Although they greatly reduce the amount of paper used in medical documentation, electronic health records also require IT infrastructure that uses massive amounts of energy. So are EHRs really green? Yes, say researchers from Kaiser Permanente, health IT can have a net positive impact on the environment, if used to its full potential.
The healthcare system, which operates in 9 states and the District of Columbia, has conducted a thorough evaluation of its HealthConnect system's impact on greenhouse gases, waste, toxic chemicals and water usage since the EHR's implementation in 2004. The findings, published in the May issue of Health Affairs, indicate that the technology has had a "positive net effect on the environment despite increased energy use and additional waste from the use of personal computers."
On the negative side, the analysis shows that Kaiser uses more than 87,000 megawatt-hours worth of energy to power its EHR system's computers and data centers, which in turn generate an additional 250 tons of e-waste.
But the positives significantly outweigh the negatives, say the study authors. For example, Kaiser's EHR system has saved:
1,044 tons of paper through digital charting;
3 million gallons of gasoline by reducing patient visits; and
68 tons of X-ray film and more than 33 tons of toxic chemicals used to process X-rays thanks to digital imaging.
If widely adopted, EHRs "could lower carbon dioxide emissions by as much as 1.7 million tons across the entire U.S. population," estimates Kaiser.
"Electronic health records can support a more environmentally sound health care sector if they are used to change workflows and care delivery, rather than just a substitute for paper records," explains Jed Wessberg, MD, Kaiser's senior vice president of hospitals, quality and care delivery experience.
In fact, the researchers estimate that simply replacing paper records with EHRs would actually increase CO2 emissions by 653,000 tons. The key is to use health IT to make significant changes in how health care is delivered — for example, by filling out prescriptions online and letting physicians interact with patients electronically instead of face-to-face for minor consults. "What stands out is the opportunity to reduce automobile trips," says Kathy Gerwig, study co-author and environmental stewardship officer for Kaiser.
Irene Tsikitas
