A world with fewer carbon emissions but less healthcare innovation would not be a better place. That was the message from Bill Gates as he gave the opening address at the COP28 Health Day in November 2023, the first of its kind. But if advances in technology and digital solutions are essential to easing suffering and preventing illness, how can we ensure they continue apace – without doing more harm than good?
Globally, the healthcare industry accounts for 4.4% of the world’s CO2 emissions, according to the Organisation for Economic Cooperation and Development. It’s also a wasteful industry and heavy consumer of natural resources – 10% of raw materials are extracted every year to serve it, while up to 13kg of waste per hospital bed are generated each day.
Given that pollution is implicated in an estimated 9m premature deaths annually, there’s an undeniable irony that the very industry that exists to provide care for people when they are sick turns out to be having such a negative impact on the environment.
Within the healthcare industry there is a growing awareness of this issue, with measures increasingly being taken to use materials for medical equipment in a more sustainable manner while also reducing the energy consumption of products such as scanners. Manufacturers see ecodesigned equipment and solutions as central to making progress in this area.
“It is clear that we as an industry need to design – and think – differently from the get-go,” says Philips’ global head of sustainability, Robert Metzke. “From hospital processes and ways of working, to the way medical equipment is designed, manufactured and purchased, to taking responsible care of products after use by a customer.
“At Philips, our responsibility as a leader in health technology is to show our customers and partners how we can collectively drive the systemic change needed to improve healthcare delivery and reduce the total environmental impact at the same time.”
A substantial part of the carbon footprint of medical equipment stems from its energy consumption, the rest mostly results from indirect emissions along the value chain (mining, transport, manufacturing, assembly). Because of the level of energy consumption, energy-efficient product design can help to reduce the environmental impact.
In the design of new products, Philips says that it increasingly applies its EcoDesign principles to address energy consumption, mitigate the use of hazardous substances and to optimise the use of scarce resources, materials and packaging across the product life cycle (design for circularity). It has created its EcoDesign passports to explain how it is becoming more environmentally aware.
Holding on to precious resources
Natural resources may feel far removed from the brightly lit, sterile environment of a hospital – but they’re present, just below the gleaming surfaces. And perhaps one of the most surprising examples is helium.
There are three key facts: first, liquified Helium is used in MRI scanners to keep the magnet in a supercooled condition; second, this seemingly ubiquitous gas is rapidly depleting; and finally, the consequences of a shortage are serious.
Helium’s role in healthcare extends from acting as an oxygen alternative to help newborn babies breathe, to cooling the magnets in MRI scanners. The average scanner requires about 1,500 litres of liquid helium to operate, plus top-ups because the harmless gas can, from time to time, escape from the system.
It’s this tendency to seep away such as happens with a party balloon that makes it non-renewable. Unlike other gases that tend to stick within our atmosphere, helium “will continue rising until it escapes into space, making it the only truly unrecoverable element”, according to the ACS (American Chemical Society), one of the world’s largest scientific societies.
A way to reduce Helium usage comes in the form of Philips’ Ingenia Ambition scanner. At its core is the BlueSeal magnet, an innovation based on “sealed technology” that requires a fraction of the liquid helium used in other MRI scanners – just seven litres. And this precious element is fully sealed during manufacturing, keeping it confined for the rest of its life. Since Philips first deployed the technology in 2018, it estimates that more than 1.9m litres of helium have been saved.
The sustainable benefits of demedicalising
A further focus is the “demedicalising” of patients as their health improves. Dr Richard Hixson, a critical care doctor in an NHS trust in the UK, says: “Over the last 12 months, on our critical care unit we have discussed sustainability in every morning staff huddle. We talk about demedicalising patients – which is reducing the frequency of blood tests, reducing the frequency of monitoring, perhaps removing them from the monitors. This is all based on sustainability, because we want to reduce the consumption and use of equipment. But actually, it’s really good for patients as well because they become more mobile, and there’s less noise pollution from the monitors and the alarms.”
