Health Affairs: EHRs go green
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The study showed that Kaiser Permanente’s EHR system saved 1,044 tons of paper for medical charts and 68 tons of x-ray film via digitized images. In addition, the EHR lowered gasoline consumption—by at least 3 million gallons per year—because patients could make virtual visits with their physician instead of driving to the doctor's office, the authors wrote.
Marianne C. Turley, senior statistical consultant for analytics and evaluation in the Health IT Transformation and Analytics Group at Kaiser Permanente in Portland, Ore., and colleagues evaluated the effects of the organization’s HealthConnect EHR use on greenhouse gases, waste, toxic chemicals and water use within the Kaiser Permanente system, which serves more than 8.7 million members in nine states and the District of Columbia.
Comprehensive use of health IT kept as much as 92,000 tons of carbon dioxide emissions out of the air through virtual visits alone, their analysis showed.
The researchers also found that the use of EHRs avoided 7,000 tons of carbon dioxide emissions through e-prescribing; and that use of toxic chemicals, such as silver nitrate and hydroquinone, was reduced by 33.3 tons through digitizing and archiving x-ray images and other scans.
In addition, 71 million gallons of water were conserved through the use of the PACS, the report found.
“The magnitude of the findings was surprising as they are very substantial,” Terhilda Garrido, a co-author of the study and vice president of Kaiser's Health IT Transformation and Analytics Group, in Oakland, Calif., said in an interview.
However, although the study revealed positive findings overall, there were some negative ones as well. “The use of personal computers resulted in higher energy consumption and generated an additional 250 tons of waste,” the authors wrote.
The largest downside was increased energy use: computers and data centers use 89,300 megawatt hours a year, according to the researchers. “The impact is the equivalent of releasing the carbon sequestered annually by 13,300 acres of forest. Switching from desktop personal computers to laptops with external monitors would reduce this impact by 2,300 acres,” the researchers noted.
Healthcare activities as a whole contribute 8 percent of the total greenhouse gases and 7 percent of the total carbon dioxide emissions produced in the U.S., they wrote.
“The total weight of carbon dioxide emissions from the healthcare sector is 434.55 metric tons, whereas the maximum benefit in our model was a reduction of 47,700 tons of carbon dioxide. If the maximum benefit in our model were extrapolated to the entire U.S. population, the total reduction in carbon dioxide would total 1.7 million tons,” the researchers asserted.
Turley and Garrido acknowledged there is a need to build on their research. “We’ve taken the first step and are offering this model, but we would expect and hope others will continue to enhance and develop on it,” Garrido stated. “We would like to understand how EHRs and IT systems can be used in a more energy-efficient way.”
“As we start to store more information about people, we’ll have to come up with ways to adapt our collection systems to minimize the amount of data storage dedicated to each person,” Turley said in an interview. “As we continue to collect more information on patients, we have to find more efficient ways to store that information reliably.”