The Common Denominators of Sustainability in Healthcare: Measurement and Transparency

The Common Denominators of Sustainability in Healthcare: Measurement and Transparency
Michael Byczkowski, Global Vice President, Head of Healthcare Industry at SAP

The global healthcare industry accounts for approximately 5% of greenhouse gas emissions. This is about the same as the cement and chemical industries combined, and more than the aviation and shipping industries combined. In the US, the figure is even higher: about 8.5% of US carbon emissions come from healthcare.

Arguably, from a carbon intensity perspective, that’s not too bad for an industry that accounts for nearly 20% of US economic output. But then, you could also say that an industry that wastes 30% of its resources should address sustainability on several fronts.

Health officials recognize this. A 2021 Forrester Consulting survey found that 81% ranked implementing and maturing sustainability initiatives as their top near-term business priority – higher even than increasing profitability and improving the patient experience. This matches a recent survey in which three-quarters of respondents said they have begun their journey towards greater sustainability, and more than half plan to strengthen their programs. These survey respondents recognize what the numbers show very clearly: we cannot have a sustainable society without sustainable health care.

It’s also clear that we can’t have sustainable healthcare without establishing industry-standard healthcare sustainability metrics and then monitoring them closely. You can’t manage what you can’t measure, and in healthcare we haven’t measured sustainability very well: a recent Health Affairs The analysis described the measurement of health care sustainability as “two decades behind efforts to improve the quality of health care through measurement.”

Do no harm

There are reasons for this. Patient care remains paramount, so the fact that each MRI uses two-thirds of the electricity an average American household uses in an entire day – or that a scanner uses the power of a microwave running for an hour – remaining marginal considerations. External pressures from payers, malpractice lawyers and patients themselves lead to marginal and, too often, unnecessary treatment. Telehealth has been slow to take hold even though the coronavirus pandemic has helped push it forward. And, let’s be honest, healthcare has always had a throwaway culture, often for good reason: you don’t want to reuse sharps, gowns and gloves. But at the same time, the Hippocratic oath to do no harm should apply broadly to the environmental impact of healthcare facilities on society, and governments are increasingly receptive to this view.

The prospect of regulation is a big part of what’s driving the industry’s new focus on sustainability. It also adds to the urgency of improving sustainability measures and health care tracking. The goals of the Paris Climate Agreement will require universal action, and health care will not be exempt. The major health players are mobilizing. England’s National Health Service announced its commitment to be carbon neutral by 2040 and rolled out a Sustainable Health Dashboard with indicators on governance, carbon emissions, water use and resources, air pollution and other measures. The Dutch Green Deal on Sustainable Healthcare aims for a 49% reduction in climate emissions from healthcare by 2030 and carbon neutrality by mid-century. The US government has created an Office of Climate Change and Health Equity, which plans to roll out emissions targets for US hospitals.

Many institutions are already taking action. UCLA Health has moved to electric buses. The Cleveland Clinic sources 30% of its food locally. Abraham Lincoln Memorial Hospital in Illinois has reduced its anesthetic gas purchases by 80%. (These high-potency greenhouse gases accounted for half of the hospital’s carbon footprint.) Mayo Clinic’s utility upgrades, improvements in waste management practices, and a focus on highly efficient new builds have reduced emissions by 20% since 2020.

Monitoring and transparency

But there is still a lot of work to do. This SAP survey found that more than half of healthcare providers say they need to improve their waste management practices, and only a third of them are considering the kinds of circular economy principles that have taken hold. in other industries. Less than 20% reported strong employee engagement in sustainability efforts.

We know that every healthcare facility is unique, with its own complex supply chain, its own legacy infrastructure, and its own portfolio of short- and long-term sustainability levers to pull for maximum effect. However, there is an ongoing industry-wide need for significantly improved tracking and transparency of sustainability data and metrics. We’re talking about a new kind of ledger, which can establish concrete baselines and then track carbon and other environmental footprints with a specificity familiar to financial ledgers. Integrating with supply chain partners through industry business networks will enable continuous improvement and demonstrate this to investors, regulators and an increasingly environmentally conscious patient population. These improvements will also make financial sense, as sustainable models of care and treatment, ideally incorporating the principles of circularity, will be more efficient than the current take-do-waste paradigm.

The World Health Organization agrees and adds that measuring the sustainability of health care “must proceed from a clear conceptual framework and a statement of purpose. Measurement should reflect strategic goals, instead of letting goals become dictated by the ease of measurement. The WHO continues: “Health system leaders must now set clear and compelling sustainability goals, invest in internationally comparable metrics to measure their success, and make them part of their core business.

If that sounds like hard work, well, it is. But it is worth doing for the good of healthcare institutions and, more importantly, for the health of the patients they serve and the planet we share.


About Michael Byczkowski

Michael Byczkowski is Global Vice President, Head of Healthcare Industry at SAP.