Measuring and Managing: How One Doctor Made His Mark on Combating Climate Change in Health Care – National Academy of Medicine

When Dr. When Jonathan Perlin first learned about the impact of operational issues on the health care industry, he knew he had to do something about it—and he did, in a big way.

For Jonathan Perlin, being a doctor was a family affair. “As the first-born son of a doctor, really, the only question was what specialty would I choose,” he jokes. However, seriously, I grew up in a family that loves service, and so I called myself to go to the field where I can help others.” Some advice from family members along the way led him to a different path such as English and philosophy, though he said there wasn’t much question about which path he would ultimately follow. of work.

But it wasn’t until years later — when Perlin became the seventh President and CEO of the Joint Commission Enterprise in 2022 — that he began to focus specifically on sustainability and greenhouse gas reduction issues within the agency. of health care. At that time, the President of the National Academy of Medicine (NAM) Dr. Victor Dzau approached Perlin with a request that would lead him in a new direction: to serve as a member of the Steering Committee of the NAM Climate Collaborative, mainly to provide policy guidance. on strategic, regulatory, and metrics information for this step.

Perlin admits: “The truth of the matter is that until then, I didn’t know much about the impact of health care on the climate. But over the past few years, I’ve learned a lot about statistics related to this issue, and many of them are very scary.”

Some of those obvious statistics: If global health care were a country, that country would be the fifth largest emitter of greenhouse gases. The United States represents 27% of the world’s land area, and about 9% of the carbon footprint in the United States comes from the health sector.

“So, once you know that kind of information, it’s a bell you can’t ring,” says Perlin. “It becomes your personal and professional mission to make a difference and improve public health and care.” of individual patients. So, it would be unreasonable not to acknowledge the negative impact that health care has on the climate.”

“As the old saying goes, if you can’t measure it, you can’t manage it—and that’s certainly true when it comes to this great challenge of promoting sustainability in health care.” beauty.”

Perlin currently serves as co-leader of the Policy, Finance and Metrics Working Group of the NAM Climate Collaborative, alongside Center for Medicare and Medicaid Services (CMS) Innovation Center director Elizabeth Fowler and former director of CMS Don Berwick. In this role, he is charged with gathering experts to make those kinds of statistics—and their impact on the country and the world—better known.

“As the old saying goes, if you can’t measure it, you can’t manage it — and that’s certainly true when it comes to this great challenge of promoting health care sustainability,” Perlin says. “Being part of the Climate Partnership, it has been a great opportunity for me to be able to bring together experts to generate understanding to create policies and incentives to support the reduction of the combined carbon footprint of the health care sector. .footage.”

And while serving in this capacity, Perlin at the same time continues to strive for excellence in health care through the Joint Commission’s business. He explains that the overall vision of this organization is to allow all people to have access to the safest, highest quality, and highest quality health care at all levels.

“We have two jobs: first, enabling the highest quality of health care, but we also support the public’s trust that care is safe,” Perlin says. “We have launched what we call the HELP agenda, which is an acronym for Health Equity, Environmental Sustainability, Learning and the responsible use of AI, and Operational Partnership,” he explains. “The goal of the operation is to make the inspection process in hospitals and health care programs less efficient and more integrated in the process.”

Over the next ten years, Perlin notes that the United States has committed to reducing its greenhouse gas emissions by 50%; and by 2050, the Commission wishes to see that number be zero. Many participants in the Climate Partnership have also made this commitment to the White House Health Department.

Perlin also emphasizes that the priorities of the HELP agenda align well with NAM’s goals—not only in terms of environmental protection, but also in terms of learning.

“Our words in general are increasingly evidence-based, data-driven, and results-based,” he points out.

Perlin’s role with the NAM Climate Collaborative has proven to be a valuable experience in this regard. Clearly, it led to his belief that the Joint Commission’s business can help accelerate the transition to sustainable health care. What followed was the development of the Sustainable Healthcare Certification (SHC) program, which began in January 2024.

