One of the ways the new healthcare law will bring down the costs of the US health care system is by helping the industry transition to the use of electronic health records for patients.
Although the appeal of electronic health records results from their projected positive effects on health care quality, safety, and efficiency, their impact on the environment hadn’t been examined until now.
An analysis by Kaiser Permanente (KP), published in the May issue of Health Affairs, finds that using electronic health records goes beyond reducing costs and improving patient care – it provides substantial environmental benefits.
Last week, we reported that the US Green Building Council launched LEED certification for Healthcare and pointed out that the healthcare industry is responsible for 16% of US GDP and 8% of total US greenhouse gas emissions.
Hospitals in particular, have huge energy costs because they operate 24 hours a day, 365 days a year. They use twice the energy of a typical building and spend nearly $8.8 billion on energy each year, according to US Energy Information Administration (EIA). They are also responsible for a huge amount of toxics and waste.
Implementing electronic records across this mammoth industry is bound to result in savings across the board.
KP’s study evaluated the effects of electronic records on greenhouse gas emissions and resource consumption: waste, toxic chemicals and water use within the Kaiser Permanente system.
KP serves over 8.7 million members in nine states and the District of Columbia. It operates the world’s largest private electronic health record, Kaiser Permanente HealthConnect®. The analysis found that its comprehensive use of health IT:
- Avoided the use of 1,044 tons of paper for medical charts annually
- Eliminated up to 92,000 tons of carbon dioxide emissions by replacing face-to-face patient visits (and the associated travel) with virtual visits
- Avoided 7,000 tons of carbon emissions by filling prescriptions online
- Reduced the use of toxic chemicals, such as silver nitrate and hydroquinone, by 33.3 tons by digitizing and archiving X-ray images and other scans
- Resulted in a positive net effect on the environment despite increased energy use and additional waste from the use of personal computers
"Electronic health records can support a more environmentally sound health care sector if they are used to change workflows and care delivery, rather than just a substitute for paper records," says Jed Weissberg, MD, senior vice president, Hospitals, Quality and Care Delivery Experience, Kaiser Permanente.
The health care industry is burdened by high energy use, high water use and a unique toxic profile. Through its green building efforts, Kaiser Permanente saves over $10 million a year and has eliminated the purchase and disposal of 40 tons of harmful chemicals in its facilities. In 2010, Kaiser Permanente launched a Sustainability Scorecard, the first effort in the health care sector to evaluate the sustainability of each medical item it purchases while also encouraging suppliers across the industry to provide greener products.
The Eco-Health Footprint has been developed by the Global Safety and Health Initiative, a partnership of non-profit organizations dedicated to improving the health care industry’s environmental impact and patients’ and workers’ health and safety. It identifies six major categories of environmental impact within health care: greenhouse gases, including anesthetic and medical gases; waste, including solid, regulated medical, hazardous, electronic, construction and demolition, and recyclable; toxic chemicals such as mercury and lead used in X-Rays, MRIs; water use, including process, potable, and waste water; air pollutants, consisting of ozone, particulate matter, carbon monoxide, nitrogen dioxide, sulfur dioxide, and lead; and built land.
The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, enacted as part of the American Recovery and Reinvestment Act of 2009, includes $19 billion in incentives to adopt electronic health records, beginning in 2011. The goal of this legislation is to computerize a significantt proportion of health records in the US by 2014. The total public and private investment could reach $40 billion over the next several years.
Original, documented investigations on Kaiser Permanente EHR, “HMO Rigs Electronic Medical Records,” are posted at http://www.hmohardball.com/HMO%20Rigs%20Patients.pdf http://www.hmohardball.com/Kalser%20Lab%20Letter%20-%20English.pdf http://www.hmohardball.com/Kalser%20Lab%20Letter%20-%20Spanish.pdf and http://www.hmohardball.com.
Robert D. Finney, Ph.D.