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Woernle A, Moore CM, Allen C, Giganti F. Footprints in the scan: reducing the carbon footprint of diagnostic tools in urology. Curr Opin Urol 2024; 34:390-395. [PMID: 38847801 PMCID: PMC11309339 DOI: 10.1097/mou.0000000000001196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
PURPOSE OF REVIEW There is an ever-growing focus on climate change and its impact on our society. With healthcare contributing a sizeable proportion of carbon emissions, the sector has a duty to address its environmental impact. We highlight the recent progress, current challenges, and future prospects for reducing the carbon footprint in diagnostic urology, specifically for imaging, without compromising patient care. RECENT FINDINGS The review is separated into four key areas of recent research: the design of a green radiology department, considering both infrastructural as well as behavioural changes that promote sustainability; individual scanners, where we provide an update on recent technological advancements and changes in behaviour that may enhance sustainable use; responsible resource allocation, where it is important to derive the maximal benefit for patients through the smallest use of resources; the recent research regarding single versus reusable urologic endoscopes as a case example. SUMMARY We offer an overview of the present sustainability landscape in diagnostic urology with the aim of encouraging additional research in areas where existing practices may be challenged. To protect the environment, attention is drawn to both more simple steps that can be taken as well as some more complex and expensive ones.
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Affiliation(s)
- Alexandre Woernle
- Faculty of Medical Sciences
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London
| | - Caroline M. Moore
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London
- Department of Urology
| | - Clare Allen
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Francesco Giganti
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
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Ghotra SS, Champendal M, Flaction L, Ribeiro RT, Sá Dos Reis C. Approaches to reduce medical imaging departments' environmental impact: A scoping review. Radiography (Lond) 2024; 30 Suppl 1:108-116. [PMID: 39146889 DOI: 10.1016/j.radi.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/17/2024]
Abstract
INTRODUCTION Global warming stands as a paramount public health issue of our time, and it is fundamental to explore approaches to green medical imaging departments/(MID). This study aims to map the existing actions in the literature that promote sustainable development in MID towards the promotion of environmental impact reduction. METHODS Following the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), this literature search was conducted on MEDLINE, Embase and CINAHL to encompass studies published after 2013. Combinations of keywords and relevant terms related to environmental sustainability, recycling, medical waste, and greening radiology were applied for this review. Three independent reviewers screened abstracts, titles, and eligible full-text. Disagreement was solved through consensus. RESULTS 38 out of 4630 articles met all inclusion criteria, and four additional articles were identified and added through reference search. A third of the studies included were published after 2022, and most were conducted in developed countries (36/41). Articles focused on computed tomography (9/41), magnetic resonance imaging (6/41), interventional radiology (4/41), conventional radiography (4/41), ultrasound (2/41), mixed modalities (10/41), or not applicable to an imaging modality (6/41). Four principal categories were identified to decrease ecological footprint: energy consumption, waste management, justification and environmental pollution. CONCLUSION To minimise the environmental impact of MIDs raising awareness and promoting education is fundamental. Examinations must be justified adequately, energy consumption must be reduced, and waste management practices need to be implemented. Further studies are required to prioritise the most effective strategies, supporting decision-making among stakeholders. IMPLICATIONS FOR PRACTICE Several strategies are already possible to implement to reduce the environmental impact of MIDs and improve the healthcare outcomes for patients.
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Affiliation(s)
- S S Ghotra
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland; Department of Radiology, Hospital of Yverdon-les-Bains (eHnv), 1400, Yverdon-les-Bains, Switzerland.
| | - M Champendal
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - L Flaction
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - R T Ribeiro
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - C Sá Dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
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Walters H, Bowden K, Limphaibool N. Reducing the carbon footprint of radiology through automatic workstation shutdown protocols. Clin Radiol 2024:S0009-9260(24)00412-4. [PMID: 39198110 DOI: 10.1016/j.crad.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/05/2024] [Accepted: 07/31/2024] [Indexed: 09/01/2024]
Abstract
AIM Climate change poses a major threat to human health, with significant contributions from healthcare systems, with the UK National Health Service (NHS) accounting for 4% of national CO2 emissions. Radiology departments, with high energy consumption from heating, ventilation, cooling (HVAC), and scanners, also contribute significantly. Workstations, though less power-intensive than scanners, are numerous and offer an avenue for emission reduction potential. This study investigates the impact of an automatic power-off/on protocol for radiology workstations at an acute hospital trust on energy consumption, carbon emissions, and financial savings. MATERIALS AND METHODS Data from 88 reporting workstations were collected on power usage, CO2 emissions, and the associated energy cost before and after implementing an automatic shutdown protocol, which ensured workstations were turned off out of hours and over weekends. RESULTS Average weekly workstation on-time fell from 148 to 75.5 hours, resulting in an annual energy saving of 17 MWh, equivalent to a reduction of 3.4 tonnes CO2 equivalent and a financial saving of £5000. No complaints or issues with workflow disruption were reported. CONCLUSION This intervention demonstrates a significant reduction in emissions and energy costs without workflow disruption, offering an easy and replicable sustainability measure for radiology departments. While savings are modest compared to HVAC and scanner emissions, the protocol's simplicity and effectiveness in addressing human factors in power management highlight its potential. Broader application across hospital networks could yield substantial environmental and financial benefits. These findings contribute to the ongoing efforts to improve sustainability within radiology and health care.
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Affiliation(s)
- H Walters
- Oxford University Hospitals NHS Foundation Trust, UK.
