IIn many ways, health care runs on “E”. But not when it comes to energy consumption.

The industry is grappling with staff shortages, cost constraints and supply disruptions as the pandemic continues to strain operations. Reducing carbon emissions may seem like another concern added to the end of this daunting list, but in reality, it will compound each of these other issues if left as an afterthought.

“It’s not going away,” said Jay Lemery, MD, professor of emergency medicine at the University of Colorado School of Medicine at Aurora, co-director of its climate and health program and a member of the National Academy of Medicine.

“It will only accelerate in terms of consequences for any business, but in particular for health care.”

If health care continues to operate as usual, the sector’s global emissions will exceed about 6 gigatonnes per year by 2050, according to Health Care Without Harm, an international non-governmental organization. In the United States, carbon emissions from healthcare account for 8.5% of the country’s total.

Work towards E

Due to healthcare’s outsized impact on the environment through harmful carbon emissions, the “E” in ESG is a smart entry point for newer healthcare organizations within the framework. . Prioritizing decarbonization in healthcare has the power to significantly influence the trajectory of climate catastrophe and mitigate the harm to the very populations it serves. For healthcare organizations themselves, decarbonization can bring quick wins that align well with the overall goal.

The people whose health suffers the most from carbon emissions and rising temperatures are inevitably those with physiological, socioeconomic and geographic vulnerabilities, Lemery said. Knowing this and the obligation of healthcare to do no harm, urgent action must be taken to decarbonise.

“We know that burning fossil fuels creates harmful emissions, and those harmful emissions cause health problems for people in our area,” said Alan Eber, director of facilities operations for the Gundersen Health System, who became in 2014 the first health system. in the country to produce more energy than it consumes. “So our whole goal is to try to reduce these harmful emissions to improve the health of the people around us.”

While decarbonization fits nicely into the mission and purpose of healthcare organizations, it can also be a big financial draw, and La Crosse, Wis.-based Gundersen is proof of that. Licensed for 325 beds, it would not be considered a massive, cumbersome institution with unlimited resources to devote to reducing emissions. Nonetheless, he prioritized and accelerated this process even before it was on others’ radars.

“There are huge benefits to reducing our carbon footprint,” Eber said.

Almost 15 years ago, Gundersen looked closely at the trajectory of its fossil fuel costs and realized that if the upward trend continued, it would affect system results and the cost of utilities. patients. By switching to wind, woodchips, landfill methane and cow manure to generate electricity, Gundersen reduced its emissions of carbon monoxide, particulate matter and mercury by more than 95% between 2008 and 2016.

“We would have spent $5.1 million more [annually] to fuel our entire healthcare system if we didn’t do what we did,” Eber said. “It cost us money to get here, but we recouped every penny spent on our energy initiatives. Our last break-even point was reached in 2021. Now everything we get back is a net gain for our organization.

Action Items to Achieve Resilience

The reasoning that motivated Gundersen to act in 2008 still resonates all too well today, in the context of record fuel prices that are having a domino effect on the supply and operating costs of health systems. Yet in 2018, only about 10% of hospital systems had attempted energy efficiency efforts as bold as Gundersen’s, a hospital energy expert with UnitedHealth Group’s Optum Advisory Services told US News World Report at the time. .

“Now that the cost of energy is rising, it’s going to be a huge burden on healthcare organizations in the future,” Eber told Modern Healthcare Custom Media. “In our organization, thanks to the investments we’ve made and all the progress we’ve made, it will have much less of an impact.”

Achieving Gundersen’s level of financial and operational resilience — and advancing healthcare decarbonization for the benefit of human health — will require action on four specific fronts, experts in the field say.

According to the New England Journal of Medicine, the main areas to prioritize are:

Supply chain

Encompassing the production, transport, use and disposal of goods, the US healthcare supply chain is responsible for approximately 80% of the sector’s carbon footprint and should therefore be a consideration. major role in the development of decarbonization efforts. Healthcare organizations can also use their purchasing power to hedge against future stresses.

“Whether it’s the environment or disruptions caused by other things, whether it’s a war like the one we’re currently experiencing or other significant events, it’s really important to strengthen supply chain resilience,” said Elizabeth Baca, MD, practice lead for Healthcare and Life Sciences Strategy at Deloitte Consulting.

Training of health professionals

While clinicians are the ones who deal with the health consequences of carbon emissions, they have not traditionally been given the resources to become subject matter experts and agents of change. This is another area of ​​opportunity to build resilience.

“When we’re asking our hospitals to divest themselves of oil and gas and we can’t talk about it – if we stay siled in patient care – then we can’t be effective,” said Lemery, who participated. to the creation of climate medicine. degree from the University of Colorado School of Medicine. “We have to be communication experts.”

Providing this type of education will also give clinicians and healthcare workers a sense of control and empowerment that they may currently lack as they struggle with relentless understaffing, burnout and other discouraging elements of the job.

Equity-focused policies, financing and measures

Decarbonization will be made possible in part through common policies, financing and actions that incentivize effective and equitable action. While sky-high oil and gas prices are already prompting executives to rethink the use of renewables, they should also consider what’s coming from a regulatory standpoint, Lemery said.

“We know it’s coming,” he said. “If hospital systems are supposed, through things like CMS reimbursement, to be able to demonstrate a lower carbon footprint, people will notice. have to’ or ‘We could do it next week’ – it’s like, ‘Oh man, we have to do it now because our refund is tied to meeting decarbonisation measures.'”

Health care delivery

Finally, it is only through system-wide commitment and change that national hospital emissions can be reduced to more sustainable levels. For a successful outcome, these actions must be integrated into a company-wide strategy, according to Baca.

“It’s not just having one document that is your climate strategy, it’s thinking about your entire operations,” Baca said. “If you are doing a revenue cycle management or digital transformation project, all of those things need to have a climate lens. That’s how we’re going to move into transformation: embedding that in the business and your bottom line. »