The built environment is a complex ecosystem of social institutions and physical infrastructures. Innovation and entrepreneurship in the building industry are critical levers for market transformation toward equitable climate action. However, climate tech innovation for the built environment is not moving fast enough for global needs, and it lacks fundamental diversity, leading to inequitable outcomes. IMPEL (Incubating Market-propelled Entrepreneurial-mindset at the Labs and Beyond) - a U.S. Department of Energy incubator–addresses these critical issues. Over five years, IMPEL has enabled 250 innovators, including 55% women and diverse founders, to accelerate their buildings and clean energy technologies towards market and climate impact. IMPEL provides access to strategic mentoring and coaching, carbon tools training, testbeds, and powerful public-private pipelines, including industry demonstrations, non-dilutive grants, and venture capital networks. The IMPEL innovation ecosystem has accelerated the pace of innovation and market adoption of building decarbonization technologies. In this paper, leverage the IMPEL stakeholder ecosystem - from innovators to investors and product industry to policymakers - to analyze the critical barriers to decarbonization still encountered in the building industry. We study the IMPEL approach and highlight lessons learned that benefit young businesses pursuing innovative building and building-edge energy technologies to develop new ideas and products. Finally, we propose a ‘market forming’ framework to improve the quality and efficiency of the entrepreneurial ecosystem in the building industry. This framework could scale vetted technologies and the participation of diverse founders to de-risk the climate tech

Energy reporting is the principle that all energy-using devices in buildings should be able to track their own energy use and report this to the local network. Energy reporting can provide building owners with easy access to highly granular energy use data. This report makes the case that energy reporting should become a free basic feature of all devices, and reports on a project intended to move us towards that goal. The project collected a set of demonstration devices with energy reporting features, including products that were modified by the project team or the manufacturer, or are already available for sale. To show these devices operating live at meetings and conferences, the team created a management system that queries the energy reporting devices for their data, stores the data, and displays it in compelling visualizations. The devices covered a wide range, including heating, ventilation, and air conditioning (thermostat and air purifier); lighting (individual bulb, task light, and auto-dimming overhead light); a vehicle charger; a water heater; electronics (notebook personal computer and universal serial bus charger); and three external meters (one integral with a dimming light switch). The demonstration uses a variety of communication protocols. The report reviews existing communication protocols that support energy reporting and describes how to use them with a proposed reference data model for energy reporting. It also assesses ways that energy codes and standards processes can be leveraged to drive energy reporting technology into the market. Energy reporting could ultimately save California on the order of 2.5 terawatt-hours per year and about $0.8 billion per year. Energy reporting is a highly practical technology with minimal (sometimes no) cost to consumers and manufacturers. This report discusses creation of the energy reporting devices themselves, analysis and recommendations for data models and protocols for energy reporting, and energy codes and standards implications of energy reporting technology. While energy reporting does not directly save energy, it provides information for better decision-making to save energy in changing equipment operation, maintenance, and replacement.

Background

The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic.

Methods

We administered a cross-sectional survey to patients who had their general and plastic surgical procedures postponed at the onset of the pandemic, asking about barriers to accessing surgical care. Questions addressed dependent care, transportation, employment and insurance status, as well as perceptions of and concerns about COVID-19. Mixed methods and inductive thematic analyses were conducted.

Results

One hundred thirty-five patients were interviewed. We identified the following patient concerns: contracting COVID-19 in the hospital (46%), being alone during hospitalization (40%), facing financial stressors (29%), organizing transportation (28%), experiencing changes to health insurance coverage (25%), and arranging care for dependents (18%). Nonwhite participants were 5 and 2.5 times more likely to have concerns about childcare and transportation, respectively. Perceptions of decreased hospital safety and the consequences of possible COVID-19 infection led to delay in rescheduling. Education about safety measures and communication about scheduling partially mitigated concerns about COVID-19. However, uncertainty about timeline for rescheduling and resolution of the pandemic contributed to ongoing concerns.

Conclusions

Providing effective surgical care during this unprecedented time requires both awareness of societal shifts impacting surgical patients and system-level change to address new barriers to care. Eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.