| | - K Bowden
- Oxford University Hospitals NHS Foundation Trust, UK
| | - N Limphaibool
- Oxford University Hospitals NHS Foundation Trust, UK
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Limphaibool N, Bowden K, Walters H. Shutdown protocols for IT-reducing energy waste in medical practice. BMJ 2024; 386:e079056. [PMID: 39079717 DOI: 10.1136/bmj-2023-079056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Affiliation(s)
| | - Kevin Bowden
- Oxford University Hospitals NHS Foundation Trust
| | - Huw Walters
- Oxford University Hospitals NHS Foundation Trust
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Pickles K, Haas R, Guppy M, O'Connor DA, Pathirana T, Barratt A, Buchbinder R. Clinician and health service interventions to reduce the greenhouse gas emissions generated by healthcare: a systematic review. BMJ Evid Based Med 2024:bmjebm-2023-112707. [PMID: 38782560 DOI: 10.1136/bmjebm-2023-112707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To synthesise the available evidence on the effects of interventions designed to improve the delivery of healthcare that reduces the greenhouse gas (GHG) emissions of healthcare. DESIGN Systematic review and structured synthesis. SEARCH SOURCES Cochrane Central Register of Controlled Trials, PubMed, Web of Science and Embase from inception to 3 May 2023. SELECTION CRITERIA Randomised, quasi-randomised and non-randomised controlled trials, interrupted time series and controlled or uncontrolled before-after studies that assessed interventions primarily designed to improve the delivery of healthcare that reduces the GHG emissions of healthcare initiated by clinicians or healthcare services within any setting. MAIN OUTCOME MEASURES Primary outcome was GHG emissions. Secondary outcomes were financial costs, effectiveness, harms, patient-relevant outcomes, engagement and acceptability. DATA COLLECTION AND ANALYSIS Paired authors independently selected studies for inclusion, extracted data, and assessed risk of bias using a modified checklist for observational studies and the certainty of the evidence using Grades of Recommendation, Assessment, Development and Evaluation. Data could not be pooled because of clinical and methodological heterogeneity, so we synthesised results in a structured summary of intervention effects with vote counting based on direction of effect. RESULTS 21 observational studies were included. Interventions targeted delivery of anaesthesia (12 of 21), waste/recycling (5 of 21), unnecessary test requests (3 of 21) and energy (1 of 21). The primary intervention type was clinician education. Most (20 of 21) studies were judged at unclear or high risk of bias for at least one criterion. Most studies reported effect estimates favouring the intervention (GHG emissions 17 of 18, costs 13 of 15, effectiveness 18 of 20, harms 1 of 1 and staff acceptability 1 of 1 studies), but the evidence is very uncertain for all outcomes (downgraded predominantly for observational study design and risk of bias). No studies reported patient-relevant outcomes other than death or engagement with the intervention. CONCLUSIONS Interventions designed to improve the delivery of healthcare that reduces GHG emissions may reduce GHG emissions and costs, reduce anaesthesia use, waste and unnecessary testing, be acceptable to staff and have little to no effect on energy use or unintended harms, but the evidence is very uncertain. Rigorous studies that measure GHG emissions using gold-standard life cycle assessment are needed as well as studies in more diverse areas of healthcare. It is also important that future interventions to reduce GHG emissions evaluate the effect on beneficial and harmful patient outcomes. PROSPERO REGISTRATION NUMBER CRD42022309428.
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Affiliation(s)
- Kristen Pickles
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
| | - Romi Haas
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michelle Guppy
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- School of Rural Medicine, University of New England, Armidale, New South Wales, Australia
| | - Denise A O'Connor
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Thanya Pathirana
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Griffith University School of Medicine and Dentistry, Gold Coast, Queensland, Australia
| | - Alexandra Barratt
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Healthy Environments and Lives (HEAL) National Research Network, Canberra, Victoria, Australia
| | - Rachelle Buchbinder
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Roletto A, Catania D, Rainford L, Savio A, Zanardo M, Bonfitto GR, Zanoni S. Sustainable radiology departments: A European survey to explore radiographers' perceptions of environmental and energy sustainability issues. Radiography (Lond) 2024; 30 Suppl 1:81-90. [PMID: 38996669 DOI: 10.1016/j.radi.2024.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/20/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024]
Abstract
INTRODUCTION The environmental impact of radiology and radiotherapy activities is influenced by the energy consumption of equipment, the life cycle of consumables, waste generation, and CO2 emissions caused by staff travel. This study aims to investigate radiographers' perception and knowledge of environmental sustainability issues. METHODS An online survey was created and distributed to European radiographers and therapeutic radiographers. The survey questions (n = 43) include demographic data; questions on their perceptions and actions regarding environmental sustainability in healthcare, energy consumption, emissions from staff travel, waste generation from radiological procedures; the role of radiographers in addressing sustainability issues within their departments. RESULTS A total of 253 responses were collected from 27 European countries. About their perception on sustainability issues, most participants considered environmental sustainability in healthcare as very important. According to 63.6% (n = 161) of respondents, the energy consumption of radiological equipment is the major source of environmental footprints from radiology activities. Additionally, 44.7% (n = 113) believe that conducting diagnostic examinations remotely could reduce environmental footprints from staff commuting About their actions at workplace, over 70% (n = 192) reported turning off devices after use. Attention to waste recycling is high, but limited to paper, plastic and glass. Contrast agents recycling procedures are implemented by 13% (n = 33). The absence or unawareness of environmental sustainability procedures in the workplace was reported by 66% (n = 167). Radiographers could play an active role in environmental sustainability programs for 243 (96.1%) participants. CONCLUSION This study provides a comprehensive overview of European radiographers' knowledge and perceptions concerning environmental sustainability issues. While radiographers recognize the importance of a green radiology department, significant gaps remain in their understanding of eco-friendly initiatives in radiology units' activities. IMPLICATION FOR PRACTICE Enhancing radiographers' skills with sustainability expertise could promote a greener culture within radiology departments.
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Affiliation(s)
- A Roletto
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Via Branze 38, 25123, Brescia, Italy.
| | - D Catania
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - A Savio
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Via Branze 38, 25123, Brescia, Italy.
| | - M Zanardo
- Radiology Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.
| | - G R Bonfitto
- Department of Information Engineering, Università degli Studi di Brescia, Via Branze 38, 25123, Brescia, Italy.
| | - S Zanoni
- Department of Civil, Environmental, Architectural Engineering and Mathematics, Università degli Studi di Brescia, Via Branze 43, 25123, Brescia, Italy.
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Rawashdeh M, Ali MA, McEntee M, El-Sayed M, Saade C, Kashabash D, Englend A. Green radiography: Exploring perceptions, practices, and barriers to sustainability. Radiography (Lond) 2024; 30 Suppl 1:62-73. [PMID: 38981301 DOI: 10.1016/j.radi.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/12/2024] [Accepted: 06/24/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION Previous research has delved into the attitudes and behaviors of diverse professions regarding environmental sustainability. However, there needs to be more research specifically targeting radiographers. This study aims to survey radiographers' perceptions, practices, and barriers to change concerning environmental sustainability in radiology. METHODS Institutional ethical approval was obtained (IRB-COHS-FAC-110-2024) and data collection was conducted using Google Forms (Google Inc., Mountain View, CA). The survey targeted 104 practicing radiographers across several countries. Questions were structured around five domains to gather insights into demographics, training in global warming and climate change, perceptions of sustainability and climate change, sustainability barriers, and current radiology practices on sustainability. Data analysis utilized descriptive and d inferential statistics. RESULTS One hundred and four radiographers completed the study. Females had a significantly higher attendance rate in environmental protection campaigns (P = 0.01). The majority of respondents (68%) believe in climate change's knowledge and impact on the natural world. Our survey findings demonstrate that 74% of respondents believe there's a need to improve sustainability practices. The most commonly used strategies to decrease energy consumption and emissions were low-energy lighting (60%), real-time power monitoring tools (41%), and energy-efficient heating systems (32%). A significant concern regarding sustainability emerges among respondents: time (50%) and lack of leadership (48%) are prevalent concerns among the identified barriers. CONCLUSION Participants are recognising the importance of environmental sustainability in radiology, but lack of leadership, support, authority, and facility limitations hinder their adoption. IMPACT ON PRACTICE Radiology must prioritize environmental sustainability by providing resources and training for radiographers and collaborating with healthcare professionals, policymakers, and environmental experts to develop comprehensive strategies for a sustainable healthcare system.
