Health Information Technology Can Create Significant Environmental Benefits

Kaiser Permanente Study Finds Use of Electronic Health Records Reduces Carbon Emissions, Waste and Water Consumption

OAKLAND, Calif. — An analysis by Kaiser Permanente shows that use of health information technology can dramatically reduce greenhouse gas emissions and produce other important environmental savings. The study, published in the May issue of Health Affairs, estimates that electronic health records could lower carbon dioxide emissions by as much as 1.7 million tons across the entire U.S. population.

The study is built on a unique model that evaluated the effects of 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. Kaiser Permanente operates the world’s largest private electronic health record, Kaiser Permanente HealthConnect®. The analysis found that comprehensive use of health IT by Kaiser Permanente:

Avoided the use of 1,044 tons of paper for medical charts annually
Eliminated up to 92,000 tons of carbon dioxide emissions by replacing face-to-face patient visits (and the associated travel) with virtual visits
Avoided 7,000 tons of carbon dioxide emissions by filling prescriptions online
Reduced the use of toxic chemicals, such as silver nitrate and hydroquinone, by 33.3 tons by digitizing and archiving X-ray images and other scans
Resulted in a positive net effect on the environment despite increased energy use and additional waste from the use of personal computers

“At Kaiser Permanente, we are committed to improving the health of our members and the communities we serve, and that mission is advanced by our leadership in health IT,” said Jed Weissberg, MD, senior vice president, Hospitals, Quality and Care Delivery Experience, Kaiser Permanente. “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.”

The health care industry is burdened by high energy use, high water use and a unique toxic profile. Health care-related activities account for 8 percent of total U.S. greenhouse gases and 7 percent of total carbon dioxide emissions. Kaiser Permanente is an innovator in environmental stewardship, with groundbreaking energy conservation, sustainable design and construction practices. Through its green building efforts, Kaiser Permanente saves more than $10 million per year and has eliminated the purchase and disposal of 40 tons of harmful chemicals in its facilities. In 2010, Kaiser Permanente launched a Sustainability Scorecard, the first effort in the health care sector to evaluate the sustainability of each medical item it purchases while also encouraging suppliers across the industry to provide greener products.

“There is a strong correlation between environmental health and the health of our communities. As health care providers, it is our responsibility to reduce our negative impact on the environment and ‘do no harm,’” said study co-author Kathy Gerwig, vice president for Workplace Safety and environmental stewardship officer at Kaiser Permanente. “The results of this study show that the health care sector is on the way to improving our environment through the broader adoption of electronic health records.”

“Prior to this study, the benefits of electronic health records were categorized primarily by their impact on the quality of care and potential to improve efficiency,” said study co-author Terhilda Garrido, vice president of Health Information Technology Transformation and Analytics at Kaiser Permanente. “As the country increases its ‘meaningful use’ of HIT, we should consider other macro impacts as well.”

The model Kaiser Permanente developed to evaluate the environmental impact of EHRs focused on six categories of environmental impact within health care to examine those most directly related to electronic health records, said study lead author Marianne Turley, senior statistical consultant, Analytics & Evaluation at Kaiser Permanente. “Our model serves as a useful framework for assessing the environmental impact of electronic health records,” Turley said.

Recognizing that health information technology is critical to clinical performance improvement, including patient safety, Kaiser Permanente began the implementation of KP HealthConnect in 2004 to support patient care and service, a process completed in March 2010. The implementation of the My Health Manager personal health record, which is integrated with KP HealthConnect, was completed in 2007. Watch Kaiser Permanente members, physicians and employees talk about KP HealthConnect and My Health Manager on Kaiser Permanente’s YouTube channel. For more information about Kaiser Permanente’s environmental work, go to: www.kp.org/green.

Co-authors of the paper include Marianne Turley, senior statistical consultant, Catherine Porter, senior analytic consultant, and Terhilda Garrido, vice president — all with Kaiser Permanente HIT Transformation & Analytics; Kathy Gerwig, vice president, Workplace Safety and environmental stewardship officer, Kaiser Permanente; Linda Radler, managing director, HIT Transformation & Analytics; Scott Young, MD, associate executive director, Clinical Care and Innovation, The Permanente Federation, LLC, and senior medical director and co-executive director, Kaiser Permanente Care Management Institute; and Ruth Shaber, MD, medical director, Care Management Institute.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.7 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.