Observatory on the future of healthcare
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Dr K-lynn Smith WHO Climate Resilient Healthcare Systems Climate and Health Alliance (CAHA) Global Green and Healthy Hospitals United Nations Climate Change UN Sustainable Development Goals

Developing a climate-resilient healthcare system

Healthcare systems have a bi-directional problem with climate change. Healthcare contributes substantial emissions and is also on the front lines of caring from those affected by climate change.

Hands holding up the Earth in front of a leafy background.

About the bi-directional problem

Climate change negatively impacts human health through:

  • exposure to climate-related events, such as hurricanes, heatwaves, floods and droughts
  • the creeping, ubiquitous intrusion of infectious and vector-borne diseases.

It also:

  • exacerbates chronic conditions, such as cardiovascular disease and respiratory illnesses
  • increases the incidence of climate-related disorders, such as heat stroke.

The damage extends beyond physical health causing anxiety, depression, and for many, existential dread. One in eight people across the world have some sort of mental ill-health, to which climate change is increasingly contributing.

This cacophony of problems exposes the bi-directional problem: every episode of healthcare produces greenhouse gas (GHG) emissions, which contributes to climate change and potentially damages human health, thereby increasing healthcare system usage.

If healthcare were a country, it would be the fifth largest contributor of the global GHG burden, at approximately 4.4 per cent of all emissions.

Program goals

This research program aims is to contribute to the development of a low-carbon, climate-resilient healthcare system – one that is affordable, cost-effective and delivers improved health outcomes for all, while limiting its contribution to climate change.

Leads
Team members

Public and private hospitals, pharmaceuticals, and physicians and clinical services account for much of the emissions that healthcare systems directly have control over.

Knowing the source of emissions is not enough; research is urgently needed into designing implementable interventions to decarbonise healthcare systems while maintaining the quality and safety of healthcare. These interventions must be evaluated to ensure health systems are meeting the goal of ‘net zero’ emissions.

Below are some of our research areas.

The 60:30:10 challenge: Reducing low-value care to lower healthcare’s carbon footprint

It has been estimated that 30 per cent of all healthcare provides little to no benefit to the patient. This includes:

  • repeated pathology tests
  • unwarranted surgeries
  • overtreatment of conditions
  • over prescribing of pharmaceuticals.

This waste not only costs the system financially, but it also contributes substantially to the carbon footprint of healthcare systems.

Our research focuses on ways to reduce unwarranted variation in care to improve the sustainability of healthcare systems.

Examples of publications:

How do we get the evidence for low-carbon healthcare systems into practice?

It is not sufficient to identify high-emission areas in health systems. Real system change is urgently needed, and everyone has a role to play, including:

  • clinicians
  • health consumers
  • policy makers
  • health administrators
  • allied health professionals
  • IT system designers.

Our research seeks to work across health sectors to create sustainable change.

Examples of publications:

Digital health: Measuring, monitoring, and mitigating using AI, Big Data, and informatics

This research aims to respond to the health impact of climate change using digital technology. Managing data during health crises can be complex; digital health is a central solution to enable healthcare systems to respond efficiently.

Examples of publications:

Integrated healthcare systems: Improving outcomes for patients and the planet

Integrated care has the potential to enable people to be more in control of their health and wellbeing and to support self‑care solutions and preventative action that reduce the need to consume healthcare resources.

Care integration – by delivering the right care, in the right place, at the right time, at the right cost – creates a better user experience and a more efficient journey through the care system.

Examples of publications:
Future proofing healthcare systems against climate change and pandemics

Learning healthcare systems (LHS) are health systems that are effective at learning, can use data well, and skilfully embed knowledge into daily clinical practice and decision making of both health providers and patients. The concept was first advanced by the US National Academies of Medicine (previously the Institute of Medicine) in 2007.

While many health systems have begun their journey to becoming an LHS, there is still much to do. And there is little time. Climate change and new infectious diseases, such as COVID-19, are placing increasing strain on already stretched health systems.

This research seeks to answer the pressing question: How can healthcare organisations be strategically enabled to become next-generation Learning Health Systems (LHS2.0)?

Examples of publications:

Creating a future-ready health workforce

A skilled and capable workforce with capacity to mount rapid response is essential to ensure ongoing health system performance as we enter the era of “global boiling” and climate-related events such as heatwaves, floods and hurricanes become more frequent.

The impacts of climate change, however, are compounded by an already stretched health workforce. The WHO estimates a shortfall of at least 15 million healthcare workers by 2030 and the Lancet Global Health recently raised alarm over the emigration of health workers from countries with some of the lowest health-care workforce densities.

What needs to be done to prepare and protect the health workforce of the future?

Publication:

Mobilising implementation science to tackle the impacts of pandemics and climate change

Implementation science is study of methods and strategies that facilitate the uptake of evidence-based practice and research into clinical practice and policy decision-making.

The goal is to close the gap between the generation of knowledge and its application.

This is particularly important given the urgency of change needed by health systems to prepare for current and future pandemics and the increasing frequency of climate-related events.

Examples of publications:

Mental health in the era of climate change and pandemics

The world is changing fast; so fast that many people are increasingly feeling that it is out of control. Our research shows that anxiety and depression are at record levels.

COVID-19 has had a massive effect on populations throughout the world. Other pandemics seem much more likely in the near future.

What must health systems do to manage these increasing demands?

Examples of publications:
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