Hospital · Monitoring and control
Monitoring and control in hospital: what the SRI measures
Monitoring and control is the building's nervous system: the building management system that coordinates installations, detects faults, reports energy use and can respond to occupancy and to grid signals.
In short
- 1Hospitals always have HVAC capacity above 290 kilowatts, which means the Smart Readiness Indicator is expected to become mandatory here.
- 2The monitoring and control domain counts for the full 3 out of 3 points for this building type, the maximum weighting.
- 3Due to the scale of hospitals, energy flexibility is often already technically feasible, even if that capability is not always fully used.
Weight of this domain for this building type
Which services count
| Service | Lowest level | Highest level | Advice |
|---|---|---|---|
| Run time management of HVAC systems MC-3 · 4 levels | Manual setting | Heating and cooling plant on/off control based on predictive control or grid signals | – |
| Detecting faults of technical building systems and providing support to the diagnosis of these faults MC-4 · 4 levels | No central indication of detected faults and alarms | With central indication of detected faults and alarms for all relevant TBS, including diagnosing functions | – |
| Occupancy detection: connected services MC-9 · 3 levels | None | Centralised occupant detection which feeds in to several TBS such as lighting and heating | – |
| Central reporting of TBS performance and energy use MC-13 · A · 4 levels | None | Central or remote reporting of realtime energy use per energy carrier, combining TBS of all main domains in one interface | highest level |
| Smart Grid Integration MC-25 · A · 3 levels | None - No harmonization between grid and TBS; building is operated independently from the grid load | Coordinated demand side management of multiple TBS | highest level |
| Reporting information regarding demand side management performance and operation MC-28 · 3 levels | None | Reporting information on current, historical and predicted DSM status, including managed energy flows | – |
| Override of DSM control MC-29 · 5 levels | No DSM control | Scheduled override of DSM control and reactivation with optimised control | – |
| Single platform that allows automated control & coordination between TBS + optimization of energy flow based on occupancy, weather and grid signals MC-30 · A · 4 levels | None | Single platform that allows automated control & coordination between TBS + optimization of energy flow based on occupancy, weather and grid signals | highest level |
Worked example
If everything in this domain is at level 0, the domain contributes nothing. At the highest level for all services, the indicative total score for this building type rises by about 20 percentage points (from 26 to 46 percent, with all other domains at level 1).
Why is the SRI relevant for hospitals?
A hospital is among the most installation-intensive buildings that exist. Air handling, heating, cooling and backup power must operate continuously and reliably, without interruption.
The HVAC capacity (heating, ventilation and cooling combined) of a hospital lies almost always well above the threshold of 290 kilowatts. Under the EPBD (Energy Performance of Buildings Directive), building automation, that is the building management system, has been mandatory for this category since end 2024. The Smart Readiness Indicator itself remains voluntary, but is expected to become mandatory by 30 June 2027 at the latest for non-residential buildings above that threshold.
Why does the monitoring and control domain carry such heavy weighting?
For hospitals, the monitoring and control domain (MC), the building management system that coordinates installations, receives the maximum weighting: 3 out of 3 points. This reflects how central this system is in a building with so many interdependent technical systems.
A building management system in a hospital must detect faults quickly, report energy consumption accurately and respond to changing occupancy. Services such as fault detection (MC-4) and central reporting (MC-13) are therefore not merely comfort functions, but contribute to continuity of care.
What does energy flexibility mean for a hospital?
Due to their scale and existing backup power systems, hospitals often already have the technical basis for energy flexibility. This means the building can respond to signals from the electricity grid, for example by shifting demand.
Services such as integration with the smart grid (MC-25) and override of demand response control (MC-29) show how far a building goes in this regard. A high functionality level on these services means the building can actively contribute to grid stability, rather than only passively consuming energy.
What does a low score reveal about operating hours management?
Operating hours management of HVAC systems (MC-3) determines whether heating and cooling run on a fixed schedule, or whether they respond to actual load and grid signals. In a hospital, where departments have varying occupancy, this makes a difference to energy use.
A building at functionality level 1, with a fixed timetable, misses the opportunity to save energy during quiet hours. Predictive control, level 3, makes use of forecasts and grid signals to plan ahead.
What this means for you
- Owner
- As the owner of a hospital, it is worth inventorying now which functionality level the building management system achieves on the services within monitoring and control, since this domain carries the heaviest weighting. This prepares you for the moment when the Smart Readiness Indicator is expected to become mandatory for buildings above 290 kilowatts.
- Tenant
- As a user of a hospital building, you will notice this mainly in reliability: faults are spotted and remedied faster when the building management system has central diagnostic functions. A stable indoor climate too, despite varying occupancy of departments, is connected to the quality of monitoring and control.
- Advisor
- When assessing a hospital, pay extra attention to the services within the monitoring and control domain, given the maximum weighting of 3 out of 3. Also focus on services around demand response and grid integration, because the scale of the building often already offers scope for energy flexibility that is not yet fully used.
Next step
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