Industry Series: sustainability and healthcare

Globally, healthcare is facing a dual challenge:

• Climate change is placing growing pressure onto health systems that are already under serious fiscal and operational stress (see figure 1).
• Healthcare providers are also having to manage their organization's services to meet regulatory requirements for their Environmental, Social, and Governance (ESG) obligations.

"The impacts of climate change have strained health systems across the globe and demonstrated how unprepared the world is to respond to these growing threats. Climate disasters are increasingly and painfully commonplace. " Figure 1 - McKinsey - Future-proofing Health Systems for Climate Change and Pandemics

Oracle supports healthcare institutions in their ESG journey through the strategic use of technology and data management to drive more efficient and better targeted services.

As highlighted in the United Nations Sustainable Development Goals, a key goal is to ensure healthy lives and promote well-being for all at all ages. At the macro level, providers can act by changing the way they deliver care. At the micro level, they can operate more efficiently, eliminating waste and duplication.

Healthcare is already undergoing a significant shift in the way care is delivered, with greater emphasis on giving people better access to their health information and services and more control over their care. Telehealth and virtual care are now seen as an integral part of modern healthcare delivery, reducing demand on the hospital system-the area of healthcare with the largest carbon footprint (see figure 2).

"Australia's health system contributes 7 percent of Australia's total carbon emissions, which amounts to 35,772 kilotons per annum. Within the health system, public hospitals are the largest contributors at 12,295 kilotons per annum, or 34 percent of the total." Figure 2 - 'The carbon footprint of Australian health care', Lancet Planetary Health, no. 2

Telehealth can also reduce greenhouse gas emissions through reduced travel. A UK study has estimated that the total quantity of potential carbon savings from telehealth for the National Health Service is equal to the annual energy expenditure of 2,295 households.[1]

Providing virtual care must be a core part of the patient's journey. Oracle enables digital connections across the care continuum by embedding patient-to-clinician and provider-to-provider telehealth capabilities into their electronic health record and the clinical workflow.

Additionally, health systems globally are seeing a rise in chronic disease putting strain on providers. Early intervention in chronic disease both improves patients' quality of life and reduces their risk of hospitalization. An estimated eighty percent of chronic disease is due to socio-economic factors such as quality of housing, economic circumstances, healthy eating.[2]

Analysing population health data enables providers to see where the community is being impacted by chronic disease and provide services targeting the underlying cause. For example, using the Oracle Health data platform, Geisinger hospital system in the United States was able to proactively identify people in their community at risk of diabetes. They then worked with a community organisation to improve nutrition and overall health for the most vulnerable cohort. Using this data has both improved the quality of life of the individuals and reduced the financial pressure that was being driven by increasing service demand.

In common with all organisations that have large capital infrastructure, hospitals are focused on reducing utility use, more green spaces, more natural lighting, renewable energy, and utilizing recycled resources. For healthcare, often behind other industries in digital adoption, there also is an urgent need to introduce efficiencies into both enterprise operations and clinical delivery.

Critical from an enterprise operations perspective is using process automation, supported by Artificial Intelligence (AI) to steamline workflow to provide easy to use tools, increase mobility and elminate the use of paper. A key area of focus is hospitals' end-to-end supply chain, from the manufacturer to the patient, to minimise wastage. Having a common view of all available data (financial, human resource and clinical) enables providers to have the agility needed to plan for and respond to disruption in supply when unexpected events arise.

"University of Missouri Health Care is looking forward to simplifying physician and nurse workflows by incorporating generative AI into their Oracle electronic health record system, which will help them spend more time with patients to improve the quality of care and healthcare experience." Richard J. Barohn, MD, Executive Vice Chancellor for Health Affairs and Hugh E. and Sarah D. Stephenson Dean, School of Medicine, University of Missouri.

There is considerable promise in the use of generative AI to reduce reliance on paper-based processes and support both clinicians and patients. In healthcare the aim is to assist not to replace clinical care, with there still being a 'human in the loop'. It may be used, for example, to assist in the documentation of patient encounters, to generate treatment plans for clinical review, or to help prepare personalised patient education materials.

The healthcare industry is increasingly facing sustainability related challenges. Natural disasters caused by climate change is pressuring front line workers and the ability of healthcare providers to respond to these disasters. Drought, wildfires, extreme heat, floods, coastal inundation and other climate-related events can result in a dangerous combination of increased healthcare demand and reduced healthcare capacity [3].

As the incidence of climate events continues to increase, the healthcare system must look to using all the technology and data tools available to minimise environmental impact and maintain quality of service. Oracle's ongoing commitment to annual investment in research and development will ensure that it remains at the forefront of the driving innovation needed to meet these challenges and partner with healthcare institutions around the globe.

[1] The King's Fund . Sustainable services: Future trends. www.kingsfund.org.uk/projects/time-think-differently/trends-sustainable-services

[2] Hood CM, Gennuso KP, Swain GR, Catlin BB. County Health Rankings: Relationships Between Determinant Factors and Health Outcomes. Am J Prev Med. 2016;50(2):129-135

[3] RACP, Climate Change and Australia's Healthcare Systems https://www.racp.edu.au/docs/default-source/advocacy-library/climate-change-and-australias-healthcare-systems-a-review-of-literature-policy-and-practice.pdf

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