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Affiliation(s)
- M Rawashdeh
- Medical Imaging Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates; Faculty of Health Sciences, Jordan University of Sciences and Technology, Irbid, Jordan.
| | - M A Ali
- Medical Imaging Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - M McEntee
- The Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Cork, Ireland; Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - M El-Sayed
- Faculty of Applied Health Sciences Technology, Galala University, Suez, 43511, Egypt
| | - C Saade
- The Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Cork, Ireland
| | - D Kashabash
- Medical Imaging Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - A Englend
- The Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Cork, Ireland
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Bastian S, André E, Jesús FL, Doreen K, Yvonne K, Michael T, Rahel A KH, Tilo N. Assessing Environmental Sustainability in Dual-Energy CT: Exploring Energy Consumption and Ecological-Economic Impact in Low Utilization Times. Acad Radiol 2024:S1076-6332(24)00288-5. [PMID: 38806373 DOI: 10.1016/j.acra.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/05/2024] [Accepted: 05/05/2024] [Indexed: 05/30/2024]
Abstract
RATIONALE AND OBJECTIVES Within global sustainable resource management efforts, reducing healthcare energy consumption is of public concern. This study aims to analyze the energy consumption of three Dual-Energy computed tomography (DECT) scanners and to predict the power consumption based on scan acquisition parameters. MATERIALS AND METHODS This study consisted of two parts assessing three DECT scanners: one Dual-Source and two Single-Source DECT. In Part A, the energy consumption for various single- and DECT scans with different acquisition parameters using a chest phantom was measured. The measurements were compared to the calculated power consumption. In Part B, the energy consumption baselines during nonutilization states of the DECT devices: idle (ready to scan), low-power (incomplete shutdown), and system-off mode (complete shutdown) were measured. Descriptive statistics were used. RESULTS The phantom study revealed a positive correlation between measured and calculated energy consumption (r2 =0.82), except for single-source split-filter DECT acquisitions, indicating a relationship between scan parameters and energy consumption. The baseline study results showed a mean energy consumption of 2.6kWh/hour ± 1.34kWh in idle, 0.89kWh/hour ± 0.42kWh in low-power, and < 0.01kWh/hour ± 0.003kWh in the system-off state. The potential total annual CO2 savings for the assessed DECT scanners amounted to 3767kg CO2 (low power) and 5868kg CO2 (system off) compared to the idle state. Time-related calculations indicated energy savings starting after 5 min in low-power- and after 2 min in the system-off state. Therefore, switching off the scanner, even during shorter periods of non-utilization, can be efficient. CONCLUSION Our results emphasize a positive correlation between scan parameters and energy consumption in DECT. Complete shutdown of DECT devices can have a significant ecological-economic impact.
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Affiliation(s)
- Schulz Bastian
- Kantonsspital Baden AG, Department of Radiology, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Im Ergel 1, 5404 Baden, Switzerland (S.B., E.A., K.H.R., N.T.); University of Zurich, Department of Forensic Medicine Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland (S.B., T.M.)
| | - Euler André
- Kantonsspital Baden AG, Department of Radiology, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Im Ergel 1, 5404 Baden, Switzerland (S.B., E.A., K.H.R., N.T.)
| | - Fernández León Jesús
- Siemens Healthineers AG, Siemensstrasse 3, 91301 Forchheim, Germany (F.L.J., K.D.)
| | - Kraft Doreen
- Siemens Healthineers AG, Siemensstrasse 3, 91301 Forchheim, Germany (F.L.J., K.D.)
| | - Käser Yvonne
- PhysMed Consulting GmbH, Uetikon am See 8707, Switzerland (K.Y.)
| | - Thali Michael
- University of Zurich, Department of Forensic Medicine Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland (S.B., T.M.)
| | - Kubik-Huch Rahel A
- Kantonsspital Baden AG, Department of Radiology, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Im Ergel 1, 5404 Baden, Switzerland (S.B., E.A., K.H.R., N.T.)
| | - Niemann Tilo
- Kantonsspital Baden AG, Department of Radiology, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Im Ergel 1, 5404 Baden, Switzerland (S.B., E.A., K.H.R., N.T.).
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Kim HHR, Leschied JR, Lall N, Otero HJ, Kadom N. That's GROSS! Practical steps towards sustainability in pediatric radiology. Pediatr Radiol 2024; 54:1036-1039. [PMID: 38374438 DOI: 10.1007/s00247-024-05878-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/26/2024] [Accepted: 02/06/2024] [Indexed: 02/21/2024]
Affiliation(s)
- Helen H R Kim
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way NE, MA.7.220, Seattle, WA, 98105, USA.
| | - Jessica R Leschied
- Department of Radiology, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Neil Lall
- Department of Radiology and Imaging Sciences, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - Hansel J Otero
- Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
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Lojo-Lendoiro S, Rovira À, Morales Santos Á. Green radiology: How to develop sustainable radiology. RADIOLOGIA 2024; 66:248-259. [PMID: 38908886 DOI: 10.1016/j.rxeng.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/22/2023] [Indexed: 06/24/2024]
Abstract
The phenomenon of global warming due to the increased emission of greenhouse gases makes it necessary to raise public awareness about the importance of promoting sustainable practices. The field of radiology is not an exception, as it consumes a large amount of energy and resources to operate equipment and generate images. Green radiology is a sustainable, innovative, and responsible approach in radiology practice that focuses on minimizing the negative environmental effects of the technologies and procedures used in radiology. Its primary goal is to reduce the carbon, water and ecological footprint in our services based on four strategic pillars: decreasing energy, water, and helium usage; properly recycling and/or disposing of waste and residues (including contrast media); minimizing the environmental impact of ionizing radiation; and promoting eco-friendly radiology practices.
