From the 'digital twin' to the digital extended family

Hospitals are a technical superlative in many respects – hardly any other asset class has such a high density of installations and such intensive maintenance needs. The same is true of their digital representation, commonly referred to as a “digital twin”: requirements are high, because highly heterogeneous systems and data environments converge here.

There are models, plans, documents, and many other, more “living” data streams from sensors, building automation, maintenance, and hospital information systems – entered into a wide range of specialized tools with little to no meaningful interconnection. In everyday hospital practice, the digital twin is therefore less a neatly organized model and more a chaotic digital extended family.

There is no doubt that large volumes of data are generated in this extended family. What is often missing, however, is what matters most: usable, quickly available, and reliable information for day-to-day operational processes.

This is exactly where Digital Information Management (DIM) begins – and exactly where plandata, the ATP Group’s consulting company, comes in.

Many data points, little day-to-day direction
In hospital projects, content is created in parallel across numerous systems. Planning, construction and refurbishment, technical and commercial operations, documentation, patient organization. Add handovers, change orders, and later adjustments. If this chain is not clearly organized, islands emerge. Without clearly defined cross-functional processes, uncontrolled growth follows. If tools do not communicate directly via interfaces, data silos form. The result: relationships are lost, redundancies and duplicate work become routine. Knowledge has to be rebuilt for every measure, and information must be rechecked for every query.

For operating companies and hospital management, this is not an IT problem – it is a governance problem. Because it hits precisely those moments when speed and certainty are essential: during faults, inspections, refurbishments, functional changes, and availability requests. The key question then is not “Which data and software systems do we have?”, but: “Which information do I get, how quickly, and which of it is reliable? Which will remain reliable over the next five, ten, or twenty years? And which can be reused for the next measure without friction losses?”

One principle provides relief
Digital Information Management (DIM) focuses on a holistic view and the interconnection of all digital building data, as well as the development of the associated processes across the entire building life cycle.

The goal is to make usable, up-to-date, and reliable information from all data sources available to all stakeholders throughout the life cycle at any time – from the janitor to the technical management, from the patient to the nurse to the chief physician.

Success Factors in Digital Information Management

Needs-Based Information Standards
Thinking from back to front – from operations management back into early design – makes it possible to define information requirements in a meaningful, lean, and goal-oriented way.

What is the point, for example, of defining content in BIM guidelines for design and execution that no one in operations can use or maintain later on? Alongside lean modeling guidelines and sensible specifications for object attribute definition in the BIM environment, the key task is to develop an identification syntax (e.g., AKS) for platform-independent object identification, as well as logical linking structures for supplementary data such as plans, schematics, data sheets, maintenance and installation manuals, and more.

The core questions when developing digital information standards are:

→ who provides
→ when
→ why
→ what information
→ in what form
→ in what format
→ according to which standard
→ into which system?

Hospitals often already have extensive standards for building documentation. In that case, these should be reviewed with BIM in mind – essentially, with a focus on object-oriented data management – and adapted if necessary.

Practical Organizational and Process Standards
Digital, object-based workflows represent a paradigm shift in almost every area. Processes must be fully reorganized; authority and accountability, roles and functions must be redefined and anchored at the organizational level.

Cross-functional, overarching information management can be used to define roles and responsibilities, authority, and constraints – the key term here is Data Governance. Commercial, technical, structural, and medical operations must define a clear target picture, responsibilities, and mutual dependencies, and set them out in functional profiles.

Once these organizational foundations are in place, processes can be developed that ensure the required data quality and optimal data flows over the long term across design, construction, refurbishment, and operations – so that reliable information can be derived from this data at any time.

Optimal Use and Interconnection of Technology
Element-based digital workflows require new tools – and these must be selected and configured to match specific requirements.

The core questions (in addition to cost considerations) are:

→ Which tools are suitable for my use cases and core processes?
→ How do they need to be adapted to meet my needs in the best possible way?
→ Which systems can be connected via which interfaces?
→ How future-proof are these systems, and how well do they interact with my existing tool landscape?

Process design and information requirements have a major impact on tool selection – and vice versa. For this reason, decisions can only be developed in interplay with these areas.

