By KIM BELLARD

I consider hospitals to be the nuclear power plants of the health care system. They are at the same time large, complex, expensive to build, beset by heavy regulatory constraints, still major components of their respective systems (health and electricity production) but declining in number. Each is seen as offering benefits to many, but also as presenting unexpected risks to some.

Interestingly, there is a ‘micro’ trend for everyone, but aimed for different purposes.

Micro-hospitals have been with us for several years. They usually only have about ten beds, as well as an emergency room, laboratory and imaging. Dr Tom Vo, CEO of Nutex Health, said: “We are positioned between the emergency room and a large hospital. A micro-hospital chief doctor admits: “We always work in partnership with our largest hospital partners for patients who may require surgery or intensive care. ”

They are not so much looking to reinvent hospitals as to support them and provide more comfort to patients. This is not the case with microreactors; they are looking to revitalize their struggling industry.

According to the US Energy Administration (EIA), there are 94 US nuclear reactors, at 56 nuclear power plants, in 28 states. Only one new reactor has entered service in the United States since 1996, while nearly two dozen are in various stages of decommissioning and only two new are under construction. Overall, the United States gets about 20% of its electricity from nuclear reactors, while the 13 countries derive at least a quarter of their electricity from nuclear power, with France in the lead at 75%.

We talk a lot about the transition from using fossil fuels to generate electricity, but none of the renewable options currently offer a realistic path to replace them. Nuclear power is the proven alternative, but, like Dan Van Boom wrote in CNET, nuclear power has a public relations problem. No one wants a nuclear power plant in their backyard, no matter how big that backyard is.

When most people think of nuclear energy, they think of disasters, especially Fukushima (Japan, 2011), Chernobyl (Russia, 1986), or Three mile island (United States, 1979). Nuclear power, in the opinion of many people, is dangerous, expensive to build, and something we should stay away from, not embrace.

Proponents of nuclear power point out that, frightening as they are, the deaths from the three disasters listed above were actually very low. In addition, they argue, almost all other forms of electricity generation are much more dangerous than nuclear.

Enter the microreactors. CNBC reported about Oklo, a start-up that sells mini-reactors small enough to fit in an A-frame and – get it! – fed by waste from conventional nuclear reactors. They only produce around 1.5 megawatts of electrical power (MWe), compared to conventional ones which can produce up to 8,000 MWe. Perhaps most importantly, however, instead of taking a dozen or more years, and up to $ 20 billion, to build them, these will take less than a year and are significantly cheaper.

This is no pie in the sky. “These reactors have been built and operated before. So they’re ready to go, ”said Oklo co-founder Jacob DeWitte. CNBC. Mr. DeWitte expects “a number of factories operational by the mid-2020s,” with potential customers including utility companies, industrial sites, large corporations, and college and university campuses. .

Oklo has already signed an agreementl with bitcoin mining company Compass Mining for 150 MW of power, at a cost Compass estimates significantly lower than it is currently paying. Mr DeWitte sees it as a “beacon” on how to fuel cryptocurrency.

Oklo still has to overcome some regulatory hurdles, not least of which is making the plans work without any human oversight on site.

Not to be outdone, China started construction of its own “small modular reactor” (SMR), Linglong One, built by China National Nuclear Corporation (CNNC). It will produce 125 megawatts, enough to power 526,000 homes. It can also be used for city heat supply, industrial steam, seawater desalination and oil exploitation. CNNC believes that SMRs offer miniaturization, high security, short build time and flexible deployment.

Likewise, the United States Office of Nuclear Energy affirms: “Small Advanced Modular Reactors (SMR) are a key part of the Department’s goal of developing safe, clean and affordable nuclear power options. He cites multiple advantages, including “relatively small physical footprints, reduced capital investment, the ability to be sited in locations not possible for large nuclear power plants, and provisions for additional power additions.” SMRs also offer distinct advantages in terms of safeguards, security and non-proliferation. “

As if that wasn’t revealing enough, the Department of Defense is working on transportable nuclear reactors, and some engineers come up with small reactors they call “nuclear batteries. “Among the latter, MIT professor Jacopo Buongiorno Told MIT News: “It’s so small that the whole plant is actually built in a factory and fits in a standard container.

CNNC and ONE overlap on many features they value in mini-reactors: small size, cheaper and faster to build, flexible deployment, and high security. All of this would be desirable in health care, especially for hospitals. But no one (to my knowledge) builds a hospital that can be built in a factory and easily transported. No one is actually proposing to replace full-service hospitals with a network of micro-hospitals.

Last year, in response to the pandemic, CMS launched both the Hospital without walls program and Acute hospital at home program. Both are commendable, but both were more about reducing pressure on hospitals, not reinventing them (and neither are permanent).

Hospital-at-home programs are already gaining ground, as evidenced by Kaiser Permanente and The Mayo Clinic jointly invest in the Medically Home Group, as well as a many other home hospital care offers. John Halamka, MD, president of Mayo Clinic Platform, says:

We can advance patient well-being by catalyzing innovative, collaborative and knowledge-driven business models to redefine the standard of high acuity care for patients with severe or complex illnesses currently receiving care in hospitals.

Amen.

If we can replace massive nuclear power plants with micro-reactors that can fit in a suitcase or shipping container, we can do better than micro-hospitals that look like small hospitals. If we can aim to run these reactors without staff on site, we find other ways to reduce staff in micro-hospitals. If micro-reactors can both significantly reduce carbon emissions and Being less expensive than traditional energy sources, micro-hospitals should help reduce health care costs and improve outcomes.

When the nuclear power industry innovates in health care, it is a good sign that health care is well behind.

Kim is a former emarketing executive for a big Blues plan, editor of the late and late Tincture.io, and now a regular contributor to THCB.

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