By Susan Xu
Do you know how many steps a nurse walks every day in your hospital? How many trauma cases happened on the highway near your hospital in the past 10 years? How about the demographic trends or disease occurrence trends in your service area? According to Ajit Singh Ph.D., considering these factors can contribute to optimized hospital design that saves time and money.
Singh is CEO of Aditazz, a Silicon Valley design startup and one of the two winners of Kaiser Permanente’s “Small Hospital, Big Idea” competition. The key, says Singh, is an algorithm that evaluates hundreds of thousands of variables to calculate the best outcome possibilities, generating an “optimized design.” Things such as steps and trends are only a fraction of the more than 100,000 input variables Aditazz’s algorithm considers to achieve “optimized operational, environmental, financial, and aesthetic performance” of a hospital.
To illustrate the concept of optimized design, Singh, who also taught at Stanford as a consulting professor, quizzed me with a multivariable calculus problem. Suppose the hospital we want to build will have 10,000 outpatient visits per month; the waiting time to see a doctor shall be no more than 10 minutes; and the time a patient spends with a doctor cannot be less than 5 minutes. How many doctors and rooms do we need? “There are many possible combinations,” says Dr. Singh, “We need to find the best combination based on the salaries of doctors and nurses, and operating cost of the rooms.” The optimal combination can be computed once we decide our priority of value, for example, to minimize costs, or to maximize revenue, or to limit patient waiting time.
This design concept is both new and old. To the founder of Aditazz, Deepak Aatresh, a microchip designer from Intel, it was a way of life in the chip industry, an industry that coined the famous Moore’s law: Performance doubled every 18 months, at the same cost. To the hospital building industry, though, it’s a new idea. That probably explains why on average it takes four years to build a hospital, while to build a similar size ship it only takes about four months.
Aditazz might be the brainchild of one man, but it takes a team to turn it into reality. The team, Singh says laughingly, looks like a little United Nations. The 70-plus employees at Aditazz represent 50 different nationalities and myriad disciplines, from architects, engineers, mathematicians, to nurses and doctors.
What the team creates is a powerful collaboration between human and computer. “Computers are great at number crunching and humans are great at pattern matching,” says Singh, who has a PhD in computer science from Columbia. Once a thought process is coded into the computer software, it can be executed repeatedly with greater accuracy and efficiency. “Computers won’t take human intuition away; instead they will allow human intuition to make more complex and higher-level decisions.”
Applications of Aditazz’s platform are not limited to building new hospitals. According to Dr. Singh, the platform can also facilitate the remodeling or repurposing of existing facilities through its ability to work with inherited constraints, such as existing layouts and floor plans. Leaders can take a virtual tour of the planned hospital design or redesign in advance, allowing them to make more informed decisions.
The result of Aditazz’s revolutionary approach is quite remarkable. It enables Aditazz to deliver what Singh calls a 10/30/10 value composition: 10 percent reduction in upfront capital expense; 30 percent reduction in execution time; and 10 percent reduction in operating expense of the building over its lifetime. Of course, the value composition itself can be optimized as well. For example, you may decide to trade capital expense for lower operating costs in the long run, for example by investing in green ecosystems.
Even more impressive, however, is the level of flexibility offered by the new approach. In the old-fashioned way, design decisions are made in a sequence—you can’t move to the next step before finalizing the current one. Changes at the last minute will be costly, if not impossible. In the virtual world created by Aditazz, though, “No decision is final until all decisions are final.” “You can keep all design options open until you are sure of the performance of the hospital,” says Singh, “You can live in the hospital virtually before you build it.” It also helps leaders make more informed decisions, because they can take a virtual tour of the planned hospital design in advance.
For the Kaiser Permanente competition, Aditazz proposed a small net-zero energy hospital. It includes, for example, a patient mobility platform that facilitates and measures patient mobility: “Ample evidence suggests patients heal faster when they are mobile.” The award also recognizes the broader impact of Aditazz’s disruptive innovation on achieving the triple aim in health care.
–Susan Xu is a senior research analyst at the Association of American Medical Colleges (AAMC). A former journalist, she brings experience from the data, tech, and medicine fields to her writing. She can be reached at email@example.com.