The Importance of Measuring Carbon Emissions in Healthcare

Measurement is critical to successful science & management. (Image co-created by R. Omary & AI)

Every physician, biologist and management leader agree that measurement is critical to describing a thing– whether it’s a tumor, an image or a clinical service line. Measurement defines the object for diagnosis, the scope of the potential intervention and the evaluation of the treatment. Management consultant Peter Drucker borrowed from Lord Kelvin’s quote which is “what gets measured gets done.”

Lord Kelvin’s ghost gives Peter Drucker the idea that propelled his career. Please note: if you don’t start measuring carbon, Lord Kelvin’s ghost may pay you a visit. (Image co-created by R. Omary & AI)

Environmental measurement is a science practiced by experts and managers of all kinds.  Even CFOs want to know the cost to manage an organization’s environment from gas, water, waste and electricity.  Carbon emissions are no different.  However, in the US it is new and in US health sector it is very new.  The SEC only clarified rules for publicly traded companies in March 2024. Still, it is a discipline with a well-tested methodology since 1998. 

The Greenhouse Gas Protocol categorizes greenhouse gas into 3 groups:

Scope 1: gases emitted from burning fossil fuels in operations

Scope 2: electricity used during operations

Scope 3: the supply chain of the organization from cradle to grave or from the mineral extracted from earth to its return. 

In healthcare, Scope 1 and Scope 2 are each estimated to be 10% of the hospital total emissions with Scope 3 responsible for 80%. (Most of Scope 3 is in supplies, capital equipment and the hospital’s investment portfolio).

So, what’s the average carbon emissions emitted per admission?  Surprisingly, there are very little data to answer this question despite calls for transparency and 100+ Health and Human Service pledge signers. It reflects the early days we are in, like quality reporting in early 2000s. 

However, I was able to calculate this answer using publicly reported and available data from HCA Healthcare for 3 years – 2020-2022. HCA Healthcare reports its Scope 1 and 2 emissions and from that data we can estimate Scope 3.  HCA Healthcare has a large N of 183+ hospitals from Alaska to New Hampshire, California to Florida with hospitals of different sizes and ages and service levels from primary care to Level 1 trauma. HCA also reports its operating statistics on a quarterly and annual basis, which allows for math to answer the question.  

The answer is each hospital admission produces ~5 tons of carbon emissions.  Each inpatient day is ~ 1 ton of carbon pollution. Each surgery is ~20 tons. That’s a lot of carbon. For reference, according to Anthesis Carbon Neutral Group, 1 ton of carbon is equivalent to 500 fire extinguishers or driving a gas-powered car in the Netherlands for half a year.

Sharing carbon emissions data is good for healthcare professionals, good for patients, & good for the planet. (Image co-created by R. Omary & AI)

Imagine the power of this number being shared across the medical staff and hospital board members. Imagine if each service line could publish their carbon footprint and the actions they are taking to reduce it. Imagine CFOs funding micro-grants for innovations to reduce emissions.  Imagine a carbon footprint number for every new purchase. 

AI imagines a CFO handing out micro-grants. Next lesson for AI? Spelling. (Image co-created by R. Omary & AI)

Call to Action: The race to the bottom starts with a number. What’s yours?

Disclosures:  Andy Draper, PhD is a CIO at HCA’s Denver region and has been working on sustainability projects for 3 years. Andy is also founder of SION60 which offers a low-cost CarbonEMR™ to help hospitals measure and reduce their carbon footprint. He is an adjunct professor of health informatics at the University of Denver, and can be contacted directly at andydraper@sion60.com.