There is no escaping the reality that the planet’s health and our own are joined, and the health community must unite with environmental affairs experts to collaborate on what must be done to keep the planet vibrant. As World Health Organization Director-General Tedros Adhanom Ghebreyesus, Ph.D., wrote in the Healthcare Without Harm report, “Places of healing should be leading the way, not contributing to the burden of disease.”
Yet, the global healthcare industry is responsible for two gigatons of carbon dioxide each year, 4.4% of net emissions worldwide. Hospitals generate some five million tons of medical waste annually from everyday trash such as medical packaging and food to regulated medical waste, which includes used surgical gowns, gloves, scissors, and syringes. If the healthcare sector were a country, it would be the world’s fifth-largest contributor to greenhouse gases following China, the US, India, and Russia. This is not the US News and World Report ranking that any hospital would want to receive.
Health systems are working feverishly to correct course, and to do this, many major centers of medical excellence must align their sustainability and health outcome priorities. Enter eco-health and the next wave of digital health approaches that have the potential to check the health ecosystem’s contribution to the pace of planetary degradation. Through eco-health innovation, the healthcare industry has the potential not only to block negative impacts, but also to become agents of positive change as we confront the greatest public health challenges of our generation — the fight to sustain a healthy planet, and therefore, us.
Healthcare’s response to the pandemic has already driven positive change without intending to. Hospitals that mobilized to implement state-of-the-art telehealth and remote care technologies, essential during the height of COVID-19, did so to increase access to care. But these digital health and medical technologies benefit our environment directly. Telemedicine and EMRs already reduced in-person office visits by up to 26% in the years prior to the pandemic, and experts report that making telemedicine a permanent healthcare delivery feature could result in a 40–70% reduction in carbon emissions.
DIGITAL HEALTH AND EMRs ALSO SAVE TREES
In a sector known for love of paperwork and files, Electronic Medical Records (EMRs), geared to provide convenient access to health information for professionals and consumers alike, also have another benefit, saving entire forests. Kaiser Permanente, the nation’s largest integrated, nonprofit health system, claims that its efforts to prioritize environmental health and patient care enabled it to become the first health system in the US to achieve carbon-neutral status. According to their report, EMRs and telemedicine reduce paperwork and in-person patient visits, and the carbon sequestered can be equal to 19,200 acres of forest. Imelda Dacones, MD, president and CEO of Northwest Permanente Medical Group affirms:
“As physicians, climate change is absolutely in our lane — let’s educate ourselves, our patients, and our communities. As a world, we will develop vaccines and effective medicines to treat the COVID-19 pandemic. Climate change, on the other hand, is a public health crisis where there will be no point of return if we don’t act today.”
CommonSpirit Health, with 137 hospitals and more than 1,000 care centers across 21 states, reports that 1.5 million virtual patient visits between March 2020 and April 2021 resulted in 37,440,731 miles not traveled and 1,678,956 gallons of gas not combusted, for a savings of $3.509 million and a reduction of 15,092 metric tons of CO2 emissions. Beyond increasing our air quality, that translates to roughly 18,490 acres of forest saved. In addition, patients gained back 923,276 hours by visiting their physicians online, no small matter for our packed workday schedules. That is the power of planning and prioritizing eco-health.
HOSPITALS CONSUME ENERGY
Beyond what goes on inside their corridors, physical healthcare facilities account for 4.8% of the total area of commercial buildings and use 10.3% of total energy consumption in this sector, making hospitals the second-largest energy-intensive consumer of US commercial buildings. Considering their medical equipment and 24-hour operation needs, It’s understandable, but hospitals have an opportunity here to tap into technologies that reduce energy dependence. Many of the nation’s leading medical centers are rallying to apply their public health expertise in order to take on climate change.
Bob Martineau, JD is senior partner, environment, energy and sustainability, FINN Partners, served as Tennessee’s commissioner of environment and conservation, and is a past president of the Environmental Council of the States. Based in Nashville, recognized as the capital of the nation’s health provider service sector, Martineau says:
“Hospitals and healers focus intuitively on delivering exceptional patient care. That mission extends to ecohealth, which impacts positively the community and its future generations. Just as health systems have been societal role models in disease prevention and self-care, hospitals can lead from the front and advocate for policies that protect us from environmental risk, and they can inspire others to act by communicating what steps they are taking to lead the way.”
Throughout a hospital, technology including robots that deliver supplies, handheld devices for staff, and integrated bedside terminals is implemented to benefit both staff and patients. By tapping into cutting-edge technologies — from those that access patient data to the chromatic glass that adjusts the facility’s temperature, Humber River Hospital in Toronto, Canada was recognized by the Intelligent Health Association as North America’s first digital hospital.
THE PROVIDER SYSTEM AS ENVIRONMENTAL CHANGE CHAMPION
When it comes to implementing science that improves quality care, crafting global medical guidelines, and taking part in drug development, hospitals have been innovators. Now, it’s time for our provider system to become change agents mobilizing for the planet by embracing green technologies such as smart beds, artificial intelligence, EMRs, virtual reality, digital health, and more.
True, the use of digital health technologies does not come without its own environmental impact. Unlike paper, which has a defined carbon footprint, digital products require power and infrastructure that still consume energy and produce electronic waste. But these negative impacts can also be mitigated through the adoption of green power and intelligent innovation in emerging recycling programs.
This should not prevent hospitals from being part of the global solution by innovating to create and adopt a new medical system dedicated to improving human health through eco-health technology. By drawing on the imaginations of architects, entrepreneurs, engineers, scientists, physicians and healthcare professionals, our hospital systems and health facilities have the opportunity to change the world in significant, sustainable, and lasting ways.
Whenever there is a pressing need to save and sustain life, the health sector has always been in the vanguard as passionate innovators and societal role models. Now, hospitals around the world are not only centers of patient-care excellence, they are poised to be among the most effective champions of planetary health.
[Special thanks to my FINN Partners colleague John Bianchi for his suggestions and encouragement.]
