Presentation at American College of Preventive Medicine on Climate Change and Health and Health care.

1. Healthy Environments, Healthy People
American College of Preventive Medicine, February 22, 2012
Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan
© 2012 The Permanente Federation, LLC
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2. Healthy Environments, Healthy People
American College of Preventive Medicine, February 22, 2012
Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan
© 2012 The Permanente Federation, LLC
Photograph: Ted Eytan, MD, http://flic.kr/p/b4iXjD
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3. Healthy Environments, Healthy People
American College of Preventive Medicine, February 22, 2012
Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan
© 2012 The Permanente Federation, LLC
Photograph: Ted Eytan, MD, http://flic.kr/p/a1f8Q6
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4. Healthy Environments, Healthy People
American College of Preventive Medicine, February 22, 2012
Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan
© 2012 The Permanente Federation, LLC
Photograph: Ted Eytan, MD, http://flic.kr/p/bxvCwH
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5. Healthy Environments, Healthy People
American College of Preventive Medicine, February 22, 2012
Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan
© 2012 The Permanente Federation, LLC
Photograph: Ted Eytan, MD, http://flic.kr/p/bvY388
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6. Why.
“Dream Grounds for a Dream Hospital”
Source: http://kasierpermanentehistory.org ; Joe Bialowitz, MS, HEM, Senior Environmental Stewardship Consultant, Kaiser Permanente
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7. Why.
“Showcases of modern, green hospital design”
Source: http://xnet.kp.org/centralvalley/pages/green_features/green_features.html ; http://xnet.kp.org/newscenter/pressreleases/scal/
2012/011712sandiegosolar.html
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8. How - Better food
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9. How - Better food
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10. How - Better food
Source: http://www.nytimes.com/2010/09/22/dining/22doctors.html
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11. How - Better food
§ 190 tons of fruits and
vegetables served to
patients sustainably
produced (50% of total)
§ Milk, yogurt free of rBGH
§ Cage-free shelled eggs
§ Partnership with UCSF,
John Muir, others for
Regional Produce
Sourcing Project
Source: http://www.nytimes.com/2010/09/22/dining/22doctors.html
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12. How - Better food
§ 190 tons of fruits and
vegetables served to
patients sustainably
produced (50% of total)
§ Milk, yogurt free of rBGH
§ Cage-free shelled eggs
§ Partnership with UCSF,
John Muir, others for
Regional Produce
Sourcing Project
Source: http://www.nytimes.com/2010/09/22/dining/22doctors.html
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13. How - Safer Chemicals
January 19, 2012
Source: http://xnet.kp.org/newscenter/pressreleases/nat/2012/011912ecofriendlyIVbags.html
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14. How - Safer Chemicals
January 19, 2012
Source: http://xnet.kp.org/newscenter/pressreleases/nat/2012/011912ecofriendlyIVbags.html
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15. How - Safer Chemicals
§ IV solution bags and IV tubing sets
– 9.2 million and 4.9 million per year
– 100 tons of medical products
§ Products in use now free of PVC and
DEHP January 19, 2012
– PVC : Cancer, through dioxin generation
– DEHP : Neuroendocrine abnormalities
§ Product change saves $5 million / year
Source: http://xnet.kp.org/newscenter/pressreleases/nat/2012/011912ecofriendlyIVbags.html
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16. How - Better care models: Blood pressure control
85%
KP member
73%
US 90th %
60%
2005 2006 2007 2008
Source: Zhou YY, Kanter MH, Wang JJ, Garrido T. Improved Quality At Kaiser Permanente Through E-Mail Between Physicians And Patients.
Health Affairs. 2010;29(7):1370-1375. Available at: http://content.healthaffairs.org/cgi/content/abstract/29/7/1370 [Accessed July 7, 2010].
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17. How - Better care models: Blood pressure control
Significant? How 85%
about p<0.0001 + email
73%
US 90th %
60%
2005 2006 2007 2008
Source: Zhou YY, Kanter MH, Wang JJ, Garrido T. Improved Quality At Kaiser Permanente Through E-Mail Between Physicians And Patients.
