This appeared last week:
Can digital health curb sector’s climate impact?
With health contributing a significant portion of global emissions, the sector needs to be part of the solution.
Climate change has been dubbed the greatest health challenge in human history – and digital health is late to the party, says Professor Enrico Coiera, who is Director of the Centre for Health Informatics and the Australian Institute of Health Innovation at Macquarie University in Sydney.
“In Australia alone, seven to nine per cent of total greenhouse gas emissions are healthcare related,” he says. “We are not going to solve climate change without addressing this impact.”
Health plays a big role in the urgent priority to reduce greenhouse gas emissions to net zero; worldwide, the sector contributes 4.4 per cent of global emissions (large portions of this from wealthy countries like the US and Australia) and is estimated to triple by 2050.
Coiera and his colleague Professor Farah Magrabi (who co-edited the recent ‘human health and climate change’ issue of the Journal of American Medical Informatics Association) have outlined ten steps health informaticians can take to address climate change.
These include building net-zero into every digital health project, embedding climate resilience into the design of information and health systems, and tackling wasteful deployment and decommissioning of software and hardware.
Coiera says that digital health will continue to play an important role in reducing the climate impacts of the health sector, through data sensing, monitoring, electronic data capture, modelling, decision support, and communication.
His scoping review with Magrabi and Hania Rahimi-Ardabili notes that digital health can reduce health sector emissions by shifting certain health services to be virtual, and will be central to managing disease outbreaks and co-ordinating the health response to population-level disasters like heatwaves, fires and floods.
Streamlined health processes and electronic medication systems reduce hospitalisation and medication errors (though the jury is out on how effective these are) – but digital health also introduces more emissions and waste.
“Generic solutions such as shifting to renewable power will improve the footprint of health care – but there are also specific risks we need to manage, such as anaesthetic gas escapes of potent greenhouse gases which cumulatively make a big impact,” Coiera says.
“In the digital health world, we focus on building real-world, interoperable systems to improve the way we deliver healthcare, and if we think about climate at all, it might include supporting renewable power or reducing transport,” Coiera says.
“But focusing on climate change while co-editing this special issue has opened my eyes to how big the problem is for digital health, and how much we need to do,” he says.
Digital health as a solution rather than part of the problem?
Coiera says that as global heating changes our world dramatically, events such as floods, fires, storms and heatwaves will “disrupt, paralyze, and even dismember the very health services we so diligently seek to support.”
And digital health is a big part of the problem: as the popularity of cloud computing and offsite storage grows, Coiera says it’s worth remembering that data centres used an extraordinary one per cent of global energy usage in 2018 – a proportion predicted to grow.
The growth of AI in digital health care is also a concern, he adds: multi-billion parameter AI models come with a substantial energy cost and matching carbon footprint.
As climate change intensifies, the human health consequences are growing, and include changed pathogen distributions that will expose new populations to over half of known human infectious disease vectors.
Climate-induced disasters have a significant health impact; Australia’s 2019-20 bushfire crisis saw increased ED and GP visits and mental health impacts; air pollution contributed to 1.3 per cent of Australia’s total 2018 disease burden; and the growing impact of heatwaves across Australia will raise demand for health services.
More here:
https://medicalrepublic.com.au/can-digital-health-curb-sectors-climate-impact/82724
Here is the link to a key article and an extract:
What did you do to avoid the climate disaster? A call to arms for health informatics
Journal of the American Medical Informatics Association, Volume 29, Issue 12, December 2022, Pages 1997–1999, https://doi.org/10.1093/jamia/ocac185
Published: 16 November 2022
Extract
The effects of human-induced climate change on our planet are already largely irreversible for many centuries1 and may remain so for at least 1000 years.2 If emissions continue to grow, their effects will trigger multiple critical tipping points and event cascades that will amplify climate effects in unpredicted ways.3 Just in 2022, we have seen flooding cover one-third of Pakistan, affecting 33 million people.4 India and Pakistan’s heatwave was the hottest yet on record.5 Recent years have seen historically extreme forest fires across North America, Europe, Asia, and Australia. Low-lying Pacific nations are slowly starting to disappear as sea levels rise, fed by melt waters from disappearing glaciers and sea ice, and coastal cities everywhere are at risk.6 The same emissions driving climate change are also affecting our health. Particulates in air pollution are likely responsible for around 300 000 lung cancer deaths globally,7 and the list of climate-induced health problems leading to poorer outcomes is depressingly long.8,9 Humanity is in trouble, and our way out is uncertain to say the least.
---- End extract.
Here is the link – if you have access!
https://academic.oup.com/jamia/article-abstract/29/12/1997/6827134
What I did not see in the parts of the article that are accessible is just how much Digital Health contributes to the total Health and total national carbon emissions. I can’t imagine it would be the first target you would try to address, unless you were keen on reverting to the pre-digital health system.
I understand that reducing emissions is a critical objective but maybe efforts should be focussed on area like power generation, transport, smelting and so?
We could also put more effort into making sure Digital Health Systems are actually delivering the promised improvements in quality and safety!
Overall, I somehow feel this is a solution looking for a substantive problem in the overall scheme of things.
What do others think? Is this an issue worthy of focus or are there ‘much bigger fish to fry”?
David.
I wonder how much double counting is going on, like how much electricity, water, gas, and plastic etc it uses?
ReplyDeleteMaybe it's just a struggle to find relevance.