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his case study, published by BSR’s Center for Technology and Sustainability, examines the environmental benefits and impacts of health IT. Through case studies, the Center for Technology and Sustainability helps companies understand how to apply technology to solve sustainability challenges, credibly measure and communicate sustainability and business benefits, manage change, and successfully implement new approaches. 

Summary

The introduction of information technology (IT) into a healthcare context continues to radically shift how healthcare is delivered. Patients today expect to be able to communicate with their doctors virtually and to do many of the healthcare tasks online that previously took place in person, such as answering questions, refilling prescriptions, and more. On the healthcare-delivery side, health IT enables the integration of patient records, providing ready access to information for doctors and patients alike.

In addition to the obvious health benefits, research to date shows that health IT can lessen environmental impacts by reducing the need for patient transportation and by reducing the amount of paper used in medical records. In turn, the electronics used in health IT use energy, create waste during manufacturing and end-of-life, and contain a variety of potentially hazardous chemicals and materials.

Approach

The Center for Technology and Sustainability supports the development, demonstration, and adoption of technology-based sustainability solutions for a variety of industries. 

This case study focuses on technology demonstration, by reviewing and adding to work done by Kaiser Permanente (Kaiser) on the environmental impacts of its electronic health records system. Work to measure the net benefits of IT in electronic health has been limited to date, with Kaiser conducting the first major study in this area.

This case study was based on interviews with Kaiser staff, BSR analysis, and published material related to Kaiser’s activities as well as the broader benefits IT brings to healthcare. With this study, the Center for Technology and Sustainability aims to advance the measurement of environmental impacts and benefits from health IT. With better sustainability measurement, companies in the healthcare sector will be able to make decisions about technology not only based on business impacts, but also on the ability of this technology to drive social and environmental benefits. In addition, companies in the technology sector will be able to quantify the environmental impacts of their healthcare technologies.

The Opportunity

Because Kaiser Permanente was an early adopter of electronic health records (EHR) and health IT, the company has already addressed questions other companies are only now facing about the net environmental benefits of such systems. It was clear to Kaiser staff that electronic records reduce the need for paper use, but the members of Kaiser’s Environmental Stewardship Council wondered whether this benefit would be offset by potential negative environmental impacts from increased computer use.

Kaiser’s decision to invest in health IT was made based on rigorous business assessment and a quantitative evidence base. An understanding of the social and environmental impacts was one part of understanding the total cost of these systems.

Kaiser employees undertook a quantitative study to understand these environmental impacts, working with staff throughout the organization and in partnership with Kaiser’s Environmental Stewardship Council.

Because no previous studies of this type had been conducted on health IT, Kaiser developed the model for assessing net environmental benefits over approximately one year, including model development, data collection, internal review, and external review. One staff person led the work part-time, with some additional assistance for field work (such as measuring the weight of charts) and analysis.

Kaiser then published the findings of this study in the journal Health Affairs, in order to help others understand the net benefits of health IT and, if desired, apply Kaiser’s approach to their own organization. This case study focuses on the business impacts of this work and updates the analysis for 2015.

The positive environmental benefits of EHR included avoided paper use, avoided patient transportation, avoided chemical use, avoided plastic waste from x-rays, and avoided water use. The study also highlighted a number of negative environmental impacts such as increased energy use, increase in plastic waste, and an increase in chemical waste.

The study found that, by far, the biggest positive environmental benefit of health IT was the fact that patients needed to take significantly fewer vehicle trips to the doctor’s office. On the other hand, the biggest negative environmental impact came from the increased energy use from computers and electronic systems.

Business benefits seen from the integration of health IT include reduced expenditures on paper use, records transportation, and chemical purchase and disposal. Additional financial savings, such as reductions in patient transportation, are not captured within the Kaiser system but are enjoyed by patients.

Kaiser’s Approach

Measuring the environmental benefits of a particular technology is a three-step process:1

  1. Define Scope
  2. Prioritize Impacts
  3. Conduct Assessment

1. Define Scope     

As an initial step, it is important to identify the purpose and scope of the study. The business processes impacted by the use of information technology must be assessed, along with a qualitative review of the environmental implications of these changes.

To assess the environmental impact of EHR, Kaiser identified four focus areas: (1) reductions in paper use, (2) changes in patient travel, (3) increased use of personal computers and data centers, and (4) changes in x-ray use (from chemical to digital processing).

There are a number of different frameworks used for defining the environmental priorities and impacts of healthcare, including the Global Green and Healthy Hospitals Agenda, Practice Greenhealth’s Eco-Checklist, and the Sustainability Accounting Standards Board’s Health Care Standard. Environmental issues that these frameworks identify as most relevant for the healthcare sector include chemicals, waste, energy, water, transportation, food, and green building. Kaiser used the Eco-Health Footprint, a 2009 report outlining the major impacts associated with healthcare.

2. Prioritize Impacts

An important part of any modeling exercise is determining what to include and what not to include either because data is not available or because the impacts are not significant when considered relative to other aspects of the model. There is often limited data available, especially in early stages of developing an environmental-impacts model, so it is important to start with the most significant impacts.

