How can we reduce carbon emissions in health care – and can technology help?

The Cop26 climate talks ended last week with a far-from-perfect agreement to take measures designed to limit the rise in global temperatures to no more than 1.5C above pre-industrial levels. To coincide with the Cop26 talks, Future Care Capital held an online event to discuss how technology could help health care reduce carbon emissions and meet the NHS’s target of net zero by 2045.

FCC, working with The NHSX AI Lab, has recently launched two pieces of research exploring the interactions between technology, climate and health.

The first was an article reviewing the use of artificial intelligence (AI) solutions to improve health outcomes, the climate impact of developing such solutions and the opportunities for using AI to improve the climate of healthcare systems.

The second, to be launched early next year, sets a starting point for better understanding the digital technologies being adopted by the NHS, the climate impacts of those technologies and the opportunities they offer to improve models of care as well as reducing emissions.

The panellists at last week’s event were:

• Dr Peter Bloomfield, head of policy and research, FCC
• Ryan Jenkinson, data scientist, Centre for Net Zero
• Pete Clutton-Brock, CEO, Radiance International
• Leanne Summers, head of AI strategy, NHSX
• Ben Tongue, sustainability lead, NHS Digital

Peter introduced the discussion by noting that there are “profound health implications to climate change.” As well as offering improvements to health, he said, we need to think about the “detrimental consequences” that such technology could have.

Health, technology and climate interact in multiple ways. We needed to think, Leanne pointed out, about the impact of the climate crisis on health, such as water supply, food and a possible increase in tropical diseases. If we implement technologies to mitigate the effects of climate, she said, “one of the things we need to be cognisant of is that we’re not introducing more harm.” As an example, she said, “most definitely online consultations have reduced the number of car journeys people have taken, but have we looked at the down chain supply chain issue of the implementation of those technologies?”

Measuring the impact of carbon is challenging, however. Ben is working with health sector groups to develop a methodology for measuring the net sustainability impact of digital technology use. Citing telehealth as an example, he said that it requires “computers for the clinicians, then the networks and data centres, and end user devices for the patients.” Set against that, he said: “It will deliver travel savings, and it will deliver us state-space savings, in associated energy and embodied carbon once it matures, local air pollution, paper reduction – a whole plethora of benefits.” Ben also noted that sometimes  decisions to reduce carbon could come into conflict with  other health service objectives, and that it was important to have a “properly evidenced decision.”

 The power of nudge

If measuring the impact of an organisation’s emissions is difficult, then quantifying emissions in the supply chain is even harder. Increasingly, Pete pointed out, organisations are moving from using their own servers to cloud computing. While some providers are transparent – Microsoft Azure, for example, has a sustainability calculator – others are less so. This creates an opportunity for the NHS, however: “Because the NHS has a lot of procurement power in determining what digital providers it works with, it could use that to nudge some of these providers a bit further and faster when it comes to the transparency issues.”

One promising option for understanding emissions comes in the form of agent-based modelling (ABM), currently being trialled by Octopus Energy’s Centre for Net Zero. This is a type of modelling that involves taking an entity, such as an individual or household, and looking at how it makes decisions as it interacts with its environment. ABM could be very useful in health care settings to understand, for example, the occupancy rates of hospital beds and running “what if” scenarios, such as the impact of a flu epidemic. But a key part of ABM, said Ryan, was examining how agents interact with each other – for example, an individual might buy an electric car if their neighbour does so. He noted that the public goodwill towards the NHS was potentially helpful in this respect: “A lot of the stuff NHS does on net zero can not only reduce their own carbon emissions but percolate out into local communities.”

Beware of greenwashing

Finally, panellists warned that we need to be wary of greenwashing, particularly the use of carbon offsets to achieve net zero. “The main way of addressing it is through transparency,” Pete said. There are established, well-defined processes for setting targets, such as the science-based target initiative (SBTi), he pointed out, and we didn’t need to “reinvent the wheel.”

But there was a great opportunity to lead by example, he said: “When organisations like the NHS are looking to work with digital providers, having high standards about not using tons of offsets is a really important way of doing that. A lot of companies have taken stick around relying on cheap offsets to meet some of their targets, and they’re not going to get any credit for net zero as a result…As we move towards faster and faster progress on climate change, the pressure to make sure you’re on the cutting edge is only going to increase.”