Why digital innovation may not reduce healthcare’s environmental footprint

Correspondence to: G Samuel [email protected]

Healthcare is becoming increasingly digitalised through innovations in information and communication technologies as well as advances in machine learning and artificial intelligence (AI).¹ Advocates enthuse that this digitalisation—including monitoring devices, streaming, and data storage—will improve key aspects of healthcare delivery such as safety, accessibility, quality of care, effectiveness, and efficiency.² Others debate whether these promises can be met because of complex social, cultural, economic, and political implementation challenges.³

More recently, digital innovation has been promoted as a means to reduce the environmental harms associated with healthcare delivery.⁴ Healthcare systems contribute to roughly 5% of a country’s total greenhouse gas emissions, with this figure often being higher in high income countries.⁵ Although digitalisation can reduce environmental harms, technologies could also be implemented in ways that do not lead to reductions. Indeed, given the paradoxical increase in energy use associated with the introduction of energy saving technologies—the so called rebound effect—digital innovation may increase resource use with little change to health outcomes.

Environmental effects of digital innovation in healthcare

Digital innovations have the potential to decrease the environmental harm from health systems in several ways (box 1). First, digital innovations are expected to help reduce the greenhouse gas emissions associated with existing healthcare facilities by improving their efficiency. In the UK the NHS has predicted carbon savings through the use of realtime monitoring, including artificial intelligence, to better control buildings (eg, lights, heating, and cooling) and to forecast resource allocation more effectively.⁶ Use of digital technologies to predict electricity and water consumption across various healthcare facilities has allowed hospital managers to identify variation in usage and deal with the causes.⁷

Box 1

How digital technologies might reduce the environmental harms of healthcare

Improving the operational efficiency of existing healthcare infrastructure

• Using sensors to turn off lights and control room temperatures

• Forecasting healthcare facility energy and water consumption to detect and address anomalies

• Forecasting resource use so only the necessary supplies are purchased

Providing applications or services that have lower environmental impacts

• Replacing paper records with electronic medical records

• Replacing in-person visits with virtual visits

Keeping the population healthy and reducing the demand for healthcare

• Using large databases and advanced AI algorithms to support improved clinical...