Kaiser’s study focused on the impact of EHR in four environmental impact areas: (1) greenhouse gases, (2) toxic chemicals, (3) waste production, and (4) water use. Kaiser excluded two environmental impact areas—the use of land for buildings and the emission of air pollutants like ozone, particulate matter, and sulfur dioxide—in order to focus on the four largest and most direct environmental impacts connected to the use of electronic health records.

3. Conduct Assessment

The final step in the model is to quantify the environmental costs and benefits of each business-process change through a combination of primary and secondary data. This should include the documentation of any assumptions made and key areas of uncertainty. Most importantly, it is crucial to assess what decisions can be made or changed as a result of the analysis.

Lessons Learned

Benefits Depend on Application

One of the most significant findings of Kaiser’s work is that the net environmental benefits of health IT depend significantly on how the organization uses the technology. A system like EHR can be used as a straight one-for-one substitution for paper use, or it can enable significant changes to delivering patient care. Also, an organization like Kaiser Permanente has several opportunities for using EHR for integrated care than would a stand-alone doctor’s office.

The Biggest Benefits Come From Rethinking the Business

If a technology enables significant transformations in how the business is operated or its services are delivered, the environmental benefits can be very large. Instead of thinking of technology as a one-for-one substitution of computers for paper-based records (which represents some modest savings in paper), Kaiser found when they thought more broadly about the transformative role of technology, they found the biggest environmental benefits. For example, adjusting business processes so that patients could interact with doctors online reduced the number of patient vehicle trips. For companies looking to apply technology, understanding the new business processes that the technology enables is a great place to start.

Concrete Measurement Improves Decision Making

This assessment helped Kaiser staff better recognize the environmental impacts, both positive and negative, of its technology decisions. Cost and quality of care are the dominant drivers of its IT systems, but a full understanding of environmental impacts helped increase awareness about these issues within the organization and gave staff a basis on which to make decisions. For example, all patients receive an after-visit summary; after assessing the environmental impacts, Kaiser provided an option for patients to receive this electronically instead of in printed form.

Assessment Requires Both Secondary and Primary Data

Much of the data used in the study already existed in the public domain. However, one challenge in conducting the study was identifying methods to obtain some key source data, such as avoided paper use and avoided patient transportation. These required the collection of primary data, including the number and types of IT equipment, the weights of paper charts, the average distance between Kaiser facilities and patient residents, and more. In addition, Kaiser had published several previous studies on the impact of EHR on the number of in-person patient visits; we used these studies as part of the analysis.

As healthcare is increasingly offered virtually, we will see further environmental benefits, such as a reduced need for clinical space and an even further reduction in patient transportation.

Looking Forward

There are two major focus areas to consider for future measurement efforts. First, computers today have lower energy use and environmental impacts than they did in 2011, when the study was conducted.

Second, there is an opportunity to expand the analysis to include other significant impacts of health IT. Aspects that were not included in Kaiser’s initial model, but which may create environmental and other benefits, include the potential to reuse floor space previously utilized for storing paper records, as well as reductions in vehicle use to transport records from site to site. The lack of paper records, for example, means that storage rooms no longer need to be heated and cooled, and being able to reuse space could potentially delay the need for additional building construction.

It is clear that the future of healthcare includes significant technology-based solutions. There is hardly an aspect of healthcare that hasn’t changed as a result of health IT, starting with electronic records but extending far beyond. As healthcare is increasingly offered virtually, we will see further environmental benefits, such as a reduced need for clinical space and an even further reduction in patient transportation. Future assessments of environmental benefits from health IT should look at these wider, more systemic impacts, especially as healthcare organizations become more integrated in the face of a changing business environment and regulatory models.

1Adapted from Global e-Sustainability Initiative (2010), “Evaluating the carbon-reducing impacts of ICT: An assessment methodology.”

 

Credit: https://www.bsr.org

Monday, 08 June 2020 22:21

ICT for Education

Abstract

“Information and communication technologies for development (ICT4D)” is a general term that is used to define the applications of ICTs for the socioeconomically disadvantaged groups. In other words, the ICT4D is applying information technologies for poverty reduction purposes. Today the concept is far more evolved from when it started just as the ICT industry. Especially along with the Internet now the possibilities for collaboration have significantly increased. Since information and communication technologies will be shaping the future, the jobs acquired in the ICT industry will be even more valid. On the other hand while the need for professionals is increasing, the number of well trained professionals is not accumulating with the same acceleration rate, due to the high costs and accessibility problems. This paper focuses on a unique and successful project called SPARK (Youth Movement in Informatics). SPARK is a partnership of UNDP, Cisco and Youth for Habitat Association. This project aims to improve the level of information technology expertise among youth using the Cisco NetAcad e-learning platform, while simultaneously encouraging volunteerism. Moreover, SPARK aims to support young people to develop their social capacities and helps them participate in the new information-based global economy through the peer education model on advanced information technology and networking skills. Through the case of SPARK, this paper also emphasizes the importance of the ICT education for development and poverty reduction and illustrates the impact it makes on people’s lives.

