How EHRs can impact climate change

If you’ve ever stared at an Electronic Health Record (EHR) screen long enough to see your soul buffering,
you already know EHRs change a lot: how we chart, bill, message, prescribe, measure quality, andyesargue about
“required fields.” What’s less obvious is that EHRs also nudge the climate needle.

In this podcast-style deep dive (minus the awkward mic pops), we’ll explore how EHRs can reduce emissions
by cutting waste and travel, how they can increase emissions through data centers and devices, and what
“climate-smart health IT” looks like when it’s more than a buzzword on a conference tote bag.

Episode snapshot (aka: what you’ll be able to explain at lunch)

• Healthcare has a big carbon footprint, and “digital” is part of the solutionand part of the problem.
• EHRs can reduce emissions by preventing avoidable care, enabling telehealth, and shrinking paper-heavy workflows.
• EHRs also have a footprint from data storage, computing, AI, networking, and device lifecycles.
• The best outcome: use EHRs to decarbonize care while making the EHR itself cleaner and leaner.

Why climate belongs in the same conversation as care

The healthcare sector exists to protect healthyet it also contributes to pollution that harms health.
In the U.S., estimates commonly place healthcare at roughly 8.5% of national greenhouse gas emissions.
That’s not a rounding error; it’s a “we should probably talk about this” number.

Here’s the twist: healthcare emissions aren’t just from hospital boilers and ambulance fleets. A large share is tied to
electricity, purchased goods, services, and supply chainsoften called “Scope 2” (electricity) and “Scope 3” (everything
upstream and downstream).

EHRs sit in the middle of this system. They’re the operating system for modern care: what gets ordered, repeated,
canceled, mailed, scheduled, routed, documented, and audited. That means EHRs can influence emissions in two ways:
(1) the emissions from the computing itself, and (2) the much bigger downstream emissions from care delivery decisions.

How EHRs can reduce emissions (without hugging a tree in the waiting room)

1) Fewer miles, fewer emissions: telehealth + patient messaging + smart scheduling

The cleanest trip is the one you don’t takeespecially when the visit is mostly education, medication adjustment,
symptom review, or test results. When patients avoid travel, the carbon savings can be meaningful at scale.

EHR-enabled virtual care (video visits, asynchronous messaging, e-consults) can reduce emissions tied to
patient travelparticularly in specialties that historically required long drives, parking garages, and the
ceremonial purchase of an overpriced latte.

Practical example: a cardiology clinic shifts routine follow-ups for stable patients to telehealth and uses the EHR
portal for vitals logs (blood pressure, weight) and symptom check-ins. Patients avoid a 40-mile round trip, the clinic
reduces no-show risk, and clinicians still catch early decompensation because the data arrives continuously instead of
only on appointment day.

2) Less paper, printing, and physical storage (the “goodbye, basement chart dungeon” effect)

Digital records reduce dependence on paper charts, faxed documents, mailed reminders, printed after-visit summaries,
and repeated copying/scanning cycles. Is the world saved because we stopped printing 12-page discharge instructions
that nobody reads? Not by itself. But across large systems, reducing paper-intensive workflows cuts procurement,
transport, and waste.

The trick is avoiding “digital plus paper” (where you run an EHR and print everything “just in case”). If your
clinic still prints the same forms because “that’s how we’ve always done it,” you’re not paperlessyou’re paper-tolerant.

3) Fewer duplicate tests through interoperability and better information flow

Duplicate imaging and labs don’t just waste money; they waste energy, materials, and time. When an EHR can reliably
retrieve prior results (and clinicians trust that data), repeat testing can dropespecially for common scenarios like
“I can’t find the last CT” or “the outside lab results didn’t make it.”

Climate-friendly care often looks suspiciously like good care: right test, right time, right patient, once.
Interoperability, health information exchange, and strong results viewing workflows all help.

