Advancing Healthcare Sustainability through Decision Support

OBJECTIVES: : Healthcare is a resource-intensive industry that contributes to pollution and environmental harm. We are in the early stages of understanding how decision support in healthcare can help address these challenges. This paper examines the role that decision support, at all levels of healthcare, could play in achieving more sustainable healthcare.

METHODS: : We synthesized the body of literature on healthcare, decision support, and environmental harm/climate change through two Medline searches. The searches focused on healthcare, decision support, informatics, climate change, sustainability, and related terms.

RESULTS: : The literature search yielded 238 papers related to climate change and informatics, but only six of those described clinical decision support systems. In order to describe the opportunities for decision support beyond the narrow corpus of six papers, we used the six priority sustainability areas identified by the Agency for Healthcare Research and Quality (AHRQ): energy, transportation, pharmaceuticals and chemicals, anesthetic gases, medical devices and supplies, and food.

CONCLUSIONS: : While there are significant opportunities to advance sustainability in healthcare, developed and implemented decision support is available for only a small fraction of them. Therefore, the informatics community worldwide should craft a comprehensive and systematic agenda for developing, implementing, and evaluating decision support tools and algorithms for sustainability. This agenda should address all emission scopes; be tailored to different stakeholders; relate sustainability to quality of care; include the development of centralized and accessible knowledge bases; work in concert with other ways to advance awareness of and engagement, including building a culture of sustainability; and encompass creating a worldwide informatics community to advance healthcare sustainability.