University of Washington Medical Center

• Six-figure savings on physical mockups
• Clinical staff tailor rooms in VR
• Ergonomic flaws caught in design

Why a Real-Time 3D Engine for Clinical Design Review

Mortenson's Virtual Insights team, four people based in Seattle and Minneapolis, was set up to bring interactive visualization into the contractor's design and customer experience offering. It delivers around twenty real-time 3D projects a year for clients including the University of Washington Medical Center, Kaiser Permanente, Stonebridge Marriott Hotels, Bucknell University and Pennsylvania State University.

Interaction, not just walkthrough

The team's own account of how the work evolved is the most useful part of this case study. Early projects were simple virtual spaces that clients could walk around in. Over time the team concluded that building interaction into the environment mattered far more for engagement than visual polish alone. In a clinical room that distinction is decisive: a surgeon who can only look at a theatre learns very little, while a surgeon who can move the boom and stand where they would stand during a procedure finds problems immediately.

An open pipeline into the model

The team pulls geometry from 3ds Max, SketchUp and Rhino and supplements it with architectural assets from the Unity Asset Store, so equipment and context can be assembled quickly without remodelling everything from scratch. They also make heavy use of the C# API, which is what allows equipment to behave rather than merely appear.

Networked review across locations

The team works networked internally and delivers networked experiences, so clients across the United States and in Europe can collaborate in real time inside the same virtual room. For a hospital, that means the surgical team, the facilities group, the architect and the contractor can hold one review without travel.

A note on the tool listing

aec+tech lists Unity Reflect against this case study. Unity's published account describes work built by Mortenson's Virtual Insights team on the Unity engine; Unity Reflect is Unity's dedicated BIM-to-real-time product for AEC. The tool tag should be read as an association with the Unity real-time platform rather than as a documented Reflect deployment.

Clinical buy-in is the real risk

Mortenson's account identifies the underlying problem precisely: if the project manager cannot get the surgical team to engage with and buy into the design, the hospital ends up remodelling as soon as it opens because the room does not work for the people using it. That is a failure of communication, not of design competence, and it is expensive.

Ergonomics cannot be read from a plan

Reach distances, sightlines to monitors, circulation around a table during a procedure and the position of booms are all judged from inside the room. Drawings confirm compliance with dimensional standards but say nothing about whether a team can actually work in the space.

Mockups are expensive and few

Physical mockups can cost hundreds of thousands of dollars on a large healthcare project, which limits how many room types are ever validated this way and how many iterations any one of them receives.

Equipment-heavy, decision-heavy rooms

A hybrid operating theatre coordinates imaging equipment, structural support, services and clinical workflow simultaneously. The number of interacting decisions is high enough that reviewing them sequentially, on paper, reliably misses conflicts.

The established method for validating a clinical room is the physical mockup. A full-size operating room or patient room is built out with real equipment or accurate stand-ins, and clinical staff are brought in to walk the procedure. It is the only traditional technique that answers ergonomic questions properly, and on a large hospital project it can cost hundreds of thousands of dollars.

The problems are cost, timing and coverage. A mockup is expensive enough that only a handful of room types are ever built, so most rooms in a hospital are approved from drawings alone. It also arrives late, once equipment has been specified, which means changes it uncovers are changes to committed decisions.

Everything else was reviewed from plans, equipment schedules and static renderings, none of which can reproduce the experience of standing at an operating table and reaching for a boom.

Unity's case study reports outcomes for Mortenson's healthcare visualization programme as a whole rather than isolating figures for a single hospital, so the results below are stated at that level rather than attributed specifically to one project.

Substantial savings on physical mockups

The headline reported benefit is that the approach saves clients large sums on physical mockups, on the order of hundreds of thousands of dollars on large projects. That is a direct budget line removed, not a modelled efficiency, and on a hospital with many distinct room types it scales with the number of rooms that would otherwise have needed building.

Design and ergonomic flaws caught early

Clients are reported to identify and eliminate ergonomic or design flaws early in the project. In healthcare the value of that is asymmetric: catching a boom position or a circulation conflict during design costs almost nothing, while discovering it after commissioning means taking a theatre out of service to remodel it.

Clinical stakeholders tailor their own workspaces

Rather than being consulted on drawings, medical staff pre-experience and adjust their workspaces at full scale. This shifts the design conversation from approval to authorship, which is what produces the buy-in that prevents post-occupancy remodelling.

Real-time collaboration between owner and project team

Because the environments are networked, clients and development teams collaborate in live three-dimensional design reviews instead of exchanging comments on document sets, which compresses the number of review cycles a room type requires.

One build, many delivery formats

The same model is output to VR headsets and to 360 video across a wide range of devices, so a clinical group without hardware can still review the space. On a hospital project, where the reviewing population is large and dispersed across shifts, that reach is what makes broad participation possible at all.

About Mortenson's Virtual Insights team

Mortenson is a privately held United States top-20 builder, developer and provider of energy and engineering services, with 5,000 employees and reported revenue of 3.8 billion US dollars. Its Virtual Insights team of four, working from Seattle and Minneapolis, was founded by emerging technologies developers Will Adams and Marc Kinsman and produces roughly twenty real-time 3D projects a year. Healthcare clients named publicly include the University of Washington Medical Center and Kaiser Permanente.

Technical stack and delivery platforms

Models are imported from 3ds Max, SketchUp and Rhino, supplemented with Unity Asset Store content and extended through the C# API. Experiences are delivered to HTC Vive, Oculus Rift, Oculus Go and HoloLens as well as 360 video.

Related Mortenson work at UW Medical Center

UW Medical Center Expansion Phase II, Seattle: over 200,000 square feet, approximately 130 million US dollars, architect NBBJ, GC/CM delivery, completed February 2018. Includes 11 operating rooms with 3 hybrid theatres, a 30,000 square foot ICU with 48 rooms, 32 new and 28 renovated private medical and surgical rooms and 41 pre and post-operative rooms.