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Affiliation(s)
- S Lojo-Lendoiro
- Servicio de Radiodiagnóstico, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
| | - À Rovira
- Sección de Neurorradiología, Servicio de Radiodiagnóstico, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Á Morales Santos
- Servicio de Radiodiagnóstico, Hospital Universitario Donostia, San Sebastián, Spain
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Anneveldt KJ, Nijholt IM, Schutte JM, Hehenkamp WJK, Veersema S, Huirne JAF, Boomsma MF. Waste analysis and energy use estimation during MR-HIFU treatment: first steps towards calculating total environmental impact. Insights Imaging 2024; 15:83. [PMID: 38517607 PMCID: PMC10959896 DOI: 10.1186/s13244-024-01655-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/15/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVES To assess the environmental impact of the non-invasive Magnetic Resonance image-guided High-Intensity Focused Ultrasound (MR-HIFU) treatment of uterine fibroids, we aimed to perform a full Life Cycle Assessment (LCA). However, as a full LCA was not feasible at this time, we evaluated the CO2 (carbon dioxide) emission from the MRI scanner, MR-HIFU device, and the medication used, and analyzed solid waste produced during treatment. METHODS Our functional unit was one uterine fibroid MR-HIFU treatment. The moment the patient entered the day care-unit until she left, defined our boundaries of investigation. We retrospectively collected data from 25 treatments to assess the CO2 emission based on the energy used by the MRI scanner and MR-HIFU device and the amount and type of medication administered. Solid waste was prospectively collected from five treatments. RESULTS During an MR-HIFU treatment, the MRI scanner and MR-HIFU device produced 33.2 ± 8.7 kg of CO2 emission and medication administered 0.13 ± 0.04 kg. A uterine fibroid MR-HIFU treatment produced 1.2 kg (range 1.1-1.4) of solid waste. CONCLUSIONS Environmental impact should ideally be analyzed for all (new) medical treatments. By assessing part of the CO2 emission and solid waste produced, we have taken the first steps towards analyzing the total environmental impact of the MR-HIFU treatment of uterine fibroids. These data can contribute to future studies comparing the results of MR-HIFU LCAs with LCAs of other uterine fibroid therapies. CRITICAL RELEVANCE STATEMENT In addition to (cost-) effectiveness, the environmental impact of new treatments should be assessed. We took the first steps towards analyzing the total environmental impact of uterine fibroid MR-HIFU. KEY POINTS • Life Cycle Assessments (LCAs) should be performed for all (new) medical treatments. • We took the first steps towards analyzing the environmental impact of uterine fibroid MR-HIFU. • Energy used by the MRI scanner and MR-HIFU device corresponded to 33.2 ± 8.7 kg of CO2 emission.
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Affiliation(s)
- Kimberley J Anneveldt
- Department of Radiology, Isala Hospital, Dokter Van Heesweg 2, Zwolle, 8025 AB, The Netherlands.
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Dokter Van Heesweg 2, Zwolle, 8025 AB, The Netherlands
- Image Sciences Institute, Division of Imaging & Oncology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Joke M Schutte
- Department of Gynecology, Isala Hospital, Dokter Van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - Wouter J K Hehenkamp
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Sebastiaan Veersema
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Judith A F Huirne
- Department of Obstetrics and Gynecology and Amsterdam Research Institute Reproduction and Development, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dokter Van Heesweg 2, Zwolle, 8025 AB, The Netherlands
- Image Sciences Institute, Division of Imaging & Oncology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
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12
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Barloese M, Petersen CL. Sustainable health care: a real-world appraisal of a modern imaging department. Clin Imaging 2024; 105:110025. [PMID: 37989018 DOI: 10.1016/j.clinimag.2023.110025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/27/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
RATIONALE AND OBJECTIVES There is universal interest in increasing sustainability in health care, including in imaging. We studied and characterized energy consumption in a representative imaging department in Denmark to identify and quantify the effect of specific optimizations. METHODS Protocols and energy parameters for the three main scanner modalities along with supportive systems and workflows were monitored and scrutinized. Potential savings were measured and/or calculated. RESULTS Only few optimizations were identified at the protocol level. However, examination of usage patterns and cooling systems revealed numerous potential optimizations which fell into three categories. 1) Optimizations requiring minimal changes in installations or workflows, for example, reduction of bed-position time, 2) optimizations requiring altered work flows such as strict adherence to timed shut-down procedures and 3) optimizations requiring retro-fitting equipment, typically at considerable monetary expense, for example fitting variable flow control on pumps. The single biggest identified optimization was raising the temperature of the circulating cooling water. CONCLUSION This study highlights the complexity of increasing sustainability in health care, specifically in imaging. We identified multiple potential optimizations but also technical, monetary and organizational barriers preventing immediate implementation.
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Affiliation(s)
- Mads Barloese
- Centre for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, Kettegaards Alle 30, DK-2650 Hvidovre, Copenhagen, Denmark.
| | - Claus Leth Petersen
- Centre for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, Kettegaards Alle 30, DK-2650 Hvidovre, Copenhagen, Denmark
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13
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Wright KN, Melnyk AI, Emont J, Van Dis J. Sustainability in Obstetrics and Gynecology. Obstet Gynecol 2023; 142:1341-1346. [PMID: 37944151 DOI: 10.1097/aog.0000000000005435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/14/2023] [Indexed: 11/12/2023]
Abstract
Current practices in the U.S. health care industry drive climate change. This review summarizes the vast research on the negative health effects of the climate crisis on patients as relevant to obstetrics and gynecology. We further propose solutions to decarbonize operating rooms, labor and delivery units, and nurseries and neonatal intensive care units through evidence-based reduction in our single-use supply, energy, and water, as well as anesthetic gases and appropriate waste sorting.
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Affiliation(s)
- Kelly N Wright
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California; the Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics, Gynecology, and Reproductive Sciences, Pittsburgh, Pennsylvania; and the Department of Obstetrics and Gynecology, Columbia University Medical Center, and NewYork-Presbyterian Hospital, New York, and the Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
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14
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Mariampillai J, Rockall A, Manuellian C, Cartwright S, Taylor S, Deng M, Sheard S. The green and sustainable radiology department. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:21-26. [PMID: 37721584 PMCID: PMC10689521 DOI: 10.1007/s00117-023-01189-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 09/19/2023]
Abstract
As manmade climate change threatens the health of the planet, it is important that we understand and address the contribution of healthcare to global emissions. Medical imaging is a significant contributor to overall emissions. This article aims to highlight key issues and examples of sustainable practices, in order to empower radiologists to make a change within their department.
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Affiliation(s)
| | - Andrea Rockall
- Clinical Chair of Radiology, Department of Cancer and Surgery, Faculty of Medicine, Imperial College London, London, UK.
