Maria Shepherd, President and Founder, Medi-Vantage04.04.24
Environmental, Social, and Governance (ESG) is built into medtech device specifications now and with good reason. The effects of climate change are demonstrated in patient health and that is a goal our entire industry champions. How can we rally to reduce our carbon footprint and take action to improve our industry’s adaptability to climate change?
According to The New England Journal of Medicine (NEJM), the U.S. health sector is responsible for approximately 8.5% of national carbon emissions. These are derived from healthcare facility operations, and secondarily, from purchased sources of heating, energy, and cooling as well as the distribution of healthcare services and goods. Even with all the attention on ESG, NEJM states healthcare greenhouse-gas emissions grew by 6% between 2010 and 2018, which is the highest rate among industrialized countries. In addition, the U.S. health sector is responsible for 25% of worldwide health sector emissions, which is the highest share of any other country.1
The U.S. healthcare supply chain is a complicated global system, including the manufacturing, shipping, use, and disposal of goods and services. NEJM states the supply chain is responsible for the majority of the healthcare sector’s carbon footprint (Table 1), and confronting its carbon emissions is vital to decarbonizing the entire sector.¹ While some organizations in the biopharmaceutical, biotechnology, and medical device industries are expanding their ESG initiatives to reduce emissions and waste, fast-tracking their evolution will require swift innovation to create sustainable products, packaging, and distribution.
In terms of the segments of the healthcare supply chain, the largest three are medical retail, hospitals, and ambulatory healthcare services (Table 2).2 These three segments account for 80% of healthcare’s carbon footprint and the high sigma variations indicate the differences in the healthcare systems structure seen across individual countries. Other segments include residential long-term care facilities, providers of healthcare system administration and financing, providers of ancillary services, and providers of preventive care.
The segments indicate where the final demand of the healthcare sector takes place. Suppose we follow the supply chain to learn the global production sectors where the actual CO2 emissions occur. In that case, we learn approximately 38% of emissions transpire in sectors correlated with heating, water, and electricity generation and 22% in transport-related sectors. Approximately 10% of CO2 emissions take place in the pharmaceutical and chemical sectors worldwide.2
Robotic generated 30% more MSW than the average of other procedures at 13.7 kg. Of that amount, 22% were gowns, drapes, and bluewrap, 50% were gloves/other, 18% was paper, and 5% was cotton. Abdominal had an average total MSW production of 9.2 kg and produced the largest amount of cotton waste at 1 kg per surgery or 11% of the MSW (Table 3).5
Packaging matters. In this study, the authors found nonhazardous, nonrecyclable materials in the recycling waste in one out of 15 cases for vaginal and abdominal procedures, in three out of 16 cases for laparoscopic procedures, and in six out of 15 cases for robotic procedures. Using this as an estimated material type and their monitored quantities of noninfectious MSW, they noted recycling rates could be increased by 45% to 60% for each hysterectomy type, decreasing the entire amount of MSW to one-third the existing average quantity by weight.5
References
Maria Shepherd has more than 20 years of experience in marketing in small startups and top-tier companies. She founded Medi-Vantage, which provides marketing and business strategy for the medtech industry. She can be reached at mshepherd@medi-vantage.com. Visit her website at www.medi-vantage.com.
According to The New England Journal of Medicine (NEJM), the U.S. health sector is responsible for approximately 8.5% of national carbon emissions. These are derived from healthcare facility operations, and secondarily, from purchased sources of heating, energy, and cooling as well as the distribution of healthcare services and goods. Even with all the attention on ESG, NEJM states healthcare greenhouse-gas emissions grew by 6% between 2010 and 2018, which is the highest rate among industrialized countries. In addition, the U.S. health sector is responsible for 25% of worldwide health sector emissions, which is the highest share of any other country.1
Why This Is Important
Reducing the healthcare sector’s environmental influences and decreasing greenhouse gas emissions will improve patient health and reduce the cost of care. The World Health Organization estimates the costs of environmental change have a direct impact on health, which will reach $2 billion to $4 billion per year by 2030.1 There is a growing focus on the environmental impact to immediately galvanize all parts of the healthcare sector to decarbonize.The U.S. healthcare supply chain is a complicated global system, including the manufacturing, shipping, use, and disposal of goods and services. NEJM states the supply chain is responsible for the majority of the healthcare sector’s carbon footprint (Table 1), and confronting its carbon emissions is vital to decarbonizing the entire sector.¹ While some organizations in the biopharmaceutical, biotechnology, and medical device industries are expanding their ESG initiatives to reduce emissions and waste, fast-tracking their evolution will require swift innovation to create sustainable products, packaging, and distribution.
