping or reevaluating hospital and healthcare facility power backup systems. Following is a checklist tear-sheet that can help identify areas for risk mitigation and support planning in advance of a prolonged or widespread power outage. This can be used to support the development or update of your organization’s HIPAA Emergency Mode Operation Plan.

Existing Generator Power Systems

• Enhance backup power generation: Diesel generators are the most available and a proven source of backup power that should be maintained and exercised. However, they have severe limitations in an extended power outage scenario. Diesel generators must have sufficient backup power to meet critical mission areas. Equally important, facilities must have sufficient diesel fuel supply to endure an extended power outage. Hospitals are required to have 96 hours of fuel, but seven days is a more realistic minimum standard for smaller day-to-day outages. If an extended power outage occurs, contracted fuel delivery would be assigned to the highest priority requirements and redirected by local and federal officials. In extended power outages, refineries may cease functioning and little fuel may be available at all. Fortunately, the infrastructure of backup power can be used to form the design basis of an on-site or near-site microgrid or battery energy storage.

New Backup Power Systems

• Create an on-site (or near-site) power generation and storage capability: Renewable energy such as wind, solar, and geothermal systems can diversify electrical energy sources and enhance resilience. The challenge is to have sufficient energy storage such as batteries to always meet critical needs. This solution (i.e., renewable and battery energy storage systems) can serve as an uninterruptible power supply (UPS) for the base load that can continue to operate through the power outage, thus allowing backup diesel generators to either be kept in reserve to support the hospital infrastructure or provide power over and above what the generator would provide in the case of a prolonged outage.
• Consider creation of EMP-protected facilities for power, network, and data center/server room infrastructure: The development of a control room for a new microgrid could be expanded to provide protection for other networking, data center, and security needs from Electromagnetic Pulse (EMP) energy.

A Checklist in Advance of a Prolonged or Widespread Power Outage (4 (in PDF)

4)For a complete HHS Sustainable and Climate Resilient Healthcare Facility Initiative Element 3 Checklist, visit

https://toolkit.climate.gov/sites/default/files/SCRHCFI%20Checklist%203%20081415_Form.pdf