Firm Profile: Levi + Wong Design Associates—Virtualizing Healthcare Architecture

Nestled within the upper reaches of an old timber-frame structure, Levi + Wong Design Associates paints a stark contrast to the ethos of the quaint and historic town of Concord, Massachusetts. Here, in one of the most important early small towns in American history, we find a firm using technology that just a few years ago was heralded as the future of architectural practice. Headed by its two key principals—Thomas C. Levi and Willie W. Wong—the multi-disciplinary design firm they lead is surprising in both its size and sophistication.

The juxtaposition between old and new was further unveiled as I spent nearly two hours touring the office with Levi and his key technology lieutenants, Lawrence Passmore, IT Director, and Vincent Boutaud.

The firm—servicing clients from Massachusetts to California, Florida to the mid-Atlantic states, and naturally all of New England—offers a full range design services including expertise in both acute care and rehabilitative hospitals, senior living and senior care facilities, specialty healthcare, and campuses and buildings for both corporate and technology.

Levi + Wong’s work is also geographically diverse. They practice all over New England and clear across the country from Florida to California. As a design firm, services include: architecture, landscape architecture, interior design and planning—all integrated into one design firm. And ‘integration’ is a good word to use to describe the firm’s design process—uniquely centered around its developed 3D ‘virtual design” workflow.

When It All Began

As it turned out, Thomas Levi didn’t begin the firm he founded 25 years ago with so much technology in mind, or that he would even one day lead a firm surfing its leading-edge. Like most architecture practices older than a few decades, they made the jump from paper to digital CAD like most everyone else, plotting along for years with PowerCADD on Macs. Then in the late 90’s Levi got introduced to the 3D ‘virtual building’ concept pioneered by Hungarian software house GRAPHISOFT.

“I wanted to be a better designer,” remarks Levi, when prompted to explain why he got into virtual building technology with Graphisoft’s ArchiCAD. “I wanted to be able to continually visualize, instead of sit here and sketch and go back and forth between CAD.”

At the time the firm learned of ArchiCAD and the ‘virtual design’ process they had been working for Millennium Partners, one of the global leaders in upscale development and major mover in the New Urbanism. “We were doing a balance between the healthcare and corporate back then,” says Levi, “and the corporate was some of the really fun work back then and Joe Larkin of Millennium here in Boston encouraged us, saying this technology was out there, was the future and to just do it. So we did.”

Upon making the leap to move to a 3D ‘virtual building’—or what is today referred to as BIM (building information modeling)—workflow the firm did go through some initial teething issues. “Of course on the hospital side initially it was quite fussy,” remarks Levi, “but these days the healthcare work is so precise it now actually helps us tremendously.” “Today the firm has more than 15 years of experience using ArchiCAD,” Levi adds, “and all projects and teams utilize it as their primary design tool.”

Benefits In Workflow Change—BIM For Levi + Wong

As the firm advanced with ArchiCAD and a true BIM process workflow it’s clients also began to adapt along with them, but at differing rates and engagement. Healthcare as an industry is a 800 pound guerrilla. It’s understandable—the industry in the US is just a behemoth, it’s a technical and information-laden industry fraught with complexity.

In healthcare architecture a lot of the ‘client-to-architect’ interaction is triune and multifarious. The architect can be asked to meet multiple, layered and sometimes competing goals. “And on the medical work a lot of information is coming into the design process from the medical staff,” adds Lawrence Passmore, Assoc. AIA, “who aren’t trained in the architectural process and yet they have to understand dimensional drawings, which can be a little strange for them sometimes. And so,” he continues, “when I started here Tom was really interested in having us model all those little details, medical equipment, and showing them to the medical staff to get their feedback on them.” (see images 02, 04.1 – 04.2)

“We model everything,” says Levi, “if we can’t buy it we can model it up quickly.” “Yes, the model is a type of diagram” adds Boutaud, “it doesn’t have to be perfect or an exact replica of a given device, but it communicates the story.” To facilitate this, Craig Boyer, a former Graphisoft technical representative, works as a BIM facilitator, building smart objects on demand and managing consistency in the process, and Keith Bradly works as a visualization coordinator, assisting design teams with CINEMA 4D to transition their models into photo-realistic images and movies.

