Sustainability in Healthcare for Patient Earth (ft. Andy Draper)

Thanks for tuning to Digital Voices Podcast, where we chat digital transformation challenges and opportunities across healthcare and life sciences. And now your host, Ed Marx.

Ed here, so happy to have you again talking Digital Voices and a new topic for us, which is on sustainability. And there's no one better to talk about healthcare, tech, and sustainability than my friend Andy Draper. Andy, welcome to Digital Voices.

Hey, Ed, good to talk to you again. Thank you.

I love this topic because frankly, I was pretty ignorant when it came to sustainability. Obviously, I know about sustainability, the whole concept and why it's important and things like that, but I never really dug deep into it at all. In fact, I'm totally honest with you, I sort of like Whatever. And since I've been speaking with you about this, cuz I've always respected you. So when we got together and I learned more about what you're doing, which is why you're our guest, we did some videos together, which I'm gonna put in the show notes. So if you missed our videos, we did some YouTube ed talks on these, on this topic, sustainability, and there's a lot of great information there as well. So anyways, we've known each other for a while. So good to have you. But Andy, the most important thing people wanna know, Other than sustainability is what songs are on your playlist?

I love it. Well, look, we're recording this in early April and this economy and this world's pretty crazy. And so what I've gone back to are the songs that have comforted me when I was growing up in a similar time, but it's in the early '80s. So I've been listening to playlists from my Apple Music from '78, '79, '80, '81, '82. Because I, and I, the reason I'm doing that is because that period of time was crazy also. And there were energy issues. There was the oil embargo. We had a change of presidents, interest rates for home ownership. I remember my folks were, got a house in Wichita, Kansas with 10% mortgages.

Yeah.

And during that whole time, I was just a young teenager, but these songs were important to me. You know, Hall and Oates. Gosh, listen to Culture Club on the way in. So I'm really dating. Dating myself. During that time, that music was important to me and it was soothing. And I'm going back now to my comfort music, as all of us do, and I'm listening to it. And I— and, and the point is, is that we will get through this too. It's going to look different. Those were happy times for me because of my music and my friends like yourself. And so I go back now to those and I'm like, we're going to do this. It's going to be okay. We're going to get through it. It will get better. And it's very, uh, up— I look at it from an uplifting perspective. Optimistic.

Yeah. No, that's a good point. Music can certainly do that. And that's why I really appreciate music. And yeah, I remember the same time period actually. I think we're probably in the same age group and remember what was going on with the economy, things like that, even though I was like a high schooler. Right. And yeah, I, but I, but I do remember that well. What about life message and mantra? Are there sort of words that lit— you live by or help guide you?

That's a good one. Perseverance is important, I think, right now in all areas of my life personally. There's massive change happening in healthcare with Medicaid cuts, potential Medicare reimbursement cuts. The stock, the investment portfolios are going down. We just went through this during the pandemic a few years ago. It will get better. So I think perseverance is important. The other thing, Right now is I'm exercising more because it changes my— I go out for short runs. I'm not a long-distance endurance person like you, Ed. I'm always amazed at your stories, but I'll do a lot of short runs, 20-minute, 30-minute runs, and it improves my mindset. It gives, you know, I feel better afterwards. Whatever I was worried about when I started, it goes away and it's outdoors. It's springtime. It's It's beautiful. And so, uh, that's what I'm doing more now.

Yeah, no, I love it. Yeah. And it, I always say it doesn't matter what you do, whether you run or bike or whatever, as long as you're doing something. So whatever people are comfortable with. But let's talk more about you. Like, who are you? What is your story? Tell us about your life growing up. So I, I heard Wichita already. So yeah, tell us, where were you born and just sort of how things were?

The, uh, so I'm a second-generation hospital administrator. My, uh, my father and mother were both in healthcare. I, I grew up, Moving around a little bit, but was born in Lawrence, Kansas, Jayhawks, and then ended up going through elementary, junior, and senior high school in Wichita, Kansas, which I consider my hometown. Then got a master's degree from University of Kansas as well. Did some consulting, strategic planning consulting for a big firm in Chicago. I remember that very vividly. Worked Did some entrepreneurship initiatives too. In grad school, I was an intern for Senator Nancy Kassebaum's Health Policy Initiative, and that was during Clintoncare, which is a long, long time ago. But then went out to rural western Kansas to be a leader of a hospital network because that's where the actions were. And then went to a physician-owned health plan, then went to consulting. And I did that to put it all together. I purposely wanted to learn The provider side, which I knew, the rural side, and then I went to the payer side. So it was a physician-owned HMO, then went to Chicago Tiber Group, and then after that went to Cerner. And the reason I went to Cerner is years ago, the capital investments were changing. So they started investing in EMRs. Remember that term?