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15
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Anudjo MNK, Vitale C, Elshami W, Hancock A, Adeleke S, Franklin JM, Akudjedu TN. Considerations for environmental sustainability in clinical radiology and radiotherapy practice: A systematic literature review and recommendations for a greener practice. Radiography (Lond) 2023; 29:1077-1092. [PMID: 37757675 DOI: 10.1016/j.radi.2023.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Environmental sustainability (ES) in healthcare is an important current challenge in the wider context of reducing the environmental impacts of human activity. Identifying key routes to making clinical radiology and radiotherapy (CRR) practice more environmentally sustainable will provide a framework for delivering greener clinical services. This study sought to explore and integrate current evidence regarding ES in CRR departments, to provide a comprehensive guide for greener practice, education, and research. METHODS A systematic literature search and review of studies of diverse evidence including qualitative, quantitative, and mixed methods approach was completed across six databases. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and the Quality Assessment Tool for Studies with Diverse Designs (QATSDD) was used to assess the included studies. A result-based convergent data synthesis approach was employed to integrate the study findings. RESULTS A total of 162 articles were identified. After applying a predefined exclusion criterion, fourteen articles were eligible. Three themes emerged as potentially important areas of CRR practice that contribute to environmental footprint: energy consumption and data storage practices; usage of clinical consumables and waste management practices; and CRR activities related to staff and patient travel. CONCLUSIONS Key components of CRR practice that influence environmental impact were identified, which could serve as a framework for exploring greener practice interventions. Widening the scope of research, education and awareness is imperative to providing a holistic appreciation of the environmental burden of healthcare. IMPLICATIONS FOR PRACTICE Encouraging eco-friendly travelling options, leveraging artificial Intelligence (AI) and CRR specific policies to optimise utilisation of resources such as energy and radiopharmaceuticals are recommended for a greener practice.
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Affiliation(s)
- M N K Anudjo
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK
| | - C Vitale
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK; IRCCS San Raffaele Hospital, Milan, Italy
| | - W Elshami
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates
| | - A Hancock
- Department of Medical Imaging, University of Exeter, Exeter, UK
| | - S Adeleke
- School of Cancer & Pharmaceutical Sciences, King's College London, Queen Square, London WC1N 3BG, UK; High Dimensional Neurology, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - J M Franklin
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK
| | - T N Akudjedu
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK.
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16
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Sijm-Eeken M, Jaspers M, Peute L. Identifying Environmental Impact Factors for Sustainable Healthcare: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6747. [PMID: 37754607 PMCID: PMC10531011 DOI: 10.3390/ijerph20186747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023]
Abstract
The healthcare industry has a substantial impact on the environment through its use of resources, waste generation and pollution. To manage and reduce its impact, it is essential to measure the pressures of healthcare activities on the environment. However, research on factors that can support these measurement activities is unbalanced and scattered. In order to address this issue, a scoping review was conducted with the aims of (i) identifying and organizing factors that have been used to measure environmental impact in healthcare practice and (ii) analyzing the overview of impact factors in order to identify research gaps. The review identified 46 eligible articles publishing 360 impact factors from original research in PubMed and EBSCO databases. These factors related to a variety of healthcare settings, including mental healthcare, renal service, primary healthcare, hospitals and national healthcare. Environmental impacts of healthcare were characterized by a variety of factors based on three key dimensions: the healthcare setting involved, the measurement component or scope, and the type of environmental pressure. The Healthcare Environmental Impact Factor (HEIF) scheme resulting from this study can be used as a tool for selecting measurable indicators to be applied in quality management and as a starting point for further research. Future studies could focus on standardizing impact factors to allow for cross-organization comparisons and on expanding the HEIF scheme by addressing gaps.
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Affiliation(s)
- Marieke Sijm-Eeken
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Center for Sustainable Healthcare, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Monique Jaspers
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Center for Human Factors Engineering of Health Information Technology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Linda Peute
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Center for Human Factors Engineering of Health Information Technology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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17
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Desterbecq C, Tubeuf S. Inclusion of Environmental Spillovers in Applied Economic Evaluations of Healthcare Products. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023:S1098-3015(23)00106-7. [PMID: 36967027 DOI: 10.1016/j.jval.2023.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/14/2023] [Accepted: 03/15/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Climate change and environmental factors have an impact on human health and the ecosystem. The healthcare sector is responsible for substantial environmental pollution. Most healthcare systems rely on economic evaluation to select efficient alternatives. Nevertheless, environmental spillovers of healthcare treatments are rarely considered whether it is from a cost or a health perspective. The objective of this article is to identify economic evaluations of healthcare products and guidelines that have included any environmental dimensions. METHODS Electronic searches of 3 literature databases (PubMed, Scopus, and EMBASE) and official health agencies guidelines were conducted. Documents were considered eligible if they assessed the environmental spillovers within the economic evaluation of a healthcare product or provided any recommendations on the inclusion of environmental spillovers in the health technology assessment process. RESULTS From the 3878 records identified, 62 documents were deemed eligible and 18 were published in 2021 and 2022. The environmental spillovers considered were carbon dioxide (CO2) emissions, water or energy consumption, and waste disposal. The environmental spillovers were mainly assessed using the lifecycle assessment (LCA) approach while the economic analysis was mostly limited to costs. Only 9 documents, including the guidelines of 2 health agencies presented theoretical and practical ways to include environmental spillovers into the decision-making process. CONCLUSIONS There is a clear lack of methods on whether environmental spillovers should be included in health economic evaluation and how this should be done. If healthcare systems want to reduce their environment footprint, the development of methodology which integrates environmental dimensions in health technology assessment will be key.
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Affiliation(s)
- Charlotte Desterbecq
- Institute of Health and Society (IRSS), Université Catholique de Louvain (UClouvain), Brussels, Belgium.
| | - Sandy Tubeuf
- Institute of Health and Society (IRSS), Université Catholique de Louvain (UClouvain), Brussels, Belgium; Institute of Economic and Social Research (IRES), Université Catholique de Louvain (UClouvain), Brussels, Belgium
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18
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Guirado-Fuentes C, Abt-Sacks A, Trujillo-Martín MDM, García-Pérez L, Rodríguez-Rodríguez L, Carrion i Ribas C, Serrano-Aguilar P. Main Challenges of Incorporating Environmental Impacts in the Economic Evaluation of Health Technology Assessment: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4949. [PMID: 36981859 PMCID: PMC10049058 DOI: 10.3390/ijerph20064949] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Health technology assessment (HTA) provides evidence-based information on healthcare technology to support decision making in many countries. Environmental impact is a relevant dimension of a health technology's value, but it has been poorly addressed in HTA processes in spite of the commitment that the health sector must have to contribute to mitigating the effects of climate change. This study aims to identify the state of the art and challenges for quantifying environmental impacts that could be incorporated into the economic evaluation (EE) of HTA. We performed a scoping review that included 22 articles grouped into four types of contribution: (1) concepts to draw up a theoretical framework, (2) HTA reports, (3) parameter designs or suitable indicators, and (4) economic or budgetary impact assessments. This review shows that evaluation of the environmental impact of HTAs is still very incipient. Small steps are being taken in EE, such as carbon footprint estimations from a life-cycle approach of technologies and the entire care pathway.