The firm has built-up a growing 3D model library with hundreds of 3D accurate models of medical and healthcare equipment found in every type of exam room, triage unit or OR suite. This is benefiting the firm as times goes on.

Levi notes that the ‘virtual design’ and BIM workflow does force decision-making earlier in the process. He indicated that when they are in the traditional schematic phase they are actually mid-way through design development. And when they are mid-way through design development they are substantially into construction documents. “It is really front-loaded decision making and it does speed the process up.”

next page: Industry Under Pressure—BIM for the Healthcare Industry

Industry Under Pressure—BIM for the Healthcare Industry

If time is money then the ability for an architecture firm to move a healthcare project from conception to completion faster than in the past is of obvious benefit to the institution, and theoretically healthcare in general. But that’s only one part of the bigger BIM story for healthcare architecture.

Thomas Levi reiterates that what’s even more important to the professionals treating patients every day is their ability to raise the level of care. “The US already has some of the best healthcare in the world, but’s that’s not stopping our nation’s leading hospitals from advancing,” remarks Levi.

“Healthcare is under tremendous pressure as an industry,” he adds. “Everything you hear in the press is real. They are under massive financial pressure to re-align their own business. By involving the client in our 3D virtual design process from the beginning and throughout the project they are able to understand the project more clearly and make better informed decisions.” 

Boston Medical Center—Case Study

Recently Levi + Wong has applied some of their latest ‘virtual design’ workflow processes to three key projects at Boston Medical Center, Boston’s academic and community hospital. In each of these projects the firm utilized Graphisoft’s BIMx software to enable the ‘virtualized building’ experience so both design staff, project managers, and the hospital’s decision-makers could experience the project virtually—as a digital prototype—in immense detail.

“Using BIMx has helped our clients because they can spend more time with the design in a way you can’t do with drawings or static 3D,” says Levi. From ArchiCAD the firm can export what is known as a BIMx file, which can be viewed on a desktop or a mobile iOS device like an iPad. With video game-like 3D navigation anyone, no matter what their computer experience level, can quickly learn to roam around inside a virtual building. (see images 03 – 04.2)

Passmore notes about BIMx that the technology takes out “the discrepancy between the firm’s presentation documents and their construction documents, as the information all comes from the same file.” This is very easy to see and understand when viewing BIMx on an iPad device, for example.

“We can take them into the BIMx model environment and say, ‘this is your workspace,’ so it’s like a virtual approval of the project,” says Levi. In one of the projects for Boston Medical Center, Levi + Wong redesigned the hospital’s critical NICU or Neonatal Intensive Care Unit. The NICU features private NICU rooms and, as can be seen in the images in this article, every single device, along with all the electronics and lighting within the device is modeled in 3D.

This level of interactive work has led to some clients being asked to come to the firm to participate in real-time or interactive design meetings—another added value that healthcare clients are not used to receiving from working with other firms. “Vincent has sat with a couple of our clients, making some changes in ArchiCAD in real-time. They thought it was normal to work that way and we said ‘oh no, this is what Levi + Wong does but this isn’t normal.'”

Solve Complexity with Simplicity—The One Tool Paradigm

While Levi + Wong may be enthusiastic about the use of advanced computer technology in their practice, they are not interested in “tooling up” in order to appear overly sophisticated or techie. Levi stated that the firm seeks to simply software complexity as much as possible and work with tools that are accessible and easy to use.

For example, Levi noted that he himself isn’t a BIM user and can’t really do much inside ArchiCAD. “A lot of the project managers and principals here, in their mid-50’s or early 60’s, like myself, don’t know CAD. But when they see this—BIMx is a tool they can use to design and review projects with.” Levi notes that for project managers and principals using BIMx on their own allows them to explore the latest state of an ArchiCAD BIM model so they can evaluate design decisions, technical and lighting decisions, independently.

And “BIMx is a great way to present the model without separating the ArchiCAD BIM workflow from the presentation itself,” notes Vincent Boutaud, Assoc. AIA, “because a lot of times there are people working on the BIM model live. BIMx gives you a way to control the presentation as well, something you can’t get with flyby animations per se.”

