When sustainability became a business strategy for healthcare

At this year’s CleanMed 2026, I had the privilege of hosting a conversation on behalf of Philips that brought together three people with distinct vantage points on this shift: Cristina Indiveri, VP of Core Tenet Programs and Spend Management at Vizient; John Vu, VP of Strategy for Community Health at Kaiser Permanente; and Dr. Reed Omary, Professor of Radiology and Biomedical Engineering at Vanderbilt University. Although each viewed the problem from a different lens, they kept arriving at the same conclusion: sustainability can’t be treated as a separate category that competes with cost or quality. It must be part of how value is defined.

“Sustainability delivers on the triple bottom line,” Indiveri says. “It shows improvements in human health, cost savings, environmental health, and then efficiency and resiliency.” The short version, as she put it: “As long as it’s integrated as a strategic business imperative, not as a siloed side project” it can be a genuine force multiplier for better care. It’s a deceptively simple reframe, and a consequential one.

For years, calling a hospital “sustainable” meant it had a composting program and turned off the lights when nobody was looking. Those things still matter. But the more meaningful shift is happening somewhere else entirely – in procurement strategy, technology decisions, supply chain design and care delivery models.

The argument goes something like this: health systems are being squeezed from every direction. Costs are climbing. Supply chains remain unpredictable. Communities face compounding health risks from pollution, extreme heat and economic stress. Leaders are expected to do more with less, which remains everyone’s least favorite impossible assignment. In that environment