And beyond many questions of technical feasibility, this is also about principles: As critical infrastructure, hospitals often have rigid cloud policies that can sensitively restrict the selection of “more modern” data platforms and Common Data Environments (CDE).

Integration of Existing Data and Systems
Hardly any hospital construction project starts on a greenfield site today. And just like the buildings themselves, existing documentation is often outdated. The same applies to the software systems used to create, maintain, and manage legacy data.

As with a physical move, digital data and systems require careful consideration of how to deal with what already exists:

→ What is worth keeping – and what can go?
→ What moves with us, and what stays where it is?
→ What goes where?
→ What will be prepared as part of the move?

The result is a migration strategy that defines which data remains untouched, which is prepared, and which is migrated into new systems – ideally in an automated way.

Transformation and Change Management
Implementing Digital Information Management is more than defining new standards. For these standards to be lived in practice, change management is essential:

→ Clearly defined goals and milestones
→ Sufficient capacity
→ A staged training concept
→ Measures to build acceptance during the implementation phase
→ Ensuring support during piloting

Because implementation typically extends over several years and ties up internal knowledge holders and decision-makers, classic project management is also required – including cost, resource, and process planning.

Why DIM Is Especially Relevant for Hospital Operators

A hospital is a high-risk operation with complex Building Services systems. Operational safety is not ensured by robust technology alone. It is ensured by the ability to make decisions. And the ability to make decisions requires reliable information.

DIM primarily supports hospital operators in achieving three operational objectives:

1) Reliable Availability of Systems and Critical Areas
When information is complete and up to date, systems can be operated and maintained in a more targeted way. This reduces downtime. It increases availability – especially where standstill is not an option.

2) Verifiable Maintenance, Inspections, and Operator Obligations
In healthcare facilities, documentation is not an archive. It is proof. DIM creates a traceable chain of information that remains valid even years after handover. This relieves operations and increases legal certainty.

3) Controllability of Costs, Energy, and Capacities
Anyone planning refurbishments, extensions, or conversions needs reliable foundations. DIM reduces information loss and improves predictability. This has a direct impact on budgets, energy performance indicators, and the management of space and capacities.

The leverage lies in the big picture

DIM delivers impact when clients create clarity: What information does operations really need? What data must be generated in the project context to provide it? What is the responsibility of design, and what sits with the executing parties? And how are roles, responsibilities, and handovers defined internally and externally so that information remains usable over the long term and does not become outdated when a new construction phase opens?

The holistic approach makes the decisive difference. Without an integrated concept for information requirements, organization, process, and technology, digitization inevitably becomes an arbitrary collection of documents, models, and platform data. With DIM, it becomes a lasting information base that supports operations and enables ongoing development – even as teams change, systems are renewed, and the building has long moved into its next operational phase.

What matters is not “more digital.” What matters is information that works in operations. Anyone who plans healthcare facilities is not just constructing buildings. They are building operational capability. DIM makes this operational capability visible, verifiable, and manageable for the long term.

The Right Steps Toward DIM in Your Organization

Introducing Digital Information Management is a multifaceted process that takes several years. With the right steps, taken in the right sequence and across the right fields of action, it becomes a manageable task with strong prospects for success.

At plandata, we have been supporting major hospital operators through all phases of DIM implementation for many years – from target definition and strategy to the development of information requirements, organizational structures, and processes, from conceptual design to the technical implementation of a new data and tool landscape. From strategies for handling existing data to automated migration into new systems. And in shaping your transformation – from training and acceptance-building to operational support for your pilot projects.

In doing so, we have developed a field-tested service profile that not only guides you reliably to your goal, but also makes the necessary investments securely plannable. For more details, explore the interactive guide in the links below.

Curious to Learn More?

As you can see, the topic is both broad and deep. If you have read this far, you are likely interested in exploring it further – and we would be pleased to do so.

Thematic dossier on the implementation of DIM at Vienna General Hospital (2016 to 2020), the second-largest hospital in Europe (PDF)

Interactive guide to implementing DIM in hospitals based on the key success factors (PDF)

Of course, our team is also available at any time to answer your questions or discuss your specific needs. Our Head of Consulting looks forward to hearing from you.