As I write this article, I am recovering from a power outage that lasted nearly two days due to trees downed by record winds created by the atmospheric river over Northern California. This on the back of a ton of rain this winter that has likely killed off my drought-resistant cone flowers.
The decision to buy those plants came because California has been in a severe drought and we’ve had water restrictions in place. A few years ago, I saw orange skies and kids in masks to ward off harmful air caused by wildfires.
Weather extremes — natural phenomenons linked to climate change — have become a reality of life for us. So the message of decarbonizing the healthcare industry that Jonathan Perlin, the CEO of the Joint Commission, was making at the closed-door, invitation-only Lake Nona Impact Forum in Florida last week makes complete sense. Having said that, I was a bit skeptical when in a video interview Perlin declared that the healthcare industry can take certain actions to reduce their carbon footprint that are actually easy and not cost prohibitive. After all, were it that easy, the federal government would not provide a tax credit to home owners purchasing solar panels.
But Perlin contends that some small steps can be taken by health systems quite easily and very cost effectively to boot.
“We use a lot of anesthetic gases that have chlorine in them. If you turn down the flow rate, then there’s not blow by that goes in the atmosphere,” Perlin explained. “Kaiser Permanente turned down the flow rate across their system, and one year alone they saved $20 million. “So I want to first dispel the myth that it costs more….”
Then there are other things that can be done across all healthcare organizations to reduce their carbon footprint and not just health systems. For instance, cutting down on travel.
“We are are working with CMS to try to reduce our own travel to sites,” Perlin said. “We have a process where we review documents that relate to quality and safety on site. That can be virtualized. That would cut the visits by about a quarter and the carbon footprint by a quarter in that alone.”
The nonprofit Joint Commission accredits more than 22,000 U.S. healthcare organizations and programs so reducing air travel would go a long ways toward the goal the Joint Commission has set for itself — a minimum of 50% reduction in carbon footprint by 2030. It also works with organizations internationally.
However, reducing travel may not be quite enough. Structural changes are needed industrywide to make more meaningful change not only in measuring and being accountable for one’s carbon footprint but also actually reducing it. That is why the nonprofit chief executive is looking to set decarbonization standards that the industry can live up to in the future.
“We have announced that we will come forward with standards likely in 2024,” Perlin said “We’re going to create standards now so we can begin to support the dialogue about measuring carbon and we want healthcare organizations to begin thinking about how they produce the carbon footprint.”
While some may cringe at new requirements for accreditation, it appears that there is appetite for such change, according to Perlin.
“The Joint Commission works across the United States, and in 76 countries. Most people at the sites that we visit to accredit don’t ask for more standards, but younger clinicians are asking us to take a stand on this.,” he said. ” … we all went into healthcare because we wanted to help people. And the first dictum of medicine and healthcare is to do no harm. But an inadvertent byproduct of healthcare today is great environmental harm. 9% of the carbon footprint in the United States comes from healthcare.”
Perlin didn’t really address specifically what some of those standards would be aside from saying that they would be “directional” — organizations would be encouraged to name a leader who will spearhead decarbonization efforts and those would revolve around three buckets — what humans do; what they burn in terms of vehicle use and in healthcare facilities; and what they buy — that lead to more greenhouse gas emissions.
There’s bound to be resistance in each of these especially when it comes to what healthcare companies buy. I asked him about that.
I somehow think that you’re not particularly popular among the … single-use medical device companies out there.
Perlin initially turned the question on its head:
“Whether it is devices or pharma … the prospect of having to relabel product and go through an FDA approval process is daunting. And so the concerns that many of these organizations have, because they have their own carbon accountability isn’t necessarily [making more environmentally friendly products], but the fear of having to go through a re-approval process with the FDA. So one of the great facilitators has nothing to do with us, has to do with changing the regulatory policies so it’s easier for manufacturers to update to more environmentally friendly packaging and more environmentally friendly approaches to reuse.”
Then he addressed it more head on, adding that the Commission is also reviewing its standards so that its safety requirements don’t automatically guide companies to over use certain plastic products.
“… we had to take a hard look at our own standards. Some critics said, ‘Hey, Joint Commission in the interest of infection prevention and safety, your standards are prompting excess consumption.’ We looked at our standards —they didn’t say ‘Thou shalt do single-use.’ They didn’t say that. But we brought together some of our harshest critics to helpfully examine each of our standards and expunge any implication that would drive excess consumption. So we’ve taken a hard look at our own standards to make sure that anything in infection prevention or safety is strongly backed by evidence,” Perlin declared.
He added that the Commission is now focused on having a dialogue with industry to begin to perform some carbon accounting that addresses climate change given that it has evolved from being merely an inconvenient truth to an existential threat.
“We need to understand and appreciate the financial realities and [what we want to do] is to set the stage for adaptation, but not tell people specifically, this is how you must adapt,” he explained. “So we want to highlight the science and we want to highlight the possibility and we want to highlight the consequences of not acting.”
Photo: The Joint Commission