Health Affairs. 2010;29(7):1370-1375. Available at: http://content.healthaffairs.org/cgi/content/abstract/29/7/1370 [Accessed July 7, 2010].
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18. Environmentally responsible, too
Health Affairs, May 2011: “Kaiser
Permanente Study Finds Use of
Electronic Health Records
Reduces Carbon Emissions,
Waste and Water Consumption”
Poten&al
CO2
emissions
reduc&ons
as
much
as
1.7
million
tons
across
the
en&re
U.S.
popula&on
Source: Turley M, Porter C, Garrido T, et al. Use of electronic health records can improve the health care industry’s environmental
footprint. Health affairs (Project Hope). 2011;30(5):938-46. Available at: http://content.healthaffairs.org/cgi/content/abstract/30/5/938
[Accessed January 3, 2012].
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19. 3.7 million members connected, via kp.org
4,000,000 members
2,000,000 members
2003 2005
2007 2009
Source: Kaiser Permanente Web Analytics
2011 (3Q)
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20. 3.7 million members connected, via kp.org
4,000,000 members
2011 (Jan - Oct)
10.8 million secure emails sent
2,000,000 members
25 million test results viewed
4.9 million past visits reviewed
Tweeting @KPMemberservice
2003 2005
2007 2009
2011 (3Q)
Source: Kaiser Permanente Web Analytics
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21. Warm Greetings from
Colorado Springs
Source: Ted Eytan, MD
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22. How much? (2010)
52
million
people
8.9
million
members
178,000
employees
36
hospitals
454
medical
office
buildings
NHS England
KP
0.8675
MtCO2e 5.04
MtCO2e
(energy
only)
MtCO2e : Metric Tonne (ton) Carbon Dioxide Equivalent
Source: http://www.theclimateregistry.org/ ; http://www.sdu.nhs.uk/sd_and_the_nhs/
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23. For whom
§ Still horrified by the waste he
regularly sees around him in
hospitals, kidney patient Mr
(Andrew) Williamson: “If
carbon reduction became all
pervasive in hospitals and
doctors’ surgeries, and if it was
in your face that they were
taking it really seriously, it
could have a transformative
effect on people, in the same
way it happened with smoking,
when doctors were leading that
change.”
Source: Moynihan R. The greening of medicine. BMJ. 2012;344(jan16 1):d8360-d8360. Available at: http://www.bmj.com/
content/344/bmj.d8360 ; http://sustainablehealthcare.org.uk/green-nephrology/news/2012/01/zero-waste-challenge-2012
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24. Catalyzed by…
§ “We aspire to provide health care
services in a manner that protects
and enhances the environment
and the health of communities now
and for future generations.”
§ “Climate change will cause health
effects that will directly impact
Kaiser Permanente’s ability to fulfill
our promise of quality affordable
care. We will take practical actions
to limit our emissions of
greenhouse gases and will help
reduce the carbon footprint of the
communities we serve.”
Vision
for
Environmental
Stewardship
&
Guideline
for
Climate
Change
Source: Kaiser Permanente Environmental Stewardship, Strategies, Principles, and Guidelines;
http://blog.epa.gov/blog/2009/10/15/healthy-health-care-leader-kaiser-permanente/ Ted Eytan, MD
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25. Catalyzed by…
§ “We aspire to provide health care
services in a manner that protects
and enhances the environment
and the health of communities now
and for future generations.”
§ “Climate change will cause health
effects that will directly impact
Kaiser Permanente’s ability to fulfill
our promise of quality affordable
care. We will take practical actions
to limit our emissions of
greenhouse gases and will help
reduce the carbon footprint of the
communities we serve.”
Vision
for
Environmental
Stewardship
&
Guideline
for
Climate
Change
Source: Kaiser Permanente Environmental Stewardship, Strategies, Principles, and Guidelines;
http://blog.epa.gov/blog/2009/10/15/healthy-health-care-leader-kaiser-permanente/ Ted Eytan, MD
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