Yeah.

And I love technology. That's where I really found, you know, How to communicate into boards and C-levels, and then been a CIO in HCA for a long time. I also teach. I love the kids and the students this time are really bright, and I teach at the University of Denver in their health informatics program.

Wow, that's amazing. Yeah, you have an incredible background, incredible career as a CIO, and I think all of those early experiences you were describing really helped set the foundation. Yeah. So you mentioned being a professor, but you also have some other passions. So you started a couple of different organizations, Green CIO, and I'm not sure, tell me how to pronounce—

Oh, Scion60. So I'll tell you about that. In my career path, I've intentionally taken jobs that have me look at the whole picture. So I went to policy in the US Senate for a summer program. Then I went and went to rural, then helped build a network of hospitals and clinics, then went to the payer side. So I can see how all those pieces go in. Then I went to the consulting side because it's the strategy that pulls it all together. Then knowing that technology was in its infancy in healthcare, went to the technology side. And then went back into the provider side and I brought all that together. And I, several years ago, there was a book written by Bill Gates and it's called How to Avoid a Climate Disaster. And I really recommend it for folks who are interested in sustainability and Earth. And he's a technologist and he's an optimist. And the answer is everything. We need to do everything. We need to leave coal behind, but we need natural gas to transition. We need nuclear. We need to reduce energy usage across the board. We need more renewables. And so as somebody who's built technology, I'm like, what can I do? And so I started a company called Sion 60, and it's S-I-O-N 6-0. And the name is the last 4 letters of emission, carbon emissions, think pollution. So S-I-O-N, and 60 is 60 months. And the brand promise is really to take a complex topic like sustainability and carbon emissions and energy reduction and put it into a business case. Because, Ed, as you know, as CIOs, our job is to take complex problems that involve multiple departments and go to CFOs and CEOs and say, this is how it all fits together. And yes, there is an ROI. And so, that's the vision. And we have a few clients. I built software based on international standards. I won't bore you with, but— Really, it's to make it easy and have a profit motive for the healthcare system to do the right thing, which is reduce pollution, be sustainable, reduce energy use and waste, reduce waste that's produced in the ORs and things like that.

Yeah, and like I admitted in the beginning, I really didn't understand how profound this all was in terms of the amount of waste that takes place, but also, and you clearly point this out, and I want to talk a little bit about your book now. You point this out, you know, in your materials that you make available, like here's some easy ways that you could take action now. So it's not like these things that are so massive to try to execute that you'll never do 'em, but it's super, super practical. But I don't wanna give too much away here. Let's, let's go into the book, Patient Earth: How Hospitals Can Profit from Sustainability. I love the title because not only are you doing good for the earth, But you can actually profit from this, which we're all looking to do, right? The last thing we want to do is continue to add expense. So what led you to write this book?

Well, you were a big inspiration for this, Ed. I've read the books that you've written, and my goal was to create a graphic-oriented book, and you can get it on the website. It's free. It's, uh, sion60.com, and just go to resources, Patient Earth, Sion 60 Patient Earth. You can type that in your browser. It's very graphical-oriented. It has references. But the goal was for the, just like you said, the occasionally interested person who is busy, who understands sustainability as a simple concept, but like wants to understand how to bring it all together. And for a hospital in particular, hospitals produce 9% of the pollution in the United States. So if you're a hospital person listening, or even a technology person who sells to hospitals listening, Your industry produces 10% of the waste in your community. 10% of the waste that's happening right now has come from hospitals. If the United States healthcare industry was its own country, it would be the 5th largest producer of pollution and carbon emissions in the planet. And that's after US and China and Russia. We would be that. So that's how important it is. I have a PhD from public health from the University of Texas, and it's in the mission of hospitals. In public health, the hospital is a provider to go into the community to provide care, to keep the population well, to fix broken bones and cancer and diseases. And part of that mission is to do no harm. That's the Hippocratic Oath physicians take. And so it's in the mission of the hospitals To reduce pollution because there's an adverse environmental impact, asthma, all, you know, waste, air pollution, all that impacts our population and our patients, and that's not good. And so how do we take that big picture concept, boil it down to a hospital, and then particularly for hospital board members like yourself and for hospital, busy hospital executives like COOs and CFOs, CEOs, chief medical officers, what can they do? And the answer is there's a lot. And so we wanted to put all that into a really short, easy-to-read book with lots of pictures. And that's what we did with Patient Earth. It's free and it's for anybody. And I hope folks just take it. It takes probably 5 to 10 minutes to kind of click through it and get the big picture.