“With Collaboration, it was clear that once people understood the problem, they wanted to get involved,” Perlin says. But it was equally clear that this was a new issue. I often start lectures with this question: ‘How many of you have spent your academic and professional career studying climate change or climate change in relation to health care?’ In fact, the answer was none other than the experts gathered at NAM. So, we realized that the Joint Commission could be a way to accelerate sustainable health care. “

“What I care about is that people are motivated to take action, and the SHC Joint Commission really helps those who don’t have the resources to create a road map for their organization to take action.”

When it comes to why the Joint Commission created the SHC, Perlin says there are many answers.

“It’s a social justice issue, a health issue, a patient safety issue, a financial issue, and a community tolerance issue all at the same time,” he says. “Take, for example, the fact that 81 percent of primary care clinics have been closed for at least one day in the past three years—according to the Harvard Chan School of Public Health—due to inclement weather directly linked to climate change of heaven.” Perlin adds that the effects of climate change are contributing to changing disease patterns in the United States. a few years ago, he explains.

Because of these many different reasons for SHC’s importance, Perlin says his overall goal within the organization is clear.

“What I care about is that people are motivated to take action, and the SHC Joint Commission really helps those who don’t have the resources to create a road map for their organization to take action,” Perlin explains.

The SHC program requires participating hospitals and health systems to collect basic data on three types of greenhouse gases—things like energy use, greenhouse gas use, gasoline use of a carbon-based vehicle—and then create a plan to reduce them. The organization must demonstrate that sustainability is a strategic priority going forward. It has been proven that commitment to environmental improvement at the executive and governance levels is critical to the success of the organization, programs and initiatives. SHC organizations also undertake to review performance annually to make improvements in selected areas.

As Perlin notes, obtaining certification can help organizations in a number of ways. For one, doing so is consistent with their mission (ie, promoting public health). Certification also demonstrates a commitment to sustainability, which can help employers grow and retain their teams.

“It’s very important to follow today’s workforce,” says Perlin. “Doctors and junior staff really want a commitment to the environment.”

In addition, Perlin points out that efforts to promote sustainability are cost savings in the long run. “Organizations that have signed up to green energy coalitions have increased energy prices over the next decade, and we’ve seen a reported benefit from that,” he says.

As a way for interested parties to build resilience and implement sustainable healthcare practices, the SHC program is an important and timely initiative. The program is also an inspiring example of how the NAM Climate Collaborative’s network of peers, partners and organizations continues to raise awareness, share ideas, and inspire action.

Perlin explains: “NAM brought together a group of experts and an organization of the willing, and that organization of the willing cultivated more experts and they became willing partners.”

These committed partners work to grow the corporation in different ways. And the SHC program demonstrates the value of doing so.

“We are very excited and look forward to seeing progress not only with the Joint Commission and that program, but also with all the work of the NAM partners in terms of cooperation,” Perlin says.

As Perlin points out, organizations that participate in SHC can be motivated by many factors including concerns about health equity and social stability. They may also be attracted to financial incentives available under the Affordable Care Act that pay for infrastructure improvements or to support green energy.

“The good thing about it is, you don’t have to invent everything yourself. You can ask, borrow and steal best practices—and that’s what networking is all about.” which it is.”

But for Perlin, the reasons for intervention are organizational. And regardless of their goals – whether related to the environment, equity, or finance – interested parties can look to the Joint Commission’s SHC and NAM Climate Collaborative program for credible workers as they chart a path toward providing sustainable health care.

Looking to the future, Perlin emphasizes that he would like to see more legal standards adopted by the government related to sustainability in health care.

“In IT, there’s an old joke that says, ‘Aren’t values ​​wonderful? There are so many to choose from.’” Perlin laughs. But of course it’s a joke, because a standard isn’t a standard unless everyone accepts it. And the government, for example, has yet to publish clear standards for things like energy reporting for health care—but doing so would certainly eliminate a lot of confusion.”

And in the ongoing effort to promote health promotion efforts, Perlin notes that the importance of surrounding yourself with a peer support network cannot be underestimated. For example, NAM’s new Climate and Health Movement, which is open to membership, is an effective way to access valuable peer networks.

“The good thing about it is that you don’t have to invent everything yourself,” he says. You can borrow, borrow, and steal good habits—and that’s what networking is all about.