Download full PDF

Data center operations account for two percent of all U.S. electricity use—and this proportion is unlikely to shrink. In 2012, BSR brought tech leaders together to form the Future of Internet Power, a collaborative initiative working toward a shared vision: an internet powered by 100 percent renewable energy.

The Challenge

While the thriving technology sector provides significant business and social benefits—many of which help to reduce negative environmental impacts—data centers are energy intensive. In 2010, data centers represented 2 percent of all U.S. electricity use, and that percentage is unlikely to decrease, given our increasing reliance on mobile and internet communications.

Today, internet companies and data center operators are addressing their impacts by considering the source of the electricity that powers their data centers, which is often a mix of renewables, natural gas, and coal. Moving beyond incremental improvements in the energy mix requires access to and use of sustainable, low-carbon electricity at scale. To make this a reality, companies will need to both collaborate across the industry and partner with local utilities and policymakers to develop the infrastructure and promote the regulations that will enable renewable energy procurement for internet power.

Our Strategy

In 2012, BSR launched the Future of Internet Power (FoIP), a collaborative initiative composed of some of the world’s most influential companies working to power the internet with 100 percent renewable energy. Today, FoIP members include Adobe, Akamai, Autodesk, Bank of America, eBay, Facebook, Hewlett Packard Enterprise, Salesforce, Symantec, TimeWarner, VMware, and Workday.

For internet companies, powering data centers with renewable energy can require clearing a number of hurdles: navigating regional environmental policies and incentives, in some cases paying cost premiums for renewable versus coal power, and addressing challenging infrastructure requirements for offsite power generation. These and other factors make sourcing low-carbon power difficult for individual companies to manage alone. Through FoIP, companies collaborate with peers, suppliers, and power developers to build smarter approaches and identify opportunities for shared or joint investment.

Our Outcomes and Impact

FoIP has played a foundational role in helping the technology sector set aggressive and achievable commitments to renewable energy. As of April 2018, nine FoIP members had committed to 100 percent renewable energy: Adobe, Autodesk, Bank of America, eBay, Hewlett Packard Enterprise, Facebook, Salesforce, VMware, and Workday.

FoIP also launched the Corporate Colocation and Cloud Buyers’ Principles, which outline six criteria that companies would like their data center service providers to meet. This includes providing data on customer energy consumption, disclosing facility energy sources, and supporting renewable energy advocacy. As of early 2018, 17 customers of industrial data center service providers (also known as “colos”) and cloud services became signatories, demonstrating their support for the six Principles, and four cloud and colo providers became Principles supporters, committing to work with their customers to put the Principles into practice.

In 2018, FoIP’s focus will be on finalizing and rolling out new tools for companies choosing renewables when making data-center siting decisions, encouraging colos to procure renewables, streamlining and standardizing the documentation required to make data-center-related renewable energy claims, and continuing to collaboratively tackle greenhouse gas accounting challenges in Scope 3 emissions.

Lessons Learned

In addition to sharing best practices and collaborating on solutions through FoIP, BSR’s one-on-one work with companies creates a model that we can customize for other businesses to develop and manage renewable energy infrastructure projects.

We have learned that big challenges like these require collaborative solutions. Building on the FoIP approach, we have been able to expand the group’s mission by working through other partnerships, including the Renewable Energy Buyers Alliance, a collaboration with the World Resources Institute and World Wildlife Fund Buyers' Principles initiative, and the Rocky Mountain Institute's Business Renewables Center. By working together, we can scale our impact even more, while making it easier and more efficient for businesses to help shift the energy mix powering the internet toward renewables.

 

Credit: https://www.bsr.org

Monday, 01 January 2018 10:55

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Monday, 01 January 2018 10:55

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Monday, 01 January 2018 10:55

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Contrary to popular belief, Lorem Ipsum is not simply random text. It has roots in a piece of classical Latin literature from 45 BC, making it over 2000 years old. Richard McClintock, a Latin professor at Hampden-Sydney College in Virginia, looked up one of the more obscure Latin words, consectetur, from a Lorem Ipsum passage, and going through the cites of the word in classical literature, discovered the undoubtable source.

There are many variations of passages of Lorem Ipsum available, but the majority have suffered alteration in some form, by injected humour, or randomised words which don't look even slightly believable. If you are going to use a passage of Lorem Ipsum, you need to be sure there isn't anything embarrassing hidden in the middle of text. All the Lorem Ipsum generators on the Internet tend to repeat predefined chunks as necessary, making this the first true generator on the Internet. It uses a dictionary of over 200 Latin words, combined with a handful of model sentence structures, to generate Lorem Ipsum which looks reasonable. The generated Lorem Ipsum is therefore always free from repetition, injected humour, or non-characteristic words etc.

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Sunday, 17 December 2017 10:38

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