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Affiliation(s)
- Carmen Guirado-Fuentes
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Santa Cruz de Tenerife, Spain
- Research Network on Health Services for Chronic Conditions (REDISSEC), Carlos III Health Institute, 28029 Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Santa Cruz de Tenerife, Spain
| | - Analía Abt-Sacks
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Santa Cruz de Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Santa Cruz de Tenerife, Spain
| | - María del Mar Trujillo-Martín
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Santa Cruz de Tenerife, Spain
- Research Network on Health Services for Chronic Conditions (REDISSEC), Carlos III Health Institute, 28029 Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Santa Cruz de Tenerife, Spain
- Institute of Biomedical Technologies (ITB), University of La Laguna, 38200 San Cristobal de La Laguna, Spain
| | - Lidia García-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Santa Cruz de Tenerife, Spain
- Research Network on Health Services for Chronic Conditions (REDISSEC), Carlos III Health Institute, 28029 Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Santa Cruz de Tenerife, Spain
- Institute of Biomedical Technologies (ITB), University of La Laguna, 38200 San Cristobal de La Laguna, Spain
| | | | - Carme Carrion i Ribas
- Research Network on Health Services for Chronic Conditions (REDISSEC), Carlos III Health Institute, 28029 Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Santa Cruz de Tenerife, Spain
- eHealth Lab Research Group, School of Health Sciences, Universitat Oberta de Catalunya (UOC), 08035 Barcelona, Spain
| | - Pedro Serrano-Aguilar
- Research Network on Health Services for Chronic Conditions (REDISSEC), Carlos III Health Institute, 28029 Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Santa Cruz de Tenerife, Spain
- Institute of Biomedical Technologies (ITB), University of La Laguna, 38200 San Cristobal de La Laguna, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Santa Cruz de Tenerife, Spain
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19
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Sumner C, Ikuta I, Garg T, Martin JG, Mansoori B, Chalian M, Englander BS, Chertoff J, Woolen S, Caplin D, Sneider MB, Desouches SL, Chan TL, Kadom N. Approaches to Greening Radiology. Acad Radiol 2023; 30:528-535. [PMID: 36114076 DOI: 10.1016/j.acra.2022.08.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/31/2022] [Accepted: 08/09/2022] [Indexed: 01/25/2023]
Abstract
The health care sector is a resource-intensive industry, consuming significant amounts of water and energy, and producing a multitude of waste. Health care providers are increasingly implementing strategies to reduce energy use and waste. Little is currently known about existing sustainability strategies and how they may be supported by radiology practices. Here, we review concepts and ideas that minimize energy use and waste, and that can be supported or implemented by radiologists.
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Affiliation(s)
- Christina Sumner
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Ichiro Ikuta
- Department of Radiology & Biomedical Imaging, Yale Program for Innovation in Imaging Informatics, Department of Radiology, Yale University School of Medicine, New Haven, CT; Mayo Clinic Arizona, Phoenix, Arizona
| | - Tushar Garg
- Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan G Martin
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina
| | - Bahar Mansoori
- Department of Radiology, University of Washington, Seattle, Washington
| | - Majid Chalian
- Department of Radiology, University of Washington, Seattle, Washington
| | - Brian S Englander
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jocelyn Chertoff
- Department of Radiology, Dartmouth Health and the Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Sean Woolen
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California
| | - Drew Caplin
- Division of Interventional Radiology, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, New Hyde Park, New York
| | - Michael B Sneider
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, Virginia
| | | | - Tiffany L Chan
- Department of Radiology, University of California, Los Angeles, California
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; Department of Radiology, Children's Healthcare of Atlanta- Egleston Campus, Atlanta, Georgia.
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20
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Climate toxicity: An increasingly relevant clinical issue in Cancer Care. J Cancer Policy 2023; 35:100410. [PMID: 36773799 DOI: 10.1016/j.jcpo.2023.100410] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/29/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
In recent years the terms time and financial toxicities have entered the vocabulary of cancer care. We would like to introduce another toxicity: climate toxicity. Climate toxicity is a double-edge sword in cancer care. Increasing cancer risk by exposure to carcinogens, and consequently increasing treatment requirements leads to ever growing damage to our environment. This article assesses the impact of climate change on patients, the climate toxicity caused by both healthcare workers and healthcare facilities, and suggests actions that may be taken mitigate them.
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21
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Shum PL, Kok HK, Maingard J, Zhou K, Van Damme V, Barras CD, Slater LA, Chong W, Chandra RV, Jhamb A, Brooks M, Asadi H. Sustainability in interventional radiology: are we doing enough to save the environment? CVIR Endovasc 2022; 5:60. [PMCID: PMC9703417 DOI: 10.1186/s42155-022-00336-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/31/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Healthcare waste contributes substantially to the world’s carbon footprint. Our aims are to review the current knowledge of Interventional Radiology (IR) waste generation and ways of reducing waste in practice, to quantify the environmental and financial impact of waste generated and address green initiatives to improve IR waste management.
Methods
A systematic literature search was conducted in July 2022 using the Medline and Embase literature databases. The scope of the search included the field of IR as well as operating theatre literature, where relevant to IR practice.
Results
One-hundred articles were reviewed and 68 studies met the inclusion criteria. Greening initiatives include reducing, reusing and recycling waste, as well as strict waste segregation. Interventional radiologists can engage with suppliers to reformulate procedure packs to minimize unnecessary items and packaging. Opened but unused equipment can be prevented if there is better communication within the team and increased staff awareness of wasted equipment cost. Incentives to use soon-to-expire equipment can be offered. Power consumption can be reduced by powering down operating room lights and workstations when not in use, changing to Light Emitting Diode (LED) and motion sensor lightings. Surgical hand wash can be replaced with alcohol-based hand rubs to reduce water usage. Common barriers to improving waste management include the lack of leadership, misconceptions regarding infectious risk, lack of data, concerns about increased workload, negative staff attitudes and resistance to change. Education remains a top priority to engage all staff in sustainable healthcare practices.
Conclusion
Interventional radiologists have a crucial role to play in improving healthcare sustainability. By implementing small, iterative changes to our practice, financial savings, greater efficiency and improved environmental sustainability can be achieved.