The environmental benefits of “demedicalising” can be clearly seen with CT scanners. These play a vital role in the diagnosis of tumours and neurological disorders, but require substantial energy to do so. One Australian medical study found that a single CT scan has a footprint of 9.2kg of CO2 – equivalent to driving a petrol or diesel car, depending on model, for around 76km. It is therefore important not to have to repeat scans simply because of insufficient or inconclusive results.
Embracing circular business models
In terms of the sustainability of healthcare technology, a strong focus is emerging on circular design – the act of extending a product’s life and thinking about what happens when it can no longer be used, with the aim of reducing waste and pollution. Philips believes that without a circular mindset and circular business models, hospitals individually and the wider industry will not be able to achieve net zero.
Through its takeback and trade-in schemes, Philips last year re-used 79%1 of material weight from returned systems during refurbishing, thereby avoiding 400 tonnes of waste and reducing the need for virgin materials. The Philips Circular Edition portfolio allows customers to benefit from refurbished, upgraded and quality-tested technology. If repair, refurbishments and parts recovery are no longer an option for a system that is returned to the company, Philips has contracts with local recycling networks across the globe for responsible recycling.
Given that, in the UK, 10% of NHS carbon emissions come from buying new medical equipment, being able to prolong its life, upgrade and refurbish, could make a real difference to an organisation’s environmental impact. Sustainable procurement is currently in its infancy, but for procurement departments, buying more green solutions (lifetime extensions, upgrades or refurbished equipment) could contribute to the sustainability ambitions that many hospitals have.
Last year, Philips and Vanderbilt University Medical Center (VUMC), a group of highly regarded hospitals in Tennessee, joined forces to research the radiology departments’ environmental impact through a comprehensive analysis of MR, CT, ultrasound and X-ray systems.
The initial results showed a significant carbon footprint of around 4.5m kg of CO2e accumulated over a 10-year period. This is equivalent to the annual emissions of almost 1,000 cars powered by petrol.
In the course of the research, it was estimated that circular business models could not only reduce the environmental footprint, but could also reduce total cost of ownership and extend system lifetimes.
“We feel a great sense of urgency to address our carbon emissions and develop a more sustainable and healthier path forward,” says Diana Carver, assistant professor of radiology and radiological sciences at Vanderbilt. “Our collaboration is leveraging our team’s collective knowledge and expertise to reveal key learnings that will direct our efforts to cut emissions.”
Ecodesign to drive social impact
Innovation is not just taking place in technology and design, but also in mindsets, with healthcare providers seeking to share medical equipment between facilities. Online platforms such as Cohealo, for example, reduce the need for multiple machines. Such shifts in thinking could lead to a sea change when it comes to pro-environment action.
Digital solutions and AI are advancing in the way care is delivered
Last November Philips received a second round of funding from the Bill & Melinda Gates Foundation to accelerate global adoption of AI algorithms, currently under development, on its Lumify Handheld Ultrasound after a successful trial in Kenya with a prototype device2.
The approach being developed is to use AI to identify abnormalities in pregnant women, so that one day ultrasound training could be cut from weeks to hours for health workers in under-served communities. This will allow many more of them to use the technology in routine care, to try to reduce maternal mortality rates. With approximately 800 women dying every day from preventable causes relating to pregnancy and childbirth, change can’t come soon enough.
This has been highlighted recently at Davos with a report from the World Economic Forum and the McKinsey Health Institute finding that improving women’s health “could add at least $1tn a year to the global economy” and that later diagnoses and lack of data mean women spend 25% longer than men in poor health.
The circle of health
With pollution responsible for so many millions of deaths a year, it’s clear that human health and environmental health are inextricably linked. So it’s timely that the healthcare industry is looking to become more sustainable, and in doing so aims to reduce the impact on the planet of the care provided to people who are unwell.
Find out more about how Philips’ EcoDesign programme is creating lower carbon and circular alternatives
1 Disclaimer: based on the average weight re-use percentage per system for Philips MR, CT, MoS and IGT refurbished systems in 2023. Results may vary based on amount, mix and age of returned systems.
2 This is a prototype device only. It is not currently CE marked, nor is it for sale in the European Union.
