There’s growing interest in reducing the environmental impact of healthcare stakeholders’ daily operations. The timing is fortuitous, as several new software-as-a-service (SaaS) offerings help aggregate and disseminate data related to carbon footprints and environmental, social, and governance (ESG) impact.
One way to measure the broadening awareness of sustainability is through The Practice Greenhealth Environmental Excellence Awards. Every year, the recipients and categories for sustainability grow. Many early adopters, governmental organizations, and innovators are bridging the gaps in sustainability metrics by emphasizing holistic accountability, planning, and foresight across healthcare at every level.
Data from the Practice Greenhealth 2022 Environmental Excellence Awards also illustrates the intersection between sustainability and cost reduction. Organizations reported avoiding 331,000 metric tons of greenhouse gas (GHG) emissions; saving enough water to fill 27 Olympic-sized swimming pools; and an aggregate annual savings of more than $157 million due to environmental programs.
Let’s explore several key challenges and solutions that paint a clear picture of where we are with sustainability in healthcare and where we’re heading in the future.
Inflation Encourages Hospitals to Practice Sustainability
The worldwide economic challenges that began with the Covid pandemic have led to significant inflation. With rising costs of operations and resources, healthcare organizations have been forced to balance maintaining high standards of care with remaining profitable.
A recent McKinsey publication outlines several key ways in which inflation will affect the entire healthcare paradigm, including:
- A shortage of clinical labor by 2025, where a gap of 200,000 to 450,000 registered nurses and 50,000 to 80,000 doctors (10% to 20% and 6% to 10% of the workforce, respectively) is expected
- Incremental wage growth in the nonclinical workforce, potentially resulting in an incremental $90 billion of cost in 2027 throughout the healthcare system
- Supply chain difficulties and increased costs across the global economy, pushing nonlabor costs to increase by up to $110 billion in 2027
With healthcare budgets increasingly restricted, stakeholders such as laboratories and hospitals have demonstrated novel approaches to add value, with a focus on improving clinical outcomes. Their approaches often not only reduce costs but also enhance sustainability.
In a shifting health care landscape, a focus on sustainability can help build resilience while better protecting the health of patients and the community.
Gary Cohen, Practice Greenhealth founder
One approach is to encourage a reduction in test ordering. A recent study of Leumit Health Services, an Israeli health maintenance organization (HMO), shows how a revision of the existing laboratory test ordering policy, along with avoidance of unnecessary laboratory tests, might contribute to sustainability.
The authors observed that a slight decrease in the convenience of ordering a laboratory test not required for routine screening led to a dramatic decrease in the number of test orders that were created and sent. This reduced waste from protective gear, sharps, and lab materials. A similar study conducted at the University of Florida Health Shands Hospital also demonstrated how automated best-practice alerts significantly reduced unnecessary tests for an estimated overall cost reduction of $72,543 over 17 months.
Another approach is to encourage usage of recycled paper and energy-saving light bulbs, along with other unorthodox and emerging methodologies, including, for example, physicians using reusable materials whenever possible during surgery, and medical personnel using ultraviolet sterilizers instead of chemical sterilizing agents.
Leveraging Innovative Tech for Sustainability
Artificial intelligence (AI), machine learning (ML), and advanced computational modeling (such as in-silico modeling) have become important research areas in determining how best to optimize both clinical and operational processes for sustainability. These processes include scheduling and patient access, which helps reduce transportation costs, equipment costs, and recycling costs.
These new technological tools enable researchers to study and analyze systems that would be difficult or impossible to study experimentally, such as molecular interactions, ecological systems, and even social systems.
Data mining and artificial intelligence are already contributing to maximizing energy efficiency and controlling carbon and water footprints. Similarly, cloud computing allows laboratories to minimize on-site hosting while enjoying the benefits of limitless data storage and access to automated technology updates, while reducing costs. Data from these systems can be aggregated into sustainability dashboards that use key performance indicators (KPIs) and objective and key results (ORKs) for progress and goals tracking.
The rapid adoption of telemedicine throughout the COVID-19 pandemic also shows promise to create a more sustainable healthcare ecosystem. From automated patient appointment setting to holding events virtually, the reduction of carbon emissions and footprints is possible. To get a sense of the scale, check out this recent study published on Science Direct. It reports that telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO2 and 5.5 metric tons of volatile organic compounds.
Governmental and Regulatory Guidelines for Healthcare
With natural resources being limited and the higher costs associated with not participating in ESG continuing to rise, sustainability in healthcare has become the central focus for many governmental and regulatory organizations.
Many organizations have compiled guidelines and certifications that are intended to serve as a path forward:
- The GHG Protocol — an international standard for quantifying and reporting greenhouse gas emissions — has focused on healthcare’s impact on sustainability. In the most recent primer issued to healthcare organizations worldwide, Reducing Healthcare Carbon Emissions: A Primer on Measures and Actions to Mitigate Climate Change, published by a collaboration between the Agency for Healthcare Research and Quality (AHRQ), the U.S. Department of Health and Human Services lays out a consistent and transparent approach for measuring and reporting GHG emissions.
- The European Green Deal (EGD) Investment Plan (or Sustainable Europe Investment Plan) has mobilized more than €1 trillion for sustainable investments over the next decade to achieve its objectives, aiming to make Europe the world’s first climate-neutral continent by 2050. This is a significant shift in policy, as it not only promotes adoption of sustainable projects but also creates a financial framework for public and private investment.
- The Institute of Medicine and Berwick and Hackbarth collaborated to outline six aspects of healthcare “waste,” regarding failures that encompass care delivery, administrative complexity, low-value care, and more.
- Many hospitals around the world are already taking steps to promote sustainability with LEED Certification (Leadership in Energy and Environmental Design). As an initiative promoted by the U.S. Green Building Council (USGBC) for establishing sustainable standards, LEED is a certification program that recognizes best-in-class green building strategies and practices. Buildings can earn LEED certification by fulfilling certain prerequisites across nine categories.
Final Thoughts
Expect sustainability to be top of mind for key healthcare decision-makers and stakeholders in 2023 and the years to come.
Cloud hyperscalers and SaaS vendors have deployed platforms and products to gather all the data required to calculate a complete carbon footprint, including cloud services. For healthcare organizations, collecting this data and building the necessary interoperability to any systems and datasets is much like the data engineering needed to implement an electronic health record (EHR), Fast Healthcare Interoperability Resource (FHIR), and AI.
Despite being a major economic and social challenge for the global healthcare industry, there is a tremendous opportunity for innovation by exploring new ways to reduce healthcare waste. Investing to reduce detrimental environmental impacts is good business for the short term and long term, in both economic growth periods and during uncertain times.
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