Smartening hospital electrical distribution for
enhancing resilience
A. Prudenzi, A. Fioravanti
DIIIE, University of L'Aquila
L'Aquila, Italy
alberto.prudenzi@univaq.it
Abstract—Power is a crucial element in hospitals whether it's
within the intensive care units, surgical bays, or medical scanning
rooms. Natural disasters and terrorist attacks remind us how
dependent we are on electricity and how fragile the system can
be. The paper deals with the resilience of hospitals’ electricity
distribution system. In particular, a supervising platform is
illustrated that can be superimposed to the main components of
the power system in order to promptly collect and centralize
anomalies or malfunctioning or outages. To this aim, an Internet
of Things (IoT) based solution has been implemented that allows
equipping at low cost the various electrical components in the
distribution MV/LV substations of the hospital’s power system.
The solution implements a platform based on Raspberry Pi3.
I.INTRODUCTION
High quality care for patients is a typical hospital’s
priority. A key point of this lies in power availability and
reliability since many medical technologies and modern
communications are reliant upon power, whilst complex
health care is increasingly being delivered in the community
[1].
To date, the impact of power loss on health is a poorly
studied area and literature is scarce [2]. However,
understanding how health is affected by power loss, especially
within the setting of extreme events, is vital to future planning
so that the health impacts can be prevented and/or mitigated
[3].
Hospitals require extraordinary reliability from their power
systems. Life-support systems, as well as critical ancillary
infrastructure systems such as HVAC, communications,
records management, and security must all remain online
during a power disruption. When widespread power outages
strike throughout the electricity grid, hospitals must be outage-
proof. Moreover, it is also evident that healthcare is
increasingly dependent on power [4,5].
Electricity was recognized by the UK Department of
Health as the ‘most vital of all infrastructure services’ because
‘without it most services will not function [6].
In recent years, utilities have begun to deploy smart grid
technologies, from advanced metering at the customer level to
enable automatic outage detection and service restoration, to
sensors and controls on the distribution system to enable rapid
detection, isolation and restoration of service at the circuit and
substation levels. After an event, the data collected through
these technologies can be used to find opportunities for further
resilience improvements.
978-8-8872-3740-5 ©2018 AEIT
M. Regoli
University of Rome “Tor Vergata”
Roma, Italy
The IoT’s industrial applications, or the Industrial Internet,
is transforming many industries, including healthcare.
Collectively, these account for nearly two-thirds of the world
economy [7].
In electric industry systems IOT technology has been
applied to the line/equipment condition monitoring, fault
location and substation security protection and many other
tasks with promising success [8]. IoT applications are indeed
implemented with the purpose of acquiring the states of LV
and MV apparatuses, thus increasing the availability of
substation components so as to reduce fault times, monitor
grid topology and use manpower more efficiently.
The paper proposes a low-cost open platform based on
Raspberry pi 3 to supervise and monitor the health parameters
of the main components of a MV/LV distribution system
delivering electric energy to the end-users of a large hospital.
The platform has the main aim of early warning about
faults or malfunctioning status of the monitored devices.
II. IOT IN ELECTRICAL DISTRIBUTION
In the fastly evolving context of electricity distribution the
strong need of integrating renewable energy sources and
distributed generation with the growing needs of the power
demand from new end uses (such as Electric Vehicles), has
required utilities to introduce more intelligence in the
components fitting their MV and LV distribution networks [9].
Nowadays, various are proprietary solutions provided by
main global manufacturers offering solutions for intelligent
transformer substations, compact medium-voltage switchgear
with communication capability, regulated distribution
transformers, as well as integrated remote control and
automation solutions which monitor and control the medium-
and low-voltage grid equipment [10].
IoT applications are implemented with the purpose of
acquiring the states of LV and MV apparatuses, thus
increasing the availability of substation components so as to
reduce fault duration and use manpower more efficiently by
[11].
The task of applying IoT solutions in an existing system
looks like a very appealing option. Although the retrofit of
existing equipment brings various difficulties due to: i)
successive generations of equipment; ii) origin from different
manufacturers; iii) different environmental conditions, leading
to heterogeneous ageing states of equipment.