4) Clinical decision support (CDS) that nudges toward low-carbon, high-value care

Not all care pathways carry the same carbon intensity. Some choiceslike selecting a less resource-intensive diagnostic
approach when clinically appropriatecan reduce emissions without changing outcomes. EHR-based CDS can support this by:

• Flagging low-value repeat labs (e.g., daily tests without clinical indication).
• Highlighting guideline-concordant alternatives (when appropriate) that avoid unnecessary imaging.
• Prompting medication choices that reduce waste (right quantity, right refills, fewer abandoned scripts).
• Encouraging outpatient pathways that prevent avoidable admissions.

This is where humor meets reality: the EHR pop-up can be annoying, but a well-designed nudge can also prevent
“because it’s Monday” testing habits that quietly scale into massive footprint.

5) Better chronic disease management = fewer emergencies (and fewer carbon-heavy episodes)

Acute care is resource intense. If EHR analytics and workflows help keep diabetes, heart failure, COPD, and hypertension
better controlledthrough outreach lists, remote monitoring integrations, medication reconciliation, and closed-loop
follow-uphealth systems may reduce emergency visits and admissions that carry higher emissions per episode.

Example: a population health dashboard identifies heart failure patients with rising weight trends and missed diuretic
refills. The care team intervenes early via portal messaging or a nurse call, avoiding an ED visit and a carbon-heavy
hospitalization. That’s a clinical win that also happens to be a climate win.

6) Smarter supply and medication workflows: less over-ordering, less expiration, less trash

A surprising amount of healthcare waste comes from “just in case” purchasing and supplies expiring on shelves.
When EHR documentation is linked to inventory and charge capture, leaders can forecast usage patterns more accurately,
reduce overstock, and target high-waste areas.

This isn’t glamorous. It’s basically “data-driven not-hoarding.” But it can reduce the hidden emissions embedded in
manufacturing, shipping, refrigeration, and disposal.

How EHRs can increase emissions (because the cloud is still on Earth)

1) Data centers and electricity demand

EHRs live on serverswhether on-premises, in a colocation facility, or in the public cloud. Computing requires
electricity, and electricity has an emissions profile that depends on the grid and the provider’s energy choices.

Data centers are becoming a bigger slice of U.S. electricity demand. That matters for EHRs because healthcare is a
24/7 industry, and health data storage tends to grow forever (healthcare’s favorite word is “retain”).

2) “More data” isn’t always “better”especially when it’s redundant

EHR ecosystems generate a lot of “data exhaust”: duplicate documents, repeated CCDAs, old images stored in multiple
repositories, and logs that nobody reviews until something breaks. If your strategy is “keep everything, everywhere,
forever,” your carbon footprint will quietly do the same.

Climate-smart data practice doesn’t mean deleting clinical records recklessly. It means governance:
what needs to be stored at high availability, what can be archived, what can be deduplicated, and what data flows can be streamlined.

3) AI and heavy compute inside the EHR

AI can reduce clinician burden and improve triagebut large-scale AI also increases compute demand. If your EHR adds
multiple AI tools that run constantly (summaries, coding, risk prediction, ambient documentation), it may increase
energy use. The goal is not “no AI,” it’s “use AI where it replaces larger waste” (avoidable admissions, redundant work,
unnecessary testing) and run it efficiently.

4) Device lifecycle and e-waste

EHR rollouts can trigger waves of device purchases: workstations, tablets, scanners, printers (yes, still), and network gear.
Hardware has embodied emissions from manufacturing and shipping, plus disposal impacts. Short refresh cycles can turn
“digital transformation” into “landfill acceleration.”

The practical playbook: making EHRs climate-positive

Step 1: Measure what you can (and don’t fake precision)

Start by mapping what parts of your digital stack you control:
on-prem server rooms, cloud contracts, colocation arrangements, end-user devices, and printing.
For electricity-based emissions, organizations often use standardized emission factors to estimate footprint.

Your goal isn’t perfect measurement on day one. Your goal is a baseline you trust enough to guide decisions:
“If we move workloads, compress storage, reduce printing, and improve telehealth workflows, do emissions go down?”