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22
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Woolen SA, Kim CJ, Hernandez AM, Becker A, Martin AJ, Kuoy E, Pevec WC, Tutton S. Radiology Environmental Impact: What Is Known and How Can We Improve? Acad Radiol 2022; 30:625-630. [PMID: 36400705 DOI: 10.1016/j.acra.2022.10.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/12/2022] [Accepted: 10/22/2022] [Indexed: 11/18/2022]
Abstract
The healthcare sector generates approximately 10% of the total carbon emissions in the United States. Radiology is thought to be a top contributor to the healthcare carbon footprint due to high energy-consuming devices and waste from interventional procedures. In this article, we provide a background on Radiology's environmental impact, describe why hospitals should add sustainability as a quality measure, and give a framework for radiologists to reduce the carbon footprint through quality improvement and collaboration.
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Affiliation(s)
- Sean A Woolen
- Department of Radiology and Biomedical Imaging, UC San Francisco, 505 Parnassus Ave, San Francisco California, 94117 (S.A.W., A.B., A.J.M.).
| | - Christine J Kim
- Department of Radiology, UC Los Angeles, Los Angeles California (C.J.K.)
| | - Andrew M Hernandez
- Department of Radiology, UC Davis Health, Sacramento California (A.M.H.)
| | - Amy Becker
- Department of Radiology and Biomedical Imaging, UC San Francisco, 505 Parnassus Ave, San Francisco California, 94117 (S.A.W., A.B., A.J.M.)
| | - Alastair J Martin
- Department of Radiology and Biomedical Imaging, UC San Francisco, 505 Parnassus Ave, San Francisco California, 94117 (S.A.W., A.B., A.J.M.)
| | - Edward Kuoy
- Department of Radiology, UC Irvine, Orange County California (E.K.)
| | - William C Pevec
- Department of Surgery, UC Davis Health, Sacramento California (W.C.P.)
| | - Sean Tutton
- Department of Radiology, UC San Diego, San Diego California (S.T.)
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23
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Lichter KE, Anderson J, Sim AJ, Baniel CC, Thiel CL, Chuter R, Collins A, Carollo E, Berg CD, Coleman CN, Abdel-Wahab M, Grover S, Singer L, Mohamad O. Transitioning to Environmentally Sustainable, Climate-Smart Radiation Oncology Care. Int J Radiat Oncol Biol Phys 2022; 113:915-924. [PMID: 35841919 PMCID: PMC10024638 DOI: 10.1016/j.ijrobp.2022.04.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/28/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Katie E Lichter
- Department of Radiation Oncology, University of California, San Francisco, California.
| | - Justin Anderson
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona
| | - Austin J Sim
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida; Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Claire C Baniel
- Department of Radiation Oncology, Stanford University, Palo Alto, California
| | - Cassandra L Thiel
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Robert Chuter
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Cancer Sciences, Faculty of Biology, Medicine and Heath, University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Amy Collins
- Health Care Without Harm, Reston, Virginia; Department of Emergency Medicine, MetroWest Medical Center, Framingham, Massachusetts
| | - Erin Carollo
- Loyola University Chicago-Stritch School of Medicine, Chicago, Illinois
| | | | - C Norman Coleman
- Radiation Research Program, National Cancer Institute, Bethesda, Maryland
| | - May Abdel-Wahab
- Division of Human Health, Radiation Oncology, International Atomic Energy Agency, Vienna, Austria
| | - Surbhi Grover
- Department of Radiation Oncology, University of Pennsylvania, Botswana-UPenn Partnership, Philadelphia, Pennsylvania
| | - Lisa Singer
- Department of Radiation Oncology, University of California, San Francisco, California
| | - Osama Mohamad
- Department of Radiation Oncology, University of California, San Francisco, California; Department of Urology, University of California, San Francisco, California
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24
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Brown MJ, Forster BB. Climate Change: How Radiologists can Help. Can Assoc Radiol J 2022; 73:456-457. [PMID: 34986669 DOI: 10.1177/08465371211064217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Maura J Brown
- Diagnostic Imaging, 8144BC Cancer, Vancouver, BC, Canada
| | - Bruce B Forster
- UBC Faculty of Medicine, Professor and Head, Department of Radiology, IOC Medical and Scientific Games Group, Canadian Radiologic Foundation, Vancouver, BC, Canada
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25
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Gendy D, Walters H, O'Mahony E, Zaman S. The scope for radiology to contribute to the NHS net zero target: findings from a survey of radiology staff in the UK. Clin Radiol 2022; 77:e667-e672. [PMID: 35688772 DOI: 10.1016/j.crad.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Abstract
AIM To assess attitudes towards the climate emergency among radiology staff and to identify current practices that may contribute towards the National Health Service (NHS) net zero target. MATERIALS AND METHODS An online survey of radiology staff was conducted assessing current attitudes to the climate emergency. Further questions focused on staff travel, home working, virtual conferences, and recycling. RESULTS Two hundred and forty-two responses were received from all staff groups within radiology. There were high levels of concern about the climate emergency among radiology staff. Active travel accounts for a relatively small proportion of commuting related to provision of radiology services. Some energy-saving measures are implemented commonly in radiology departments but these are likely to account for only a small proportion of energy use within a department. CONCLUSION There is significant scope for reducing the carbon footprint of radiology services by reducing travel, both for work and for radiology education. We discuss the potential for large savings related to energy-saving measures.
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Affiliation(s)
- D Gendy
- St Helens and Knowsley NHS Trust, Warrington Road, Prescot, L35 5DR, UK
| | - H Walters
- Oxford University NHS Trust, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - E O'Mahony
- Bristol Royal Hospital for Children, Paul O'Gorman Building, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - S Zaman
- St Helens and Knowsley NHS Trust, Warrington Road, Prescot, L35 5DR, UK.