 Integration of various equipment with even very different
technology typically would require high-cost custom made
solutions implementing closed architectures. The closed
architecture, however, would make difficult to the customer to
extend the supervisory system to other equipment, also
critical, but not strictly making part of the electrical system
(fire alarm systems, intrusion detection systems, etc.). So, it
could be of interest an open solution that could be applied to
equipment of most different type to make them smarter by
building a network in which they can communicate.
III. HOSPITAL’S ELECTRICITY DISTRIBUTION SYSTEM
A typical distribution system layout for a hospital is
reported in Fig. 1. A medium voltage distribution ring owned
by MV customer, connecting several MV/LV distribution
substations is operated with a normally-open point, splitting
the ring into two separate feeders connecting the different sub-
stations with an in-out insertion scheme. The purpose of the
point is to ensure selectivity for protection systems and reduce
the impact of faults in the grid by limiting the number of
distribution substations that are affected when protection trips.
Figure 1: Hospital’s typical electrical distribution layout.
A distribution substation typically provides:
• a MV (20 kV) section including a MV switchboard
system consisting of cubicles containing the following
equipment:
- MV circuit-breakers and fuse switches (vacuum or SF6),
- measuring transformers,
- digital relays,
- busbars,
- customer connection interlocks,
• MV/LV transformers (two or more, paralleled or not),
• a LV (400/230 V) section including main LV
switchboards structured in two separate but
interconnected busbars (normal power, emergency
power), where emergency power is originated from a
motor-generator set. A further distribution busbar is also
provided for supplying critical loads through an
uninterruptible power supply (UPS).
The typical electrical layout of a distribution substation is
reported in Fig. 2.
Therefore the following main sub-systems of the electrical
distribution system have been identified:
• MV/LV substations including the following individual
components: MV switchgear, MV/LV transformers, LV
switchboard (containing metering equipment, main and
branch disconnects, protective devices, power switching
devices including also all the auxiliary systems),
• motor-generator sets,
• UPS systems,
• control and regulation systems (such as power factor
correction system).
Figure 2: The typical electrical layout of a distribution substation
IV. THE SUPERVISING SYSTEM LAYOUT
Each of the above mentioned sub-systems can be usefully
supervised through a superimposed open supervising system.
To this aim, all the devices providing programmable outputs
or relay contacts for alarming about their own fault or
anomalous operation have been identified. Those outputs can
be easily collected and processed by the supervising system,
thus implementing a finer-grained monitoring tool without the
need of knowing any communication protocol or standard of
the proprietary technology.
A. Distribution Substation
Both at MV and LV, all the different busbars (normal
power, emergency power, no-break power) are individually
monitored in order to early identify and signal voltage
anomalies through a minimum voltage relay.
The correct operation of transformers is also monitored by
monitoring the alarm signal deriving from a temperature
control unit that equips dry type and cast resin transformer,
since they are more typically adopted in hospitals for fire
protection security purposes. The control unit is coupled to the
dedicated infrared sensors allowing the temperature control
without physical contact between the sensor and the surface.
Output relays are generally available for ALARM, TRIP,
FAN1 / FAN2 and FAULT status.
The supervising system typically dedicated to a
distribution substation provides the following input The
supervising system typically dedicated to a distribution
substation provides the following input [12]:
• minimum voltage at MV busbars (V1),
• alarm signal from dry type transformers’ temperature
control (S1),
• minimum voltage at normal LV busbars (V2),
• minimum voltage at emergency busbars (V3),
• minimum voltage at no-break busbars (V4).
The above mentioned monitoring points are illustrated in
detail in Fig. 2
B. Motor generator sets
Hospitals typically have backup generators onsite to
supply electricity in the case of a grid failure; the necessity of
having a backup generator, is required by law [13]. Often the
term “emergency” power is used to refer to all power needed
on a backup generator in a hospital. Emergency power
includes only those loads required to be restored within dozens
seconds as required by laws.
