Healthcare may hold the key to long-duration energy storage adoption

From left: Walt Vernon, principal and CEO at Mazzetti, and Chad Beebe, deputy executive director of regulatory affairs at the American Society for Health Care Engineering, discuss the adoption of long duration energy storage in healthcare facilities at a summit hosted by the Long Duration Energy Storage National Consortium.

Image courtesy of Mazzetti

I had the opportunity to participate in an interview and discussion at the Long Duration Energy Storage (LDES) Summit in Salt Lake City in July. The audience in attendance during the session, “The Evolving Agenda for Healthcare Infrastructure,” included researchers from Sandia National Laboratories, Argonne National Laboratory, Idaho National Laboratory, Oak Ridge National Laboratory and other national laboratories; technology developers; policymakers; and industry leaders working to accelerate the adoption of long-duration energy storage (LDES) technologies.

As someone who spends most of his time in healthcare facilities, code development and regulatory affairs, I found myself representing a somewhat different perspective. While many discussions around energy storage focus on technology development, manufacturing capacity and grid applications, healthcare asks a much simpler question:  Can we trust LDES when lives depend on it? That question shaped much of my discussion during the event.

Healthcare's relationship with reliability

Hospitals are unique environments. Unlike many industries, failure is rarely measured in dollars alone. When critical infrastructure fails, patient care can be affected.

For more than 50 years, hospitals have relied on diesel generators as the backbone of emergency power systems. Are diesel generators perfect? Absolutely not. They require maintenance, consume fuel, create emissions and occasionally experience failures.

Yet healthcare leaders continue to trust them because they have decades of experience proving they work when needed. Facilities directors have personally lived through hurricanes, wildfires, utility failures and natural disasters and watched diesel systems perform exactly as expected. That history matters. One of the observations I shared during the interview was:

"Healthcare doesn't adopt infrastructure because it's innovative. Healthcare adopts infrastructure because it's boringly reliable."

In healthcare, "boring" is often the ultimate compliment. The most successful infrastructure systems are the ones nobody has to think about because they consistently perform as expected. The challenge facing LDES is not proving that it can work. The challenge is proving that it can eventually reach that same kind of reliability.

The question isn't technology. It's trust.

Throughout the summit, I was repeatedly asked what would need to happen for healthcare organizations to embrace LDES as part of their critical infrastructure. 

My answer in the interview was straightforward. Healthcare does not need another laboratory demonstration. It does not need another theoretical analysis showing that a new technology could be more reliable than traditional systems. Healthcare needs operating history. 

Facilities directors want to see real hospitals operating real systems while carrying real patient risk. They want evidence that a particular energy storage system can handle difficult situations, such as extended utility outages, extreme weather conditions, equipment failures, maintenance mistakes and black-start scenarios. Most importantly, healthcare leaders need confidence that these systems will perform consistently under the worst possible conditions. Trust is earned through experience, and healthcare tends to adopt new technologies only after that trust has been established.

The biggest remaining barrier may be regulatory adoption

As someone involved in numerous codes and standards committees, I also was asked about the barriers preventing broader deployment of LDES in healthcare.

Several years ago, the answer would have been simple: the codes themselves. At the time, many of the concepts being discussed today had not yet been fully addressed within the model codes and standards that govern healthcare facilities. Through the work of industry experts, regulators, engineers, manufacturers and organizations like the American Society for Health Care Engineering (ASHE), significant progress has been made to modernize those requirements and create pathways for new technologies. Today, the challenge is less about  whether the codes can accommodate innovations such as LDES and more about whether healthcare facilities are allowed to take advantage of those updates.

One of the continuing challenges for healthcare is that the Centers for Medicare & Medicaid Services (CMS) still relies on older editions of codes from the National Fire Protection Association (NFPA), including NFPA 99, Health Care Facilities Code, and NFPA 101®, Life Safety Code®. While the code development process has worked diligently to evaluate new technologies, incorporate lessons learned and modernize requirements, healthcare providers often remain subject to regulations based on standards that are more than a decade old. As a result, there can be a significant gap between what the current codes permit and what healthcare organizations regulated by CMS are able to implement.