And like he said, where you can get it, scion360.com. We'll also put that all in the show notes so people don't have to write this down in case you're running or Jogging or whatever. So you have 3 key tools in there. And going back before I go there, the graphical interface is awesome, right? It makes it easy to read. And then I feel like I could almost cut and paste and use it for PowerPoints that I need to do to get the approvals to move forward. But you provide 3 key tools. And so I wanna break each one of these down with you. And again, this gives someone reason to go and look at the book themselves. Carbon EMR. Tell us about what the Carbon EMR is.

So Carbon EMR is an environmental record. And as a healthcare technologist, I built this tool based upon international standards called the Greenhouse Gas Protocol. The Joint Commission has a sustainability protocol that they're encouraging hospitals to do. The EPA has sources. And so It's built like an EMR. It has a tab on the left-hand side. You can put in the different data points you need. We can do interfaces and things, but it's structured to build the organization, build your governance model, build your ROI module, build the projects that you want. We have 80+ projects ready to go. We can build automatic calculations of energy efficiency opportunities for hospitals. Those are In the facilities department, they're called retrofit projects. We look at anesthesia gas, we look at fleet fuels, you know, trucks and cars and tractors and helicopters and ambulances and supply chain. 40% of a hospital's carbon footprint, carbon emissions footprint, comes from things they buy. Because if you think about a hospital, it's a building with concrete and glass where humans use technologies, and then we're just constantly using supplies. And so supply chain is huge. Investments is another thing to look at. There's an argument out there that says no hospital owns tobacco stock anymore, and it's an open question of whether a hospital should be owning a coal factory, a piece of coal. So how do you take all those different components, which cross many different departments— facilities, investments, finance, anesthesia, OR— And put them all together so it's easily managed. And that was our goal. And it's really taken the EMR metaphor from healthcare and putting it into a sustainability approach.

Yeah, I love that. And again, a really easy-to-use tool that someone else put all the hard work into developing and is available for individuals. And something you said, Andy, reminded me, I was just returning from Australian Healthcare Week. which is sort of their HIMSS equivalent, if you will. And on the showroom floor, it's completely different than what you find in the West. And they have vehicle fleets, as an example, that are all EV. And it took me a while to get it, but it really is about sustainability. 'Cause they're like, look, you've got these giant fleets of all these vehicles and you're burning all these fossil fuels. And if you go to this sort of technology, you know, you can make an impact. So, It's just kind of interesting. Maybe they're a little bit ahead of us in the West where they're already doing a lot, you know, on the showroom floors, introducing these kind of more sustainable technologies, if you will. So the second—

yeah, go ahead. Just on that real quick, my friend Nick Watts, who's a physician who's also over the England UK National Health Service, he's an ED physician, he's over sustainability. They're encouraging their hospitals to buy electric ambulances. There's all these different things out there. And so as a CFO, it's like, oh my God, I don't know how to fix this. I don't know how to measure it. CFOs wanna measure. And that's what we built in there. And then the other thing that reminds me of is there's an oft-quoted statement says, the future is here, it's just not evenly distributed.

Right.

You're smiling. You hear that one? And so the answer is, as we come out, going back to the '80s comfort songs, We're gonna come out, we're humans and we're Americans and we're capitalists and we're gonna come out of this. And as we rebuild our infrastructure, sustainability's gonna be a core pillar. The people who are 40 years old and less, this is absolutely an existential thing they worry about.

Yeah.

And building this into the operations is important. And in order to do that, you need technology to make it easy. And then you need to aggregate all these different things like, well, where do you go buy an electric ambulance? And how do we look at renewable aviation fuel? And so we tried to put it in there at a low cost. And for all our CIO friends who are out there, this is a fraction of the cost of Epic. It's probably one day's support of Epic.

