Hospitals operate 24/7/365 and remain one of the highest energy consumers per building type. In today's Hospital environment we are seeing demand for energy continue to rise. Advanced technologies for diagnostics and treatment, increased areas where invasive procedures take place, doctor demands for lower temperatures, increased air quantities and filtration measures for improved indoor environmental quality, infection control strategies, and large data centers that power the digital world has led to an escalation in energy demand. How do we improve energy efficiency and lower energy consumption? Our discussion will explore current trends of engineered systems that focus on increasing energy efficiency and reducing demand while maintaining or improving the indoor environment within the confines of our regulatory agencies. There are many new systems and products that we are looking at. Here is a partial sampling of the things we are exploring and might be of future research interest: - Backpressure steam turbines - 100% outside air systems with heat recovery - Cogeneration - Natural ventilation - Chemical free water treatment systems - Aeroseal duct sealer - Day-lighting - Variable air volume systems - Heat recovery from sterilizers - Fuel switching technologies. There is another effort that will be discussed. EPA, GGHC, USGBC, and NYSERDA desire to create an accurate whole energy modeling tool for hospitals. This is a potential area of research where LBNL's expertise could be employed.