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Schoen J, McGinty GB, Quirk C. Radiology in Our Changing Climate: A Call to Action. J Am Coll Radiol 2021; 18:1041-1043. [PMID: 33716017 DOI: 10.1016/j.jacr.2021.02.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/08/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Julia Schoen
- Department of Radiology, Wake Forest Baptist Health, Winston-Salem, North Carolina.
| | - Geraldine B McGinty
- Department of Radiology and the Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Cody Quirk
- Department of Radiology and Radiological Science, MUSC Health, Charleston, South Carolina
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Büttner L, Posch H, Auer TA, Jonczyk M, Fehrenbach U, Hamm B, Bauknecht HC, Böning G. Switching off for future-Cost estimate and a simple approach to improving the ecological footprint of radiological departments. Eur J Radiol Open 2021; 8:100320. [PMID: 33457469 PMCID: PMC7797527 DOI: 10.1016/j.ejro.2020.100320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 12/24/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Besides diagnostic imaging devices, in particular computed tomography (CT) and magnetic resonance imaging (MRI), numerous reading workstations contribute to the high energy consumption of radiological departments. It was investigated whether switching off workstations after core working hours can relevantly lower energy consumption considering both ecological and economical aspects. Methods Besides calculating different theoretical energy consumption scenarios, we measured power consumption of 3 workstations in our department over a 6-month period under routine working conditions and another 6-month period during which users were asked to switch off workstations after work. Staff costs arising from restarting workstations manually were calculated. Results Our approach to switching off workstations after core working hours reduced energy consumption by about 5.6 %, corresponding to an extrapolated saving of 3.2 tons in carbon dioxide (CO2) emissions and 2100.70 USD/year in electricity costs for 227 workstations. Theoretical calculations indicate that consistent automatic shutdown after core working hours could result in a potential total reduction of energy consumption of 38.6 %, equaling 22.2 tons of CO2 and 14,388.28 USD/year. However, staff costs resulting from waiting times after manually restarting workstations would amount to 36,280.02 USD/year. Conclusions Switching off workstations after core working hours can considerably reduce energy consumption and costs, but varies with user adherence. Staff costs caused by waiting time after manually starting up workstations outweigh energy savings by far. Therefore, an energy-saving plan with automated shutdown/restart besides enabling an energy-saving mode would be the most effective way of saving both energy and costs.
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Affiliation(s)
- L Büttner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Radiology, Germany
| | - H Posch
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Radiology, Germany
| | - T A Auer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Radiology, Germany
| | - M Jonczyk
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Radiology, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178 Berlin, Germany
| | - U Fehrenbach
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Radiology, Germany
| | - B Hamm
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Radiology, Germany
| | - H C Bauknecht
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Neuroradiology, Germany
| | - G Böning
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Radiology, Germany
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Hainc N, Brantner P, Zaehringer C, Hohmann J. "Green Fingerprint" Project: Evaluation of the Power Consumption of Reporting Stations in a Radiology Department. Acad Radiol 2020; 27:1594-1600. [PMID: 31843389 DOI: 10.1016/j.acra.2019.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/13/2019] [Accepted: 11/16/2019] [Indexed: 11/15/2022]
Abstract
RATIONALE AND OBJECTIVES To quantify the power or energy consumption of reporting stations in a radiology department and to consider a hypothetical scenario to reduce energy waste. METHODS We measured the energy consumption of 36 radiology reporting stations over a mean time frame of about 194 days and then extrapolated results to 1 year. Reporting stations were configured (by default) to enter a stand-by mode after 4 hours of inactivity. A hypothetical scenario was calculated in which stand-by was skipped and the reporting stations were shut down after 1 hour of inactivity. RESULTS Data from four stations was corrupted. The overall power consumption of the 32 remaining reporting stations was 53,170 kWh/a, equivalent to 12 family households (4500 kWh/a per household in Switzerland in 2014) or 97.2 barrels of oil. We identified three main power consumption patterns of the reporting stations: mainly off, mainly on, and always off. The on-mode consumption per year was 40,763 kWh/a, the stand-by consumption was 10,010 kWh/a, and the off-mode consumption was 2397 kWh/a. The reporting stations spent half of their on-mode time awaiting the initiation of stand-by, resulting in a wait-time consumption of 18,243 kWh/a. With the hypothetical scenario, we achieved an energy consumption saving of 23,692 kWh/a, a reduction of about 45% of the initial energy consumption, equivalent to 5 households or 40.8 barrels of oil consumed. CONCLUSION The power consumption of the reporting stations is not negligible. Reducing energy waste in the radiology department can be established through simple changes in device configuration which will simultaneously promote energywise habits. ADVANCES IN KNOWLEDGE Minor changes to the settings of the reporting stations in a radiology department can result in significant long-term energy savings and promote energy-wise habits.
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Affiliation(s)
- Nicolin Hainc
- Department of Medical Imaging, Division of Neuroradiology, Toronto Western Hospital, Toronto, Ontario, M5T 2S8, Canada.
| | - Philipp Brantner
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel/CH, Switzerland
| | - Caroline Zaehringer
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel/CH, Switzerland
| | - Joachim Hohmann
- Department of Radiology and Nuclear Medicine, Cantonal Hospital, Winterthur/CH, Switzerland; Medical Faculty, University of Basel, Basel/CH, Switzerland
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Martin MF, Maturen KE. On Green Radiology. Acad Radiol 2020; 27:1601-1602. [PMID: 32473782 DOI: 10.1016/j.acra.2020.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
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30
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Brassil MP, Torreggiani WC. Recycling in IR, What IR Specialists Can Do to Help. Cardiovasc Intervent Radiol 2019; 42:789-790. [DOI: 10.1007/s00270-019-02206-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/11/2019] [Indexed: 10/27/2022]
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Melício Monteiro EJ, Costa C, Oliveira JL. A Cloud Architecture for Teleradiology-as-a-Service. Methods Inf Med 2016; 55:203-14. [PMID: 26940635 DOI: 10.3414/me14-01-0052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 01/19/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Telemedicine has been promoted by healthcare professionals as an efficient way to obtain remote assistance from specialised centres, to get a second opinion about complex diagnosis or even to share knowledge among practitioners. The current economic restrictions in many countries are increasing the demand for these solutions even more, in order to optimize processes and reduce costs. However, despite some technological solutions already in place, their adoption has been hindered by the lack of usability, especially in the set-up process. OBJECTIVES In this article we propose a telemedicine platform that relies on a cloud computing infrastructure and social media principles to simplify the creation of dynamic user-based groups, opening up opportunities for the establishment of teleradiology trust domains. METHODS The collaborative platform is provided as a Software-as-a-Service solution, supporting real time and asynchronous collaboration between users. To evaluate the solution, we have deployed the platform in a private cloud infrastructure. The system is made up of three main components - the collaborative framework, the Medical Management Information System (MMIS) and the HTML5 (Hyper Text Markup Language) Web client application - connected by a message-oriented middleware. RESULTS The solution allows physicians to create easily dynamic network groups for synchronous or asynchronous cooperation. The network created improves dataflow between colleagues and also knowledge sharing and cooperation through social media tools. The platform was implemented and it has already been used in two distinct scenarios: teaching of radiology and tele-reporting. CONCLUSIONS Collaborative systems can simplify the establishment of telemedicine expert groups with tools that enable physicians to improve their clinical practice. Streamlining the usage of this kind of systems through the adoption of Web technologies that are common in social media will increase the quality of current solutions, facilitating the sharing of clinical information, medical imaging studies and patient diagnostics among collaborators.
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