Why digital innovation may not reduce healthcare’s environmental footprint
BMJ 2024; 385 doi: https://doi.org/10.1136/bmj-2023-078303 (Published 03 June 2024) Cite this as: BMJ 2024;385:e078303- Gabrielle Samuel, lecturer in environmental justice and health1,
- Geoffrey M Anderson, professor2,
- Federica Lucivero, associate professor3,
- Anneke Lucassen, professor of genomic medicine4
- 1Department of Global Health and Social Medicine, King’s College London, London, UK
- 2Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- 3Ethox Centre, University of Oxford, Oxford, UK
- 4Centre for Personalised Medicine, Centre for Human Genetics, University of Oxford, Oxford, UK
- Correspondence to: G Samuel gabrielle.samuel{at}kcl.ac.uk
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
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 …
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