Right. Yeah. Yes. Yeah. It's definitely a great tool. I was always looking for those sort of tools like these. Hey, what are some free or low-cost tools I can leverage that have immediate impact? And this is certainly one. One of them. And, you know, to your point that you were also making, Andy, and you touched on the Joint Commission earlier, this is now going to become and is becoming, you know, part of what they look at. And they've got a big drive on sustainability as well, because this is the future and it's now.

Yeah.

So, definitely want to jump right on it. The other second tool in the book is a sample of 75 to 80 projects you can initiate Day one. So, it's not like this is such an esoteric problem that you're gonna have difficulty figuring out what to do. There's so much low-hanging fruit. Can you just talk maybe about one or two of them?

Sure. So, it's like a model. The EMRs, when you buy an electronic medical record or you're implementing, we all remember those days early on, you want content. You need the pharmacy data, you need the order sets, you need the physician note templates, you need the nursing note documents. You need the decision support alerts. And so we built that into the software. So here's some projects. The first one I always encourage is start a workgroup. It doesn't have to be the C-suite. They're probably too busy, but you can find people. Nurses are fantastic human beings and they're the best workaround artists on the planet. Physicians are also engaged. The National Academy of Medicine and a lot of subspecialties. There's the Medical Society Consortium on Climate and Health. It's a lot, but a lot of words there, but every medical specialist society has a climate sustainability initiative going on. Anesthesia's big. There's a drug that is used in anesthesia from a long, long time ago. It's called desflurane. When you— anesthesia comes as a vial, as a liquid, it's gasified, and then the human breathes it out during the course of surgery. As that goes out, it filters through the air system and goes out into the planet. And it's very toxic. It's very potent. You don't need to use desflurane. All the anesthesiology groups across the world, Australia and New Zealand are leaders on this, have eliminated it. It's also the most expensive. And so that's one of the things too, Ed, is what some of these things are polluting and expensive. And just having those in the projects are important. Another thing is green ICU. So no, no surprise to folks who know hospitals, the ICU is the most resource-intensive area in a hospital along with surgery. Put together an ICU group, the ICU director, couple interested nurses, there's hospitalists out there. I just wrote a paper with the Society of Critical Care Medicine, a lot of smart hospitalists on how to green the ICU. And our benchmark for that was a great Australian physician in New Zealand who have done a lot of this. So, green ICU, green OR, green ED, putting sustainability into your purchasing contracts. We look at your top 50 things that a hospital buys and the top 50 vendors. And between the top 50 products and the top 50 vendors, you've probably got 80% of what a hospital buys.

Yeah.

You can go to them and say, hey, we're about ready to buy this. What's your carbon footprint? There's a whole company, a wonderful company called LaForma, who does renewable surgery gowns. So you don't need to have single use. So all these things you could do. There's old boilers and chillers. We worked with our utility and found that there's a dimmer switch, it's called a variable frequency device. You put that on a blower and a fan and it saves the energy. And so there's all these little things that you can do. Bring it together in a, in a single database with a single project plan and really go after it.

Yeah. And I think the third thing that's sort of a key tool in Patient Earth: How Hospitals Can Profit from Sustainability is how to please the CFO. But I think it's really an amalgamation of what we just spoke about, right? It's like we all know that ultimately you have to get the CFO before you do any sort of project and, you know, get the funding and approval. But everything you just talked about from the Carbon EMR as the tool, the sample of these ready-to-go projects could actually not just reduce costs, but improve profitability. So, right. How do you build the case for the CFO?

Absolutely. And it's in the quality department now too. Like, I've never met a quality director who didn't need extra credit with the Joint Commission. I mean, everybody wants And so that's a way to do it. And there's 5 different metrics that the Joint Commission wants. There is ROI all over these hospitals in windows, old boilers, chillers, air handling equipment. Most of the electricity in a hospital is used by pushing air around and keeping it cool. And there's lots of inefficiencies there. And surfacing those are important and then allocating money. And the great thing about the ROI for this is these hospitals are built to last a very, very long time, right? The hospitals near Akron, Summa, built a long time ago, also going to stay around for a long time. So once you do the investment, you know, like $10,000 for this dimmer switch I was talking about, that's going to have a payback for a long time.

Yeah.

And so these are, it's a no-brainer. I think the last thing is in the environment we're in. With Medicaid reimbursement cuts coming, they've said they don't want to change the benefits. So that means, you know, benefits times price equals total expense of an insurance program. If benefits are going to stay the same, then Medicaid reimbursement may decrease. And all these hospital systems, as you know, being a board member, are living on very thin margins. And so every little bit helps. So if you can go and reduce, eliminate desflurane and get a couple wins in the facility, and get your OR teams engaged, that can add up. That can save jobs. These are about job-saving initiatives that are very low cost and long-term ROI. So I'm very excited about, as the health system comes out of these next few years, this will be a pillar that will be part fulfilling the mission and creating margins and profit.

Yeah, I love this. As you said, both from a board perspective, as a practitioner, as a CEO or any member of the C-suite, and most importantly, any member of society, right? The Habits Work in Healthcare being the 9%, you know, the 9% in America of the waste comes from hospitals, comes from the health systems. That's truly a remarkable number. And I think it is incumbent upon us to take action and you make it super, super easy and simplify everything. So thank you for doing that. And again, in the show notes, we'll put access to the book. Access to the website, previous videos that we've done together on this super important topic. Let's finish off with leadership. So obviously you've got this great career going, Andy, and you've done a lot of different things. That's one of the takeaways is that it's good to have a diversity of experience like someone like yourself. What else would you say to listeners that are maybe, you mentioned 40-year-olds earlier, maybe they're directors today, aspire to be a CIO like yourself. What's one or two things in addition to sustainability and making sure that that becomes central to any sort of go-forward actions? What are one or two things that they might want to think about as they look to develop their skills and to become a member of the C-suite?

Well, relationships. And you talked about this, Ed, when you and I saw each other and you presented this whole Colorado Statewide Association. It was a great presentation. It was— your presentations are amazing. They're Single photos, which is the best practice, and then you tell the story. And so much today are little simple messages on Slack team rooms. You know, there's lots of team rooms out there. There's text messages, there's emails, but, you know, talking to a human being, not just for the social benefit and the human and the psychology benefit, but understanding their problem. Like, Somebody emailed me last week and said, how do I get this through? I'm like, wait a minute, we got to stop and take a step back. Here's the 2 big hurdles you need to do. You don't need to worry about the legal piece now. You need to worry about these, getting these people. I didn't know that. And so I think we're just running and we're so distracted that with overwhelming inputs, just monstrous inputs and volume every day, that slowing down and relationships are key. It's still the way that humans advance in society, the way we develop and mature and grow. And so I would just say for the folks that are building their career, have strong relationships. And even if it's for people you don't know, or if you're a department director and you're like, gosh, I want to meet the CEO because I want to be a CEO one day, just put a 15-minute hold on her calendar. Just 5 minutes or find her at the elevator and just say, hey, I'm Andy Draper and I'm very interested in being a CEO. I know you're busy. Here's a couple things I'm working on. Thank you. Those relationships are key.

No, I love it. That is sage advice. Andy, this has been a great conversation. Everything from late '70s, early '80s music, the whole mantra around perseverance, especially given all the activities that are going on today that we find ourselves in and society and economy and things like that. And then from your career, it was great. You, you started off, you know, in policy and working rural and then working systems, working payers, consulting, tech provider, a great example of someone with a broad experience and then came in to focus it once they honed in on the tech aspect of it. And we talked a lot about your book, Patient Earth: How Hospitals Can Profit from Sustainability, the 3 key tools, lots of content, and then ended with leadership. Is there something that we missed or anything you wanna double down on? I leave you with the last word.

Thanks for all your leadership and what you've done in this industry and your presentations. I just love them all. I would just say that everyone has a common patient. It's patient Earth. And everyone has a responsibility to enjoy and keep this planet for our grandchildren and their grandchildren and to enjoy it now.

Yeah.

So healthcare folks, your number one patient is patient Earth. Go out there, find a couple projects to do, grab a friend. We're going to do this.

Love it. Andy, thank you for being our guest on Digital Voices.

Thank you.

Thank you for listening to Digital Voices podcast with Ed Marx. If you enjoyed this episode, subscribe on your preferred streaming service and leave a rating and review. And most importantly, thanks again for listening.