# BIM and Digital Twin for healthcare facility management

> How BIM and Digital Twin help run hospitals: asset data, maintenance, energy and space. With BIMON's work on Prato hospital and the Etlik Health Campus.

Published 2025-06-04

BIM and Digital Twin help hospitals by putting every room, system and piece of equipment in one model linked to the data the technical team already uses: BMS readings, meters and maintenance records. The result is faster maintenance decisions, better energy control and fewer failures that reach clinical areas.
Hospitals are among the hardest buildings to run. They work 24 hours a day, contain systems where a failure has clinical consequences, and change their layout often. This article explains where BIM and Digital Twin make a measurable difference, using two BIMON projects as reference.

## Why hospitals are a special case
Three features make healthcare facility management different from offices or housing.
Critical systems. Medical gases, operating theatre ventilation, isolation rooms, emergency power. These systems need planned maintenance that does not interrupt care, and a fast diagnosis when something goes wrong.
Density of equipment. A large hospital contains tens of thousands of maintainable assets, many in false ceilings and technical shafts. Finding the right valve or damper quickly is a real operational problem.
Continuous change. Departments are reorganised, new diagnostic equipment arrives, rooms change use. Each change touches structure, MEP and fire compartments.
A model that stays aligned with the building answers the most frequent questions of the technical office: what is there, where it is, what it serves, when it was last maintained.

## What BIM and Digital Twin do in operation

### A single asset register
The BIM model becomes the register of rooms and assets, with codes shared with the maintenance software. Each object carries manufacturer data, warranty, maintenance plan and service area. When an operator opens a work order, the model shows where the asset is and which rooms it serves.

### Maintenance planning
With assets and spaces in one model, planned maintenance can be scheduled around clinical activity. The team can see which rooms lose ventilation or power when a unit is stopped and coordinate with the wards.

### Energy and environmental control
BMS data on temperature, humidity, air changes and consumption, read in the context of the model, shows where energy goes and where conditions drift. In operating theatres and isolation rooms these conditions are part of patient safety.

### Space management
Rooms, functions and occupancy in the model support planning of reorganisations. Before moving a department, the team can check MEP capacity, fire compartments and routes.

### Predictive analysis
When historical data from BMS and maintenance is clean and tied to model objects, analytics and AI can detect anomalies and anticipate failures. This is the step where the digital twin pays back most, but it only works on top of the previous ones.

## Prato hospital: digital twin of a 540-bed hospital
The new Santo Stefano hospital in Prato is one of four large hospitals built in Tuscany with project financing. Impresa Pizzarotti built it and manages it for 25 years. It covers 60,000 m² in two buildings, a hospital block and a service block, with 540 beds, 20 short-observation intensive beds, 40 dialysis stations, 15 operating rooms, 6 labour rooms and 4 delivery rooms.
For Prato hospital, completed in 2022, BIMON created the digital model of the hospital and of all its MEP systems. We analysed the available data and connected the model with the hospital's management system. BMS and IoT data were piped, together with the model, into a digital data platform.
On that platform the data is analysed with AI algorithms to support predictive maintenance and energy savings. The project's aim is direct: optimise energy consumption and maintenance activities of a hospital the operator will run for a quarter of a century.
What made it work:

- a model built for operations, with the codes and attributes the maintenance team uses, not a design model handed over as is;
- automated recognition and classification of objects, to manage the volume of assets in a hospital of this size;
- checks on information content, to monitor modelling and information non-conformities before they reach the platform;
- simple data visualisation, so technicians who do not use BIM software can query the model.

We explain the general structure of this kind of project in what a digital twin really is.

## Etlik Health Campus: MEP design at very large scale
The Etlik Health Campus in Ankara, commissioned by the Turkish Ministry of Health and built by Astaldi, is one of the largest hospital complexes in the world. It has about 3,600 beds, 120 operating theatres, an emergency department designed for 3,000 patients a day and a total area of 1,071,000 m².
On Etlik BIMON designed the mechanical systems and supported the design of electrical systems and civil works, developing the executive design of electrical, special and mechanical systems. All discipline models were integrated in one aggregate model for interference management, and all technical drawings of the final and executive design were extracted from the BIM model. The model was also used for site progress management and construction cost control.
For facility management, this matters because the quality of the twin depends on the quality of the design model. When MEP is designed and coordinated in BIM from the start, the as-built is a refinement, not a reconstruction.

## Examples from around the world
Some of the world's most advanced projects, delivered by other organisations, show where this approach leads in healthcare.

### Cleveland Clinic, Abu Dhabi
With 364 beds and 13 operating theatres, Cleveland Clinic Abu Dhabi is an international benchmark for Digital Twin in hospitals. Its twin goes beyond facility management to monitor patient and staff flows. AI-based predictive analytics forecast peaks in emergency department admissions and reallocate resources in real time. The results:

- 30% shorter waiting times in the emergency department;
- 23% better energy efficiency;
- better use of operating rooms, with productivity up 18%.

### Humber River Hospital, Toronto
Described as North America's first fully digital hospital, Humber River Hospital in Toronto runs a complete Digital Twin that integrates:

- robotic systems for medication distribution;
- 7,000 connected IoT devices;
- real-time monitoring of all environmental parameters;
- geolocation of patients, staff and equipment.

This integration has led to a 30% reduction in medical errors and a significant improvement in overall operational efficiency.

## Standards and guidance worth knowing
Healthcare BIM projects draw on general and sector references.

- EN ISO 19650, parts 2 and 3, for information management in delivery and in operation. Part 3 is the one owners often forget.
- ISO 55000 series, for asset management systems that a twin can support.
- Health Technical Memoranda (HTM) in the UK and FGI Guidelines in the US, as design and operation references for healthcare engineering. They are useful to structure the information a hospital twin should hold.
- In Italy, public hospital works above €2 million fall under the BIM obligation of the Public Contracts Code. Maintenance is excluded, unless the hospital was delivered with BIM, in which case BIM continues. See our article on the BIM mandate.

## How to start on an existing hospital

- Choose the first use case. Critical-system maintenance or energy are usually the strongest.
- Survey and model what matters. A Scan to BIM survey of plant rooms, shafts and critical areas gives the base. Phase the work around clinical areas.
- Align codes. Asset codes in the model, BMS and maintenance software must match.
- Connect existing data before adding sensors. BMS and work orders already tell a lot.
- Train the technical office. A twin used by two people in the BIM team does not change how a hospital is run.

## What BIMON does in healthcare
We design and coordinate hospital MEP systems in BIM, as at Etlik, and build O&M digital twins for hospitals in operation, as at Prato. Our O&M Digital Twin and MEP design services cover both sides. If you manage a hospital and your maintenance data and drawings live in separate worlds, we can help you bring them together.