Providence study explores better way to measure healthcare’s carbon footprint

RENTON, Wash. [Sept. 30, 2026] - There is no easy way to measure the carbon footprint of the products health systems purchase. A Providence study with medical technology company Becton Dickinson, or BD, offers the potential to make those measurements more accurate and meaningful.<_o3a_p>

The study, published recently in NEJM Catalyst, examined seven types of syringes Providence purchases in large quantities from BD. It traced carbon emissions associated with materials, manufacturing, packaging, transportation to several Providence hospitals, storage, use and disposal.<_o3a_p>

The work applied an accounting approach known as e-liabilities, which seeks to track carbon through a product's supply chain in a way similar to how financial costs are tracked in accounting.<_o3a_p>

"I think this was illuminating," said Beth Schenk, Ph.D., RN, chief environmental stewardship officer for Providence. "It's a small study, but that's what we need more of so the health sector can understand how to measure emissions in products and why it's so important."<_o3a_p>

The project grew from the work of Robert Kaplan and Karthik Ramanna, co-founders of the E-liability Institute, who developed the e-liabilities approach. Schenk knew of their work and connected with Kaplan and a BD sustainability leader at a conference in 2024. That conversation led to the pilot project with Providence.<_o3a_p>

The research addresses a fundamental challenge in healthcare sustainability: Health systems generally do not know the precise carbon footprint of individual products they purchase.<_o3a_p>

One commonly used approach is the spend-based method. Instead of measuring the actual emissions associated with a particular product, the method estimates emissions based on the amount of money an organization spends in a category. But those estimates can vary substantially depending on which category is selected.<_o3a_p>

In the syringe analysis, Schenk said, different applicable spend-based categories produced a wide range of estimates when compared with more precise product-level assessments across the three hospitals in the study.<_o3a_p>

That variability matters because more precise information could eventually help health systems make better-informed purchasing and sustainability decisions, Schenk said.<_o3a_p>

Getting there will not be simple. Suppliers often lack information about upstream raw materials, and proprietary materials and manufacturing processes can make assessing some products particularly challenging. <_o3a_p>

Still, the research yielded insights that could prove useful today. For example, Schenk said transportation represented a larger share of the syringes' carbon emissions than she expected, pointing to transportation efficiency as one potential area for additional attention.<_o3a_p>

For Providence, the next step is not necessarily another study. Instead, Schenk emphasized continuing to share the findings, participating in national supply chain and carbon discussions, encouraging group purchasing organizations and manufacturers to advance the work, and pursuing practical opportunities as they emerge.<_o3a_p>

A long-term goal of the project is "to develop and formalize the principles and practices that would enable the carbon footprint of all health systems and their suppliers to be measured accurately and then to be used to guide their decentralized decarbonization decisions." Providence is prioritizing efforts to amplify the need to assess supply chain emissions and use project data to help create a more environmentally conscious health sector.<_o3a_p>

The research is an early step, not a final solution. But it demonstrates something important: Health systems and suppliers can collaborate to move from broad estimates toward a clearer understanding of the carbon embedded in the products healthcare uses every day.<_o3a_p>

"More and more industries are using e-liability methodology now, but it's still a small percentage of industries that are counting carbon emissions for their products," Schenk said. "I see this as a hopeful way through the fog, and it's a viable method, especially for purchased goods."<_o3a_p>

About the Author

At Providence, we are called to care wisely for our people, our resources, and our earth. Further, Sisters of Providence that preceded us asked to be a model of good stewardship, so that we may demonstrate faithfulness to our values and that others may learn sound stewardship practices from us. The Providence Center for Environmental Stewardship is a virtual platform that serves as a central site to share many aspects of Providence's Environmental Stewardship initiative. This includes the three pillars of our environmental stewardship initiative - WE ACT (mitigation), We REACH (adaptation & resilience), and We SHARE (advocacy & leadership).