Step 2: Pick the “big levers” inside the EHR

The biggest climate impact is often not the serverit’s the care pattern the EHR enables. Look for:

• Travel reduction: expand appropriate telehealth, e-visits, and asynchronous follow-up.
• High-value care nudges: reduce low-value repeat testing and unnecessary imaging when clinically appropriate.
• Transitions of care: close follow-up loops to reduce avoidable readmissions.
• Medication efficiency: reduce abandoned prescriptions and improve adherence workflows.
• Supply waste: connect documentation to inventory signals to reduce expiration and over-ordering.

Step 3: Make the computing cleaner and leaner

• Right-size infrastructure: don’t overprovision “just because.” Measure actual utilization.
• Improve storage hygiene: deduplicate, archive intelligently, compress where safe, and retire unused systems.
• Choose efficient hosting: if you use colocation or cloud, ask for energy efficiency practices and credible sustainability reporting.
• Optimize workflows: reduce unnecessary clicks and reworkinefficiency wastes human time and compute time.

Step 4: Design climate-smart telehealth (not just “telehealth exists”)

Telehealth doesn’t automatically reduce emissions if it simply adds visits instead of replacing them.
Build protocols that define:

• Which visit types are appropriate for virtual-first pathways.
• How remote monitoring data enters the EHR without creating alert fatigue.
• How to avoid “double documentation” across systems.
• When in-person care is necessary (and how to schedule efficiently when it is).

Step 5: Governance: the boring superhero of sustainability

Create a small cross-functional group (clinical ops + informatics + IT infrastructure + sustainability) with permission to:

• Prioritize EHR optimization work that reduces waste and emissions.
• Set data retention and storage policies that are clinically safe and operationally rational.
• Evaluate new digital tools for net impact (does this reduce downstream emissions or just add compute?).
• Track a few metrics over time (printing volume, virtual visit substitution rates, repeat testing rates, storage growth, server utilization).

“Podcast mode”: talking points you can read out loud

Cold open

“We talk about healthcare and climate like they’re separate topics. But healthcare is part of the emissions storyand
health IT is part of the healthcare story. So if you’ve ever yelled at an EHR, congratulations: you’re already emotionally prepared
for climate strategy.”

Segment: EHRs reduce waste

“The EHR can prevent duplicate testing, support telehealth, and improve chronic disease management. Those things reduce
unnecessary resource use. In other words: fewer miles driven, fewer avoidable admissions, fewer ‘why did we order this again?’ moments.”

Segment: EHRs have a footprint

“Data lives somewhere. Servers use electricity. Devices get replaced. And the explosion of AI tools adds compute demand.
A climate-smart EHR strategy means cleaning up the computing and using the EHR to steer care toward high-value pathways.”

Segment: What should leaders do on Monday?

“Pick two levers: one clinical (like reducing unnecessary repeat labs) and one technical (like storage governance or efficient hosting).
Measure, improve, repeatlike quality improvement, but your outcome is also fewer emissions.”

Quick FAQ

Do EHRs automatically help the climate because they’re “paperless”?

Not automatically. They can reduce paper, but they can also increase compute demand and device turnover.
The climate impact depends on implementation: workflow, substitution (virtual vs in-person), and infrastructure choices.

Is telehealth always greener?

Often, travel avoidance can lower emissionsespecially for longer trips. But if telehealth becomes an extra visit
instead of replacing an in-person visit, the net benefit shrinks. Design matters.

What’s the simplest EHR-related climate win?

Reduce avoidable duplication: tests, visits, printing, and rework. It’s not flashy, but it scales.

Experience-based notes from the field (composite stories, 500+ words)

The best lessons about EHRs and climate don’t come from a glossy brochure. They come from the day-to-day “why is this so hard?”
moments. The stories below are composites drawn from commonly reported implementation patterns across health systems
(so: real-world flavored, without pretending one clinic’s chaos is everyone’s chaos).