In terms of the segments of the healthcare supply chain, the largest three are medical retail, hospitals, and ambulatory healthcare services (Table 2).2 These three segments account for 80% of healthcare’s carbon footprint and the high sigma variations indicate the differences in the healthcare systems structure seen across individual countries. Other segments include residential long-term care facilities, providers of healthcare system administration and financing, providers of ancillary services, and providers of preventive care.
The segments indicate where the final demand of the healthcare sector takes place. Suppose we follow the supply chain to learn the global production sectors where the actual CO2 emissions occur. In that case, we learn approximately 38% of emissions transpire in sectors correlated with heating, water, and electricity generation and 22% in transport-related sectors. Approximately 10% of CO2 emissions take place in the pharmaceutical and chemical sectors worldwide.2
Personal-Use Devices
These problems apply to at-home devices and single-use medical devices as well. For example, metered-dose inhalers, prescribed to treat two familiar respiratory diseases—asthma and COPD—use hydrofluorocarbon aerosol propellants to help deliver medication to the lungs. The propellants are greenhouse gases. Other inhalers are cost-competitive, effective, and have the same active ingredients but aren’t as damaging to the climate. Replacing high-emission inhalers could result in better outcomes for patients and the planet. This isn’t trivial. British researchers estimate inhalers account for 3% to 4% of its national health system’s emissions.3Anesthesia Equipment
As in personal-use devices, the environmental effect of general anesthesia can be diminished through the use of inhalation ingredients with low global warming capability—moving from gas-capturing systems to methods of regional or intravenous anesthesia.⁴ For anesthesia single-use devices, the majority of the carbon footprint is accumulated during manufacture and distribution,4 strengthening the argument anesthesia providers should collaborate with the industry to transform sustainably and guide procurement choices based on sustainability evaluations.Hysterectomy Procedures
In a clinical study, waste auditing of abdominal, laparoscopic, vaginal, and robotic hysterectomies showed the average material components of municipal solid waste (MSW), as measured by weight and recycling of each by hysterectomy type. Across all four surgeries, polypropylene fabric material gowns, bluewrap, and drapes composed the majority of MSW, from 22% for robotic hysterectomies to 35% for laparoscopic. Surgical gloves were about 5% of each surgery’s waste. Other plastic packaging was accountable for 36% of MSW for vaginal hysterectomies and a maximum of 46% for robotic procedures. Paper (package labeling and cardboard) varied from 5% of MSW for abdominal hysterectomies to 18% for robotic.5Robotic generated 30% more MSW than the average of other procedures at 13.7 kg. Of that amount, 22% were gowns, drapes, and bluewrap, 50% were gloves/other, 18% was paper, and 5% was cotton. Abdominal had an average total MSW production of 9.2 kg and produced the largest amount of cotton waste at 1 kg per surgery or 11% of the MSW (Table 3).5
Packaging matters. In this study, the authors found nonhazardous, nonrecyclable materials in the recycling waste in one out of 15 cases for vaginal and abdominal procedures, in three out of 16 cases for laparoscopic procedures, and in six out of 15 cases for robotic procedures. Using this as an estimated material type and their monitored quantities of noninfectious MSW, they noted recycling rates could be increased by 45% to 60% for each hysterectomy type, decreasing the entire amount of MSW to one-third the existing average quantity by weight.5
The Medi-Vantage Perspective
Although developing medtech includes the goal of improved outcomes and reduced costs, many devices use more resources, especially plastics and packaging, and produce more waste. As medtech innovation continues to improve patient care, more research to reduce the environmental emissions and human health impacts is good for society but may also present as a competitive advantage. Expect the Value Analysis Committees of hospitals to start asking for this information to reduce their carbon footprint. Further, consider medical product design to reduce product emissions as well as environmental and public health concerns. This can be done with Voice of the Customer and case observations to get the data.References
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Maria Shepherd has more than 20 years of experience in marketing in small startups and top-tier companies. She founded Medi-Vantage, which provides marketing and business strategy for the medtech industry. She can be reached at mshepherd@medi-vantage.com. Visit her website at www.medi-vantage.com.