This issue extends beyond energy storage. The healthcare field has invested enormous effort in updating codes and standards to address evolving technologies, improve resilience, reduce regulatory burden and support innovation while maintaining patient safety. The value of that work is only fully realized when those updates are adopted and available to the facilities expected to use them. Modern codes provide healthcare organizations with access to current best practices, updated technologies and risk-informed approaches that better reflect today's healthcare environment.

The path forward requires continued collaboration among code developers, regulators, healthcare providers and technology leaders. Innovation can only be implemented when the regulatory framework allows healthcare organizations to benefit from the advancements that have already been incorporated into the codes.

What we are learning about battery safety

I also had the opportunity to discuss ASHE's battery safety efforts. One of the most important lessons emerging from our work is that battery safety is about much more than battery chemistry. When people hear about a battery incident, the focus is often on the battery itself. In reality, overall risk is heavily influenced by storage arrangements, charging practices, separation distances, ventilation, detection systems, suppression strategies, monitoring, maintenance and operational procedures. During the discussion, I made an observation that resonated with many in the room: Healthcare organizations often incorporate battery-powered equipment for a very simple reason — “We don't have to plug it in.” Mobility and convenience frequently drive procurement decisions. The conversation often ends with the operational benefits of cordless equipment, mobile devices, automated systems or battery-powered infrastructure.

What we don’t ask are the next questions that should follow:

• Where will these batteries be charged?
• What battery chemistry is being used?
• How will damaged batteries be identified and managed?
• What are the fire and life safety implications?
• What happens when hundreds or thousands of batteries are deployed across a campus?

As batteries become embedded in more healthcare technologies, organizations are discovering that battery management cannot be an afterthought. Charging locations, storage practices, ventilation requirements, emergency response procedures and end-of-life disposal all become important considerations. Another important realization is that healthcare facilities already rely on batteries extensively. 

Energy storage installations often receive the most attention, but hospitals are seeing rapid growth in batteries associated with medical devices, mobility equipment, logistics systems, robotics, information technology infrastructure, autonomous mobile robots and countless other applications. The question is no longer whether batteries exist within healthcare environments. The question is how organizations can safely manage batteries at scale. That shift in perspective is driving many of the conversations happening within ASHE and the broader healthcare community. 

Increasingly, we are encouraging facilities leaders to think about batteries not as individual devices but as an enterprisewide operational and safety issue that deserves the same level of planning and risk assessment as any other critical infrastructure system.

A challenge for the national laboratories

My final question during the interview was directed toward the researchers in the room. Healthcare often finds itself responding to innovations developed elsewhere. The LDES Summit provided a rare opportunity to reverse the flow and allow healthcare to identify a challenge that researchers could help solve. If I could place one research question on the desk of every national laboratory represented at the summit, it would be this:What evidence would a hospital board need to see to trust LDES as much as diesel generation for mission-critical patient care?

Not simply whether the technology works. Not simply whether it is cost-effective. But what testing, operational experience, reliability metrics and performance standards would create the level of confidence healthcare requires before making widespread adoption decisions? Answering that question could accelerate the deployment of energy storage in healthcare more than any individual technological breakthrough.

Looking ahead

The conversations at the LDES Summit left me optimistic, not because all the answers have been found but because the right questions are being asked. The healthcare community is not opposed to innovation. Hospitals adopt new technologies every day when those technologies improve patient care and demonstrate reliability. LDES offers tremendous potential to improve resilience, reduce emissions, lower operating costs and fundamentally rethink how healthcare facilities are powered.

But healthcare will not embrace these systems because they are exciting. Healthcare doesn't adopt infrastructure because it's innovative. Healthcare adopts infrastructure because it's boringly reliable. The challenge for LDES isn't proving it works; it's proving it can become boring.

Chad Beebe, AIA, CHFM, CFPS, CBO, FASHE, deputy executive director of regulatory affairs at the American Society for Health Care Engineering.