Return on Investment – What extra value – added benefit does DCPower4C offer the Hospital against a standard LIFE block battery or a low-cost Monitor battery?
Consider the big picture, an IT investment in Carts and Batteries is a small part of a large overall investment to achieve Digitalisation. Estimates on the return on this investment are as high as Euro 50 million over 5 years for a medium to large hospital, not to mention the anticipated improvement in patient outcomes. Price- Cooper-Waterhouse estimated that the UK NHS would save GBP 4.4 billion by going paperless and UK hospital studies documented a 15% fall in death rates associated with implementation of digitalisation at the Point of Care. In this scenario, battery TCO is a minor factor, but full system functionality and Nurse Compliance are essential to achieve a full Return on Investment.
- Battery or Power failure in a mobile IT scenario – either total or partial – is unacceptable. Documentation of patient data, clinical history, diagnostics, therapy measures & outcomes, medication logistics etc. cannot be offline. Nurse compliance is essential and will not be forthcoming if the system is only working sporadically. A US report describes the typical problem with Carts: Nurses often struggle to find one that has been properly charged for the morning shift! Uptime is key, a cart that has no power or is plugged in to charge is not functioning in the sense of mobile IT.
- It is our conjecture that most current Power systems supporting Computer Carts are not properly designed for this application and technically cannot fulfil power requirements for a sustained period and furthermore do not allow IT infrastructure to evolve.
- DCPower4C believes that only a Hot Swap system aiming at 24-7 power capability can provide an around the clock solution. If block batteries are used, then these need to be modular and flexible and technically designed to handle the unique hospital environment. The Hospital Cart usage with a daily full battery discharge is incredibly challenging for modern battery chemistries. No other mainstream applications imply such a high strain on the power system, this includes Electro-Car batteries, E-bikes, Laptops and Camera batteries. Many Cart Manufacturers outsource the battery supply, and do not appreciate the complexity, opting for a cheaper solution, afraid of justifying the price associated with proper value. The result is that Power issues have become the number one IT Cart issue. An FDA report confirms this, over 50% of US Hospital support calls are battery related!
- Therefore, we can confidently state that this application is both Mission Critical and that it is technically challenging. If the customer understands and accepts this – there is no logic or value in them putting up with a low spec, cheap battery solution that is simply not designed to meet the challenge.
- Thus, the battery cell pack and charge system must be High Quality – designed for Critical applications – long life – with tight manufacturing tolerances. These solutions are unlikely to be the cheapest bid in the Tender. But since resolution of the power issue makes the enormous Cost savings and Patient Outcome improvements associated with going Digital possible, a smart investment on power system quality secures massive returns on the overall IT investment and significantly reduces the Maintenance costs.
Block Battery with Inverter /charger
Take a typical Hospital scenario with a 500Wh battery and a pro-rated warranty to 60% over 5 years. Sounds good? Well consider this:
- A typical cart infrastructure pulls 40W per hour if used. That is 960Wh for 24 hours.
- A new battery will deliver 500Wh, but after a year it is probably 420Wh, after 2 years 350Wh. Warranty starts at 300Wh.
- Most Block batteries run in combination with an Inverter/charger. DC is converted to AC and then converted back down to DC!! Another 25-30% of capacity is lost.
There is no way to run a shift. Let alone 24 hours. So, the nurse must charge frequently during shift. The low capacity is not covered by warranty since 1) the battery capacity test excludes inverter loss and 2) nearly every warranty specifically excludes lost capacity from the warranty.
- If the Night shift forgets to charge - mobile equipment is tied to a socket
- If the IT department wants to add new improved infrastructure to the cart, low capacity is fixed.
Hot Swapping is the only rational solution for heavy power needs.
These tend to run a lighter load, usually 25W an hour, with much lower sleep mode power. A typical battery capacity is 3x 85Wh = 255Wh. Yet these batteries tend to have no warranty on capacity retention and a poor reputation on this. Their specification and technical design imply a short life in a high cycle environment. Less than a year. In fact, these batteries are likely to be below 60% of original capacity within 6 months.
The consequence is frustration and failure. Mobility is lost unless the batteries are replaced every 6-9 months. That would be horrendously expensive over a cart life and is thus not done. Instead, nurses have to plug the cart in and walk to the cart a highly inefficient use of scares and expensive nurse time. The imagined cost saving will cripple the hospitals productivity drive.
Li-Iron batteries became popular as an improvement on SLA batteries which were simply horrendous. They have a reputation for being safe, charging somewhat faster, and their nameplate life expectancy is longer. But – as explained in the Battery Cell technology section, LiFeP04 is a mismatch for Hospital workflow. Monitor batteries – often in banks of 3 or 6 – have a track record of failure and issues. The design is all about low cost, the performance is not good.
It is a combination of Hot Swapping or long-life blocks with high capacity backed by a strong warranty that gives the true Return on Investment. If the cart is always up and running, it will be used, and the benefits of going digital can be harvested, if the cart is always unreliable, the nurse needs to find a socket and plug in or have power down, it will then be used as little as possible, and the digital dream remains unfulfilled and the investment wasted.
Block batteries are fine in scenarios where the power needs are limited, where nurses will reliably charge during downtime and where high capacity can last the shift.
The Hospital purchasing mindset is to look at the cost of a battery. Tenders prevail. Yet they need to look at the cost and impact of battery failure. It is outrageously high and as the pressure to improve staff productivity, avoid medication wastage and enhance patient outcomes grows.