New technology is being tested by doctors in a $43 million Veterans Affairs simulation hospital.

• SimVET, a $43 million Florida-based facility, is being used by health-care workers at the VA to test technology and practice procedures.
• No real patients are treated at SimVET, despite its realistic hospital appearance.
• A dedicated space is provided by the building for clinicians to test new ideas without endangering individuals.
• CNBC visited SimVET in March.

The sprawling $43 million Veterans Affairs facility, equipped with operating rooms, intensive care units, and an outpatient clinic, has no real patients.

The National Center for Simulation Validation, Evaluation and Testing, or SimVET, is a 53,000-square-foot building located near the Orlando International Airport in Florida. It serves as the main facility for front-line health-care workers from the VA to practice procedures and test new technologies, all while minimizing risks to patients.

By practicing in a controlled environment, health-care workers can refine their response to opioid overdoses and evaluate the effectiveness of new artificial intelligence tools. VA officials stated that this approach allows clinicians to identify potential issues and ensure that new ideas are practical and safe to implement.

SimVET, established in 2016, demonstrates the growing trend of simulation in healthcare and its advancements in recent years. With numerous new AI tools on the market, health systems can utilize facilities like SimVET to sift through the clutter.

In the U.S., the Veterans Health Administration serves 9 million veterans through 172 medical centers. These centers have simulation programs, with some even featuring dedicated spaces on site.

The SimVET facility in Orlando is the largest simulation center in the country, according to Dr. Scott Wiltz, the medical director of the VA's Simulation Learning, Evaluation, Assessment and Research Network, or SimLEARN.

Flight simulators are commonly used in the military and aviation industries to practice high-risk scenarios for hours.

In healthcare, medical schools and hospital systems have traditionally utilized professional actors to train doctors. However, virtual reality headsets are gaining popularity for surgical practice. SimVET, on the other hand, takes a more advanced approach.

Wiltz stated in an interview with CNBC that the goal is usually to achieve "a high level of realism."

""Two fully staffed operating rooms with all the necessary equipment, including lights, booms, anesthesia machines, and a realistic mannequin, are available at our facility," Wiltz stated."

In March, CNBC visited SimVET and observed the mannequins as a permanent feature of the facility. The mannequins come in various skin tones, hairstyles, and facial features, with some programmed to speak, move, and develop complications. An older mannequin has wrinkles and more prominent veins, while another can give birth to a "baby" mannequin.

According to Wiltz, the mannequins at the facility represent not only the VA's population of veterans but also the broader population of the country. There are "well over" two dozen mannequins at the facility, he stated.

SimVET, despite its unique patients, resembles typical healthcare settings with fluorescent lights lining a hallway of examination rooms and operating rooms filled with medical equipment similar to those found in a nearby hospital.

The facility resembles a real medical center, except for its classrooms and educational spaces.

"The space we have is diverse and realistic, giving you the impression that you can truly care for patients in that building," Wiltz stated. "However, our patients are mannequins and actors."

A space to 'fail safely'

SimVET has approximately 60 full-time staff members who work on multiple pilots and projects simultaneously. National program offices and front-line workers within the VA often approach SimVET with simulation ideas, and employees at the facility may also be inspired to come up with their own projects.

Wiltz advised that it is more advantageous for groups to seek services from SimVET, which can receive funding directly from the VA, rather than attempting to pay someone outside of the government.

In May of last year, Amanda Borchers, a patient safety manager at the Lexington VA Medical Center in Kentucky, was part of a surgical emergency team that visited SimVET. She stated that they were seeking to enhance their response to unforeseen complications that may arise during surgery, so they contacted SimVET with suggestions in the winter of 2023.

Borchers' team aimed to create a new protocol to better handle high-risk veterans with breathing, heart, and circulation problems that may arise during procedures. They focused on developing a plan to quickly retrieve blood and transport it to the operating room in case of sudden issues.

Borchers and her teammates received assistance from SimVET leadership in preparing simulations prior to their on-site visit, and were also introduced to numerous field experts from around the country.

The team's first day at the SimVET facility began promptly at 7 a.m., with hours spent walking through procedures and discussing problems with experts and SimVET employees.

"Borchers advised CNBC in an interview that failure is acceptable, but it should be done safely. Afterward, the change can be made, and the process repeated. The transformation and the ability to handle unexpected emergencies were impressive, according to Borchers."

Borchers had previously participated in simulations, but nothing compared to SimVET. She said the facility replicated her daily work environment, enabling her to practice every detail of her routine.

""You could perform a surgery right then, right there," she said."

Borchers and her team developed a framework for a new medical code at SimVET, which is a facility-wide response to a specific type of emergency. This code, such as "code blue," signifies when health-care workers spring into action after a patient goes into cardiac or respiratory arrest.

Borchers stated that the new code developed by the team would be announced over the overhead speakers as a "code SET," meaning "surgical emergency team." She explained that it is intended to notify a specialized team that offers assistance when unforeseen difficulties arise during or following a surgery.

Borchers and her team received the initial practice and assurance from SimVET for their idea, but they still needed to gain the support of the Lexington VA Medical Center. They presented the code to their executive leadership and began to determine which individuals and resources would be involved in its implementation.

The medical center started conducting facility-wide simulations with the code in the spring after fine-tuning it in small pockets throughout the fall.

The medical center is currently updating its paging system, and Borchers stated that the facility will simulate the code again once the new system is implemented. If everything proceeds as planned, code SET will be utilized with real patients in the next two to three months.

Borchers aims to implement code SET in VA medical centers nationwide, with staff from states such as Tennessee, Mississippi, Louisiana, Arkansas, and Texas having already participated in simulated training sessions.

The code is on its way to becoming a national program at the VA, as stated by Wiltz.

According to Wiltz, the issue didn't arise from an unfavorable incident but was instead brought up by individuals who believed that despite doing well, there was room for improvement.