The motor-generator set is typically provided with a
control panel that is an increasingly complex piece of
electronics with a microprocessor that can manipulate input
from sensors to help give feedback to the machine to manage
itself. The microprocessor will then take effective measures to
regulate the performance of the machine including shutdowns.
The microprocessor or microcontroller is embedded in the
circuitry inside the control panel and is programmed to take in
the sensor input and react to that with the programmed control
rules. The panel provides programmable outputs in electrical
terminals.
From the control panel the supervising system can receive
in input one or more of the following relay contacts that in
Fig. 2 are classified as an alarm signal from motor-generator
set control board (S3) [14]:
• speed alarms
• generator alarms
• oil pressure alarms
• coolant temperature alarms
• fuel alarms
• sensor input alarm
• electric output alarm
C. Uninterruptible power supply (UPS)
The uninterruptible power supply (UPS) is required in
hospitals to support and protect the vital medical equipment.
The use of electronic and power demanding medical
equipment has increased over the years. The frequent voltage
drops, power failure, and voltage fluctuation can damage the
costly medical equipment which can have an impact on the
safety of the patients.
Some of the medical equipment such as anesthesia
machine and ventilator has a battery backup of 30 to 90
minutes which depends upon the device and manufacturer. But
if the power doesn’t back until the batteries of these machines
are depleted it can take the life of the patients. Additionally,
most of the medical equipment does not have the battery
backup which can run in the absence of the electricity. When
hospitals do not have UPS, critical medical equipment can
stop working as soon as the power goes. This can adversely
affect the patients who are on the life-saving machines.
The most of UPS systems makes available at control panel
some relay contacts providing information concerning the
following status conditions [15]:
• UPS fail
• summary alarms
• bypass
• battery low
• UPS on
• line loss
Among the above mentioned diagnostics, at least the one
alarming the fault of the machine is generally made available
even for the simplest UPS’ types. Such an input is classified as
alarm signal from the UPS control board (S4) by the
supervising system.
D. Power Factor Correction
The most of automatic power factor correction systems
makes available at their control panel some relay contacts
providing information concerning the following status
conditions [16]:
• internal temperature too high
• current too high or too low
• voltage too high or too low
• over-compensation or under-compensation
• capacitor overload
• micro-interruptions
• insufficient reactive power of equipment
• incorrect reactive power on condenser arrays
Among the above mentioned diagnostics, at least the one
alarming the fault is generally made available and by
supervising system is classified as alarm signal from the PFC
control board (S2).
Electrical distribution in hospitals typically provides that
motor generator sets and UPS’ serving a specific area or a
building are located in positions that are adjacent or very close
to the relevant distribution substation. So, often a single
supervising device can be used to monitor all such subsystems
and in this case the device can be usefully placed within the
distribution substation.
V. THE SUPERVISING PLATFORM
The supervising system has been implemented in a
platform called “Detector”. The platform has the following
main characteristics.
A. Hardware
The supervising system has been developed around the
Raspberry pi3 platform. Raspberry pi3 is a mini computer,
where the Raspian operating system is installed, that has the
size of a credit card. The algorithm that controls the 40 pins
above the board can be written via the Python programming
language. In addition, these pins can be used as serial port,
I2C and SPI ports. The latest version of the Raspberry has also
4 USB ports to connect mouse, keyboards and memory keys,
an HDMI output to connect the PC screen and a LAN port.
The Wi-Fi implemented in the card allows easily manage both
domestic’s and WPA-enterprise networks [17].
The supervising shield thus implemented includes:
• 16 Digital Inputs,
• 2 Changeover Relays,
• 1 RS485 Port,
• 3 status leds.
Figure 3: The Detector system implementation.
Starting from the arrangement of the 40 pins, a PCB board
has been developed, equipped with an RS485 output, 16
digital inputs that can be connected through practical terminals
and two power relays with NC and NO contacts. The whole
arrangement has been enclosed inside a plastic box for an 8-
module DIN support.
In Figure 3 the supervising device that is the elemental
component of the supervising platform is reported in picture.
