Kaiser Permanente, a managed-care consortium with nearly 9 million U.S. health plan members – as well as the world’s largest private electronic health record (EHR) system – says there are major medical and environmental benefits to purging paper medical files.
In fact, converting from paper to an EHR system could reduce C02 emissions across the nation by as much as 1.7 million tons annually, according to a study published in the May issue of Health Affairs.
But not when the EHR system is used in a traditional fashion.
The reductions are realized when patients use email to ask their doctors about mild illnesses and prescription renewals, and get test results, rather than getting into their cars or using public transportation for an office visit. Making those behavioral changes is the pollution equivalent of taking 300,000 cars off America’s roads, the study claims.
In fact, the researchers found that if electronic records simply replace paper records – without concurrent behavioral changes – the national impact would be to increase C02 emissions by 653,000 tons. (That’s the equivalent of putting 100,000 more cars on America’s roads.)
Kaiser used its own EHR system, HealthConnect – installed at 454 clinics and 36 hospitals in nine states and the District of Columbia – as its laboratory. The model Kaiser Permanente developed to evaluate the environmental impact of EHRs focused on six categories of environmental impact within health care to examine those most directly related to electronic health records, said study lead author Marianne Turley, senior statistical consultant, Analytics and Evaluation, at Kaiser Permanente. “Our model serves as a useful framework for assessing the environmental impact of electronic health records,” Turley said.
In the Kaiser system, the researchers concluded, electronic health records have been decidedly green. Specifically, the study found that, in one year, Kaiser’s use of health IT:
Avoided the use of 1,044 tons of paper for medical charts,
Eliminated up to 92,000 tons of C02 emissions by replacing face-to-face patient visits (and the associated travel) with virtual visits,
Avoided 7,000 tons of C02emissions by filling prescriptions online
Cut patients’ gas consumption by 3 million gallons
Reduced the use of toxic chemicals, such as silver nitrate and hydroquinone, by 33.3 tons by digitizing and archiving X-ray images and other scans
“At Kaiser Permanente, we are committed to improving the health of our members and the communities we serve, and that mission is advanced by our leadership in health IT,” said Jed Weissberg, MD, senior vice president of hospitals, Quality and Care Delivery Experience. “Electronic health records can support a more environmentally sound health care sector if they are used to change workflows and care delivery, rather than just as a substitute for paper records.”
Apparently, Kaiser’s patients appreciate the convenience of the EHT system. With more than 3 million active online users, HealthConnect welcomes about 55,000 new online users each month. In total, patients use the system each month to:
Access 1.8 million lab results,
Send more than 700,000 emails
Fill 550,000 prescriptions
Schedule 150,000 appointments
“Prior to this study, the benefits of electronic health records were categorized primarily by their impact on the quality of care and potential to improve efficiency,” said study co-author Terhilda Garrido, vice president of Health Information Technology Transformation and Analytics at Kaiser. “As the country increases its ‘meaningful use’ of HIT, we should consider other macro impacts as well.”
The health care industry is burdened by high energy use, high water use, and a unique toxic profile, according to Kaiser Permanente. Health care-related activities account for 8 percent of total U.S. greenhouse gases and 7 percent of total carbon dioxide emissions
Recognizing that health information technology is critical to clinical performance improvement, including patient safety, Kaiser Permanente began the implementation of KP HealthConnect in 2004 to support patient care and service, a process completed in March 2010. The implementation of the My Health Manager personal health record, which is integrated with KP HealthConnect, was completed in 2007. To see Kaiser Permanente members, physicians and employees talk about KP HealthConnect and the My Health Manager, check out this video. For more information about Kaiser Permanente’s environmental policy, go to: www.kp.org/green.
Cheryl Kaften is an accomplished communicator who has written for consumer and corporate audiences. She has worked extensively for MasterCard (News - Alert) Worldwide, Philip Morris USA (Altria), and KPMG, and has consulted for Estee Lauder and the Philadelphia Inquirer Newspapers. To read more of her articles, please visit her columnist page.Edited by
Jennifer Russell