The firm’s main tools are Microsoft Excel for data intake and manipulation, ArchiCAD for design and the BIM workflow, Cinema 4D for advanced visualization and animations, plus BIMx for creating self-directed or presentation-led BIM model walk-thrus. Levi also notes that the firm has a solid history of using Trimble’s SketchUp for early design work as well; but “year by year its use is dwindling” notes Levi as ArchiCAD has taken over as the primary design tool. Additionally, the firm uses Apple’s Keynote because it presents animations very well and can create them interestingly among slides in a presentation.

next page: US Realities—Getting Along with Revit

US Realities—Getting Along with Revit

One of the most fascinating moments in my discussion with Levi, Passmore and Boutaud came when I asked them how their clients, consultants and the builders respond to their Graphisoft-based BIM workflow, here in the US where Autodesk Revit is more commonly encountered among BIM workflows.

On the healthcare client side, hospitals are still catching up to what is possible and what is normative. It’s an education as Levi will tell you. When asked how Boston Medical Center responded to the BIMx ‘virtual building’ workflow process, he stated, “I just say this is our workflow. I take this around to other area hospitals and they say ‘what does this cost?’ and I say nothing, this is just our workflow. I’ll tell you—they are stopping to think what this means.”

[The animation above is from the project South Cove Manor. The animation was built using ArchiCAD with the inclusion of IFC files for MEP components and all rendered and animated with CINEMA 4D. Copyright Levi + Wong Design Associates, Inc. All rights reserved.]

Passmore and Boutaud note that working with consultants and general contractors is straight forward as they can export out IFC files for incorporation into programs like Autodesk Navisworks for BIM model viewing, coordination, and clash detection. In working on the Boston Medical Center projects the firm had the pleasure of working with Odeh Engineers of Rhode Island, one of the nation’s most advanced structural engineering users of BIM tools. While some of their partners have equal sophistication with BIM many do not, notes Levi.

“The reality is most builders are not really taking full advantage of the BIM model and the data buried within it,” says Levi. “We work with small and medium contractors and their knowledge base isn’t there yet—it’s evolving. On the Boston Medical Center project, Suffolk and Shawmut Construction, two of Boston’s largest contractors, are for the most part taking full advantage of the power of BIM.”

“They are planning to have mini workstations on the job site,” continues Levi, “so that the workers can look at the IFC file of a BIM model, and will also have the opportunity to look at the BIMx model, or they can go and look at the floor plans on which they bid on. They have multiple ways of looking at it now and I think it’s going to help them in many ways.”

 Closing Comments—Confidence and Growth

Thomas Levi and his team are enthusiastic about the firm’s future and advances with its ‘virtual building’ workflow. While they may be located in a small and bucolic New England town, they internally think like a bleeding edge design firm in a major global city—like London, New York or Toyko.

The firm is recognized by Graphisoft in Hungary as one of its top US-based users and they are regular beta testers. “If we call them up and have a problem, they know that Vincent or Larry have discovered a true limit—we’ve run into a wall—and they are more than willing to help us search around to solve the problem we’ve bumped up against,” notes Levi.

The firm’s entire platform infra-structure is based on Apple’s Mac OS X platform and Apple is also aware of how far this architecture firm is pushing the envelope with its technology. The firm has a small fleet of Mac Mini’s for its own render-farm and each iMac workstation can be turned into a Cinema 4D remote render unit for nighttime animation jobs. “Apple’s regional reps have been here recently and asked us: ‘how can we help you further?’ And so we are now talking to them because they said they have some enterprise methodology that can help us take this further,” says Levi.

And speaking of further. Levi has been talking to healthcare institutions across the entire US—all the way to San Diego—and they have expressed enthusiasm for what they see. “We’ve shown this to three other major institutions in town [Boston] and we said this is our workflow, this is the way we do it, this makes for better communication, better design decisions…if you don’t like what you see you better let us know now.”

 

[photography credit: article title graphic–photo taken of the D’Youville Center for Advanced Therapy taken by Warren Patterson, all rights reserved.]