Can Digital Health care be sustainable?

Florencio Travieso — Thu, 18 Nov 2021 12:00:49 +0000

We have written not long ago that Big Data is revolutionizing the health care delivery systems, increased by the omnipresence of digital devices. And the next ten years are going to deepen this growth in terms of technological developments.

Taking only into consideration the growth since 2020, we have witnessed that the pandemic has increased the acceleration of digital tools. There is no way back in the certainty that digital health care is here to stay.

But at what cost for our environment and our social values?

We cannot help but realizing that the global impact of these digital innovations is considerable from a sustainability perspective. Traditionally, health care is an important consumer of resources and a consequential source of multiple environmental footprints. Hospitals are energy intensive buildings, pharmaceutical companies are large consumers of water, Insulin pens, after use are mostly discarded in landfills.

Global health care has an approximate impact of around 1% to 5% of the total global impact (this is comprised of Greenhouse gases, Nitrogen, Scarce water use, Particulate matter, Nitrogen oxide -NOx and Sulfure dioxide -SO2).

The growing role of digital identity of patients

Digital patients have become the cornerstone source of data collection. Patients create structured and unstructured data that, in turn, is transformed through data science into commercial data strategies.

Global patients, armed with smartphones, have accepted to share data using trusted applications that gather personal and sensitive information and feed predictive algorithms for (not only) health purposes. Digital health care applications are using data that was not originated for health purposes.

In the near future, companies processing data should treat patient data as a “coherent health data loop” -both structured and not structured- and alimented by different actors, most of them will not essentially be health care.

The role of the Sustainable Development Goals reshaping healthcare

Sustainability in the health care sector should not just be perceived as an environmental strategy.

Taking into consideration some of the SDGs, we discover that the link with health care becomes a universal approach:

SDG 3: Ensure healthy lives and promote well-being for all at all ages
SDG 10: Reduce inequality within and among countries
SDG 12: Ensure sustainable consumption and production patterns
SDG 13: Take urgent action to combat climate change and its impacts

We realize that sustainability in this sector will have a global impact, including the understanding of the access to health, the right of access to care, the respect of workers and first respondents’ rights, developing a social concern for the staff, the awareness of the gender gap.

Unfinished business…?

Inequalities on access to data and data infrastructure

The current data paradigm that we experience as a society should not blind us in believing that all people have an almighty access to digital infrastructure.

Different factors must be considered, as smartphone penetration and internet presence are not uniform around the world. And even if there is large access to technology, smartphones and internet, there are gaps in terms of bandwidth, quality of connections or hardware and many cultural and local issues. This can bring consequential inequalities, as basic limitations to a full access to technology will reduce the access to basic care.

Distortions on the deployment of the digital transformation

We have seen that in certain companies the adoption of digital transformation strategies sometimes involves an extremely analog vision of digitization (a symbolic transition towards digital records but directly connected to paper).

An important factor for data health care providers will be to properly manage the data governance across multiple platforms in the ecosystem. Data will not only be multiplied, but power over data will be held by patients across the system. Therefore, a more robust governance of the data circulation will be necessary.

Time to drawdown

Digital health care (as many other industries) will have to set drawdown as a priority. Creating industry strategies that will have less impact on the environment and on society as a whole. Health care is very carbon intensive, and the US health care system alone gathers around 25% of the world’s health care greenhouse gas emissions.

Impact of the global health care supply chain structure

The current supply chain structure is extremely carbon intensive, and this is also consequence of the localization of production facilities, pharmaceutical companies and distributors, vendors and patients in general. The stress that the global health care supply chain has suffered during the 2020 pandemic is a testimony that measures must be taken to tackle accessibility with a sustainable approach. This calls to consider the possibility to diversify the source of (closer) supply chains from different vendors and do not rely on a unique (and far) supplier. Major suppliers could be strategically placed to source to regions, reducing the carbon footprint and also increase availability. A specific regulation of licensing of Intellectual property and pharmaceutical patents should also be discussed, to speed up supply processes of essential components in urgent situations.

Clearly, a more global appreciation of the situation is required. In that case, the industry and the regulators will be able to better design the future sustainable policies.

…But hope on the horizon

However, not all is lost. We can assert that digital health care has the potential and elasticity to adapt and generate efficiency for sustainability.

Digital and IT health is the biggest circular economy in the sector.

The increased use of big data has an important positive consequence in terms of infrastructure and more efficient electronic medical records. The constant rising of the of medtech industry implies the redesign of the patient pathway and the recognition of the patient’s rights over their personal medical data. This includes, obliviously, increased power on prevention thanks to the use of connected and integrated devices and solutions from Artificial Intelligence in the processing of large and worldwide medical imaging.

A new business model: Sustainable health care.

A patient-centered industry is not a new vision for health care 4.0. The customer experience must be reimagined increasing the value over the way the user not only enjoys the digital experience, but mostly trusts in it. Teleconsultations are understood to be a carbon emission palliative.

Under regulations like GDPR in the European Union, users have become more aware and demanding of respect of their basic rights. This also implies that users will become more sustainability demanding in the future. The industry will have to prove their data accountability and the way they are contributing to the global drawdown, which will probably include a new reuse, refurbish and recycle policies, and understanding that these policies will also be a driver for the company’s reputation.

Conclusions and proposals

The goal for the next years will be to understand that sustainability implies good business. Companies across the digital health care sector will certainly insert sustainable policies into their agenda, from reducing carbon and climate footprints from their systems and hospitals, increasing renewable energy and decarbonize the supply chains.

The role of the “demanding patient” will be key in the next few years. A patient/user that compel companies to be climate responsible and zero-emission certified might be a change factor in the industry, in the same way data protection regulations are bringing the power back to the user.