The supervising system is directly powered by 230V line
voltage because inside the box was also placed the 2.5A
switched power supply that powers the 5V cards.
In the upper part of the box, visible from the hosting
electrical panel, three LEDs indicate normal operation,
anomalies or faults.
B. Software
The algorithm written in Python can be easily
programmed; the program reads the values of the digital inputs
(open or closed loop), then reads the values of the energy
meters via the RS485 port. It saves this data in the internal SD
card and in addition it sends this data via the internet
connection to the central server. In the case of an internet
network collapse or a server problem the data are thus locally
available and the system continues to monitor the various
inputs with warning LED activated.
The central server is composed of a PC using a Linux
Server. MySQL database is used for storing data in structures
called tables. By using PhpMyAdmin, tables are created and
the devices are added directly from the browser.
PhpMyAdmin is a graphical interface that allows you to
manage MySQL allowing user to view, create, modify, delete
entire tables or individual records, to make a backup of the
data and display interesting information about the database.
The communication of client-server data by means of the
HTTP protocol is performed via the REST interface
(Representational State Transfer). This type of communication
greatly simplifies the design and implementation of
applications. In this way the data client sends data collected to
server sending a JSON string with the POST method, while
the user applications request the data through the GET method
and re process the JSON string to display them.
A user interface for Android mobile phones, see Fig. 4,
was created with the Android Studio development
environment. In Fig. 4 several windows are reported as
example.
Every subsystem or component is marked with a color that
operates as a warning light and signals normal operation
(green light), a warning condition (orange light), and a fault
condition (red light).
By clicking on the selected sub-system a window shows
the status of every signal/alarm as monitored and the history
of such alarms as well.
In the grey bar it is possible to select several options like
the key to go back, the information button, for the user that
wants to write a text, the key to return to the main screen, the
option for geolocation where saving a picture (for example the
hospital map) and its GPS coordinates and finally the settings
button, that makes change the various options of the given
sub-system.
In the window dedicated to energy monitoring, the graphs
of voltage, current, active and reactive power and power factor
can be displayed by scrolling the screen. In addition, at the top
are the keys to choose the selected time scale of diagrams (1
hour, 1 day, 1 week, etc.).

Figure 4: Detector’s user interfaces for Android.
C. Network
The supervising devices are connected to Internet via the
LAN network that is typically available everywhere inside
hospitals, for medical requirements. The supervising devices
can use also wi-fi connections where needed.
The platform implements a client-server architecture as
reported in Fig. 5.
The platform adopts all the typical provisions for a secure
storage and management of monitored alarms and data.
Figure 5: Network architecture
VI. SUPERVISING SYSTEM ESTIMATED COSTS
An overall estimation of the possible cost of such an
application can be attempted by referring to a particular case
study. This is mainly due to the local area network (LAN)
characteristics required. So, apart from LAN requirements, the
cost can be estimated for each elemental component of the
supervising platform: the supervising device of figure 3.
The estimated cost, as reported in [18], is about 82 €. The
costs of relays as required for monitored components interface
to the supervising device is in the range of about 20-50 € each
(voltage monitoring relays, auxiliary contacts, wires, etc.).
Installation costs are excluded, but they can be easily
estimated by making reference to work hours required for
implementation.
More than avoided costs, the proposed supervising
platform allows a huge improvement of maintenance
efficiency thus determining both availability and resilience
enhancement of electrical distribution.
VII. CONCLUSIONS
The paper deals with the resilience of hospitals’ electrical
distribution. In terms of resilience, the electricity distribution
of a hospital can be considered as structured in some main
subsystems that it can be useful to continuously monitor in
order to have an early warning system for anomalies or faults
of individual components.
To this aim, a low cost IoT based solution has been
implemented that allows superimpose to any component of
the sub-systems a supervising platform that centralizes the
alarms occurring on the electrical distribution, thus permitting
a remote management of those and a prompt answer to faults
and anomalies that can significantly enhance resilience in case
of extreme events.
The platform provides also an energy monitoring section
dedicated to the remote management of distributed energy
meters.
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