Sustainability continues to be an often-discussed topic in various sectors of the economy. From finance to retail to manufacturing, firms have been looking to see what they can do to be more sustainable. Whether this means changing the materials used in their products or reducing the amount of waste in their office spaces, sustainability has become a principal concern for many modern organizations.
Healthcare is no different. In a study published in JAMA in late 2019, researchers found that the healthcare sector in the United States wasted $760 billion to $935 billion annually. That adds up to a quarter of total medical spending in the country. Researchers noted how this issue could be addressed through a series of interventions; however, the U.S. healthcare sector is multi-layered and complex. Rarely are there quick fixes for industry-wide issues and especially not in one as intricate as healthcare.
Comparatively, medical imaging is another multilayered field of healthcare which presents its own sustainability issues. Medical imaging encompasses a variety of modalities, such as ultrasound, magnetic resonance imaging (MRI), and x-ray. These modalities are used in a wide range of clinical areas such as radiology, gynecology, sports medicine, obstetrics, and pediatrics. This signifies that any one approach to sustainability in medical imaging will not suffice, but rather must be tailored to the unique needs of that practice.
For example, radiology departments may address waste issues differently than a gynecology practice. Additionally, practices vary in size, volume of procedures, and population being served. Hospitals differ in their level of waste when compared to a medical imaging center or sports medicine clinic. Thus, sustainability programs will have to be implemented at the facility-level for maximum efficacy.
Regardless of the unique needs of each practice, researchers from the JAMA studied identified “six wasteful domains” which they recommend addressing to reduce waste. These domains consisted of the following areas: “failure of care delivery, failure of care coordination, over-treatment or low-value care, pricing failure, fraud and abuse, and administrative complexity.”
One major roadblock to reduce waste and becoming more cost-efficient is the lack of coordination between providers and payers, noted the research team. The authors of the study called “administrative complexity” the greatest source of waste and the issues rooted in this area stretch to medical imaging.
For example, an article published in Diagnostic Imaging discussed how the bundling of Medicare payments would lead to a reduction of revenue for facilities. The article discussed ways in which radiology departments could cut waste to compensate for those projected losses. It noted how imaging departments such as these may experience waste in multiple areas: transport, inventory, over processing, overproduction, and more.
One area of concern is the imaging equipment itself. To remain ahead, many facilities look to replace machinery periodically, but at times, this consistent replacement can be wasteful. MRI machines and CT scanners may be replaced because they are considered “old” when in reality they may have “dozen or more years left,” says Andrew Northup, Director of Global Affairs for the Medical Imaging & Technology Alliance (MITA).
MITA recommends that facilities practice refurbishment to lower costs and extend the lifetime of its machinery. Doing so not only eliminates wasteful spending, but also benefits the environment. When manufacturers properly refurbish imaging machinery, it can be left good as new. Northup describes the practice of purchasing and refurbishing imaging equipment as a “viable diagnostic imaging upgrade option” for hospitals looking to conserve their budgets. This practice can also be extended to imaging centers and other practices outside of hospitals which are seeking to be more sustainable and lower overall costs.
Facilities can also save in their supplies. For example, ultrasound transducers utilize specially formulated gels which can produce high-quality images. These gels, however, present an area of waste. Although designed to be safe for patient use, product waste from ultrasound gels can be harmful to the environment. Their packaging is typically not environmentally friendly nor are the solutions created with sustainability in mind.
Moreover, the design of some gel packets and bottles leads to unused gel being discarded. However, the industry has responded to these issues by creating sustainable options. EcoVue, a sustainable ultrasound gel, offers an innovative FlexPac which has been designed to reduce gel waste by allowing for up to 99.5% evacuation of the product. This leads to 800,000 less pounds of wasted gel.
Switching to ultrasound gels such as these can lead to other big results not only for the facility, but also for the industry. The company which creates EcoVue, HR Pharmaceuticals, notes how the switch to the gel leads to 1.5 million less containers in landfills and $1.875 million in savings for the industry. EcoVue is also designed to reduce Co2 emissions, and can reduce them by 60,000.
Sustainable options such as EcoVue do not have to sacrifice quality either. The FDA-approved gel is exceptionally safe for patients and imaging equipment and is made of 97.8% natural ingredients and contains no dyes or parabens. Supplies such as these provide a cost-efficient option to practices looking to reduce waste and help the environment in the process.
In addition, manufacturers of imaging equipment have also been researching ways to reduce waste in their machinery. Philips has been developing MRI scanners which use less helium and are more cost-efificient. Their innovative BlueSeal magnet is able to operate with only seven liters of liquid helium and is fully sealed, thus minimizing the amount of helium which escapes unlike in conventional MRI scanners. In addition, Philips says this technology frees up MR operations from potential helium complications and contributes to reducing siting costs. Additionally, the company has designed the magnet to be 900 kg lighter than its predecessor and does not require a vent pipe. This allows facilities to potentially lower construction costs and perform easier siting.
Furthermore, there has been a trend in healthcare to move towards single-use supplies and equipment, particularly in interventional settings. This is mainly due to the positive effects it has on both patient safety and costs. Single-use instruments eliminate the need for cleaning, disinfection, and sterilization post-procedure and minimize the chance of cross-contamination by not having been previously used on another patient. However, as they can only be used once unlike reusable instruments, they contribute to more waste.
But healthcare facilities have options: Stryker Sustainability Solutions is an example of a company which specializes in the sterilization and reprocessing of single-use medical devices (SUDs). This is an FDA-regulated practice to ensure that all reprocessed SUDs are safe for patient use. By reprocessing rather than disposing, healthcare facilities can eliminate excess waste, keep patients safe, and also reduce the environmental impact of single-use supplies and instruments.
Overall, sustainability should be seen as an integral part of managing a healthcare organization. Both medical imaging practitioners and administrators should seek to identify areas of opportunity in their facilities wherein they can reduce waste. This should be done with a long-term vision to produce long-term results rather than focusing on quick wins which only produce short-term gains. Prioritizing sustainability in medical imaging not only increases efficiency and lowers costs, but also leads to better care and a healthier environment.