Story #1: The rural specialty clinic that discovered travel was the biggest “hidden emitter.”
A multi-site system noticed that specialty follow-ups (cardiology, endocrinology, oncology) created a steady stream of long drives.
They assumed the main problem was “access,” but an analyst also asked, “How many miles are we generating per month?”
The EHR team did something surprisingly low-tech: they used appointment ZIP codes and clinic locations to estimate travel distance.
Then they built a virtual-first pathway for stable follow-ups and results reviews, with clear rules:
new concerning symptoms = in-person, stable follow-up = video, medication check = asynchronous portal plus vitals upload.
Within a few months, clinicians reported fewer no-shows, patients reported fewer lost workdays, and the system started to see
a measurable drop in total travel miles. The funny part? The biggest friction wasn’t technologyit was habit. Once the care teams
trusted that virtual visits weren’t “lower quality by default,” the workflow stuck.

Story #2: The hospital that cut printing by changing one default.
Another organization rolled out the patient portal, but printers still ran like it was 2006. After-visit summaries printed automatically.
Lab instructions printed “just in case.” Reminder letters printed because the template had always been there. The sustainability lead begged
for a printing reduction project and got… a committee. Progress was slow until an informatics nurse asked,
“What if we just change the default to not print, and allow exceptions?” They added a quick EHR prompt:
print only if the patient requests paper or lacks portal access. They also trained front desk staff to offer portal enrollment at check-in.
Printing volume dropped fast. Staff joked they could finally hear themselves think because the printers weren’t screaming all day.
The key lesson: climate wins often look like boring configuration changes paired with respectful workflows for patients who need paper.

Story #3: The “duplicate labs” problem that turned into a quality project.
A quality team suspected daily labs were overused on certain inpatient units. Instead of shaming clinicians, they built visibility.
The EHR team created a dashboard showing repeat lab patterns and added a gentle ordering nudge:
“A similar test was ordered within the past 24 hoursreview results before reordering.” They also worked with physician champions to define
when daily labs were appropriate. Over time, unnecessary repeats decreased. Clinicians didn’t feel policed; they felt supported.
The sustainability angle was a bonus: fewer tubes, fewer reagents, fewer courier movements inside the hospital, and less downstream waste.
The key lesson: when “green” aligns with “high-value,” it stops being a moral lecture and becomes a clinical improvement.

Story #4: The cloud migration that didn’t magically solve anythinguntil governance showed up.
One health system moved analytics workloads to the cloud expecting instant sustainability gains. Instead, storage growth accelerated because it was
“easy” to keep everything, in multiple copies, across multiple environments. Costs rose, and nobody could clearly explain what data lived where.
They fixed it by creating a data retention policy, tagging datasets by purpose (clinical, billing, research, audit), and enforcing archiving rules.
Only then did the cloud environment become both cheaper and more efficient. The key lesson: the cloud is not a compost binyou can’t just dump
everything in and expect it to become environmentally friendly.

Put together, these stories point to a surprisingly hopeful conclusion: EHR-driven climate action is mostly the same work as good operational work
fewer unnecessary steps, smarter pathways, and systems that respect both people and resources. The climate benefit is real, but it tends to appear
when teams stop asking, “How do we bolt sustainability onto the EHR?” and start asking, “Where is waste hiding in plain sight, and how can the EHR help us remove it?”

Wrap-up

EHRs aren’t climate villains or climate heroesthey’re climate influencers (and not the fun kind that gets free skincare).
Used thoughtfully, EHRs can reduce travel, prevent duplicate care, support chronic disease control, and cut paper-heavy workflows.
Used carelessly, they can drive storage bloat, unnecessary compute, and device churn.

The sweet spot is “climate-smart health IT”: cleaner infrastructure plus better care pathways.
If you’re recording a podcast episode on this topic, your closing line can be simple:
the EHR should help patients breathe easierand not just because it finally stopped freezing.