Do no harm
Healthcare needs to go 100% renewable 🌞💡🔋✅
Can the healthcare sector match big tech in going 100% renewable?
It seems like every month for years now some company in the digital set has committed to, or better yet, achieved 100% renewable power supply.
Facebook, Apple, Google and Amazon have all pledged to go 100% — and some have made it, at least with their energy-intensive data centers. Even data center company Switch is building a 1GW solar power farm in Nevada
I think that the healthcare sector will be next. And with it the US will keep moving the needle in the right direction (though not yet far or fast enough).
Building a Climate-Smart Healthcare System for California
I’m heartened by a report just out from the Bay Area Council Economic Institute (BACEI).
It has lots of great facts and great ideas for the giants of the medical industry to tackle cost, customer need and carbon emissions.
“Kaiser Permanente is committed to eliminating and, not later than 2025, reversing our contribution to climate change by becoming carbon net positive. We will achieve this goal through a combination of initiatives including continuously improving the energy efficiency of our buildings, activating more solar and wind energy both onsite and offsite, and sourcing more responsibly the food we serve our patients and employees. These measures are good for the climate, and make good business sense.”
Ramé Hemstreet,
Chief Sustainable Resources Officer & Vice President of Operations for National Facilities Services, Kaiser Permanente (Kaiser Health News)
The reason I’m optimistic we’ll see a similar move from big health companies, as with big data companies, is that it just makes sense.
Dollars and cents. They have a lot to save.
Embarrassing note: I had no idea what a big business — and how wasteful — healthcare is…
California’s healthcare sector spending was 13% of state GDP in 2016, the last year for which we had the numbers. That’s a bigger economy than Oregon!
At a national level, where these things have been tracked for some time, healthcare emissions were 10% of all emissions. Those emissions are growing. And so is the scale of the industry, from $3.4 trillion nationally in 2016 to an estimated $5.5T by 2025.
That’s trillion with a T.
So Doc, where should we start? In my amateur understanding of triage, where the bleeding is worst.
Hospitals produce much of the “healthcare system” emissions — a whopping 36%. Hospitals are like the data centers in tech — they are the energy hogs in the ecosystem known as our healthcare industry.
After spending ten days in a modern hospital recently, visiting a sick relative, I kind of had a sense that they could do better with lighting, cooling and heating.
But boy, they can do better with lighting, cooling and heating! 💡☃️🔥
And sure enough, the BACEI report found that “ventilation reform” is the lowest hanging fruit. Hospitals use 3 to 5 times as much energy as a 5-star hotel on heating, ventilation and air conditioning. This is often two thirds or even three quarters of a hospital’s energy use!
That’s a lot of hot air…
Kaiser Permanente’s South Bay Medical Center is host to a first-in-the-nation demo project for advanced air distribution design and sensors.
They’ll use smart building control systems and monitoring based commissioning and will reduce on-site natural gas consumption for space conditioning and ventilation by 30–50%.
gAnd all the while they’ll meet or beat health and safety standards for indoor air quality in such a controlled environment.
Not just heat but light
Lighting is another low hanging bit of kit inside and outside most hospitals. As I learned in my recent visit, lights are on all day and night throughout one of those big hospital buildings.
There are opportunities galore to manage the lumens and to create a better, healthier experience for the patients and for the people that care for them.
In 2014 the VacaValley Hospital in Vacaville became one of the first healthcare facilities in the nation to install an energy-efficient-network-adaptive outdoor lighting system.
The changeout to LED luminaires led to a 33% reduction in energy use. 💡✅
The networked control system then reduced the LED lighting’s energy requirement by 49%! The hospital saves 29MWhrs annually against the baseline.
(Hat tip to the UC Davis California Lighting Technology Center, which I am proud to say the California Clean Energy Fund has long supported!)
And then there’s new build
As you may have noticed, there are a lot of new hospitals going up. An ageing population plus the replacement of buildings for seismic safety requirements means there will be many new hospitals built in coming years.
So let’s build ’em right!
Which means tight and energy efficient. The DOE estimates that hospitals are 2.5 times more energy intensive than office buildings of similar size, when they’re built as they have been historically. Time to change.
Again, there’s good news on this front thanks to our partners in supporting the report, an awesome organization called Healthcare without Harm.
They ran a pilot program from 2002–2011, which laid the foundation for LEED certification of healthcare facilities by the US Green Building Council.
These LEED-certified buildings, when built and run right, are estimated to reduce a hospital’s energy use by 25%, bills by 19% and emissions by 34%. 📉
The University of California in San Francisco, one of the well-known med schools and hospital campuses, has pledged to build all new facilities to meet a minimum Silver-level LEED certification. 🌲🏥💚
This is part of the broader University of California plan to achieve total carbon neutrality by 2025 and comes as they rebuild their main hospital with a $500m donation from the Helen Diller Foundation.
But it’s not only UC San Francisco leading the change.
Across the Bay, Kaiser Permanente has committed to be carbon net positive, not just neutral, by 2025. So, they have been maximizing energy efficiency — as demonstrated with the ventilation project above — as well as procurement of 70MW of solar energy at up to 100 of their hospitals and other facilities.
To get to “net positive” they will also buy offsite wind and solar and purchase offsets. And they’ll divert 100% of their non-hazardous waste from landfill, which is a big solution to reducing carbon emissions.
And it’s not just the crazy kids on the left coast that are doing it — Gundersen Health System in LaCrosse, WI became the first “energy independent” health system in the US by offsetting 100% of its fossil fuel use with locally produced renewable energy.
Whole system care — not just the symptoms
Some of the more ambitious plans, like those from Kaiser and Dignity Health, get into waste and also water and food. This reminded me that a hospital is so much more than a data center. Patients in beds are not like servers in racks and they will require much more ingenuity to serve better and better each year. Reducing the electron drip to an AMD processor feeding my Facebook addiction is a lesser problem than just the right drip into the lifeblood of a new born babe in a NICU. The report understatedly notes that Kaiser’s plans for the largest integrated system in the US “is intentionally ambitious”.
And indeed it is. There are technologies, goods and services that they cannot yet get to achieve the vision. But their strategic intent will create a market for entrepreneurs and intrapreneurs within the system to fix it. By going upstream into supply chains for food and water, they save expense and emissions. By going downstream into waste management, they tackle much more of the system. But they will also have to tackle transportation.
Taking on transport too
Hospitals are big employers and have complex logistical supply chains. From ambulances to hazardous waste trucks, they are well-placed to reduce transportation emissions. Some strategies could include changing employee commuting behavior, using EVs and fixing distribution channels.
UCSF has also been a leader in this field. They’re the second biggest employer in San Francisco, with 25,000 people, and offer a wide variety of commuter options and benefits to staff, faculty and students. They’ve won awards for being one of the “Best Workplaces for Commuters” from the National Center for Transit Research.
More left to do
There are many more examples in the report from BACEI of this whole systems approach to being climate-smart, fiscally and physically healthy in the management of hospitals. Perhaps the most striking is the story of UC San Diego Health, which switched to a hotel room service model in their hospital.
In this system, patients got to order the food they wanted, when they wanted of course within the dietary bounds set by their Doc! This increased patient satisfaction, but it also had an enormous impact on food waste and emissions. UCSD Health Patients can also now use iPads to control their own room temperature and lighting and access their electronic medical records! 📋📲
In 2016, UCSD Health Nutrition Services compared food waste generated from this kind of room service (at their Thornton Hill hospital) to the cook-chill operation at Hillcrest Hospital, which reheats and serves up conventional meals in wards. They found that food waste per patient was 66% less! So they’re switching to room service at Hillcrest too and this year they project to reduce food waste by 53,000 pounds and saving $50,000.
As BACEI notes, “UCSD will have happier, healthier patients and at the same time reduce greenhouse gas emissions by 147 MT of CO2e, which is equivalent to taking 31 cars off the road every year.” And ain’t that what it’s all about.
Single-payer or not, healthcare should be focused on better care, reduced cost and fewer greenhouse emissions! After all, professionals like the California Nurses Association, who have long championed climate action, know that an ounce of prevention is worth a pound of cure — at least when it comes to the harmful effects of carbon pollution.
So let’s have a new race — a race like the one between big tech that started a decade ago — to de-link our bits and bytes of data from dirty energy.
Let the games begin to see who can come up with the smartest solutions to the problems facing hospitals and healthcare more broadly — so those whopping trillions of dollars of care, can first do no harm.
Shine on! 🌞
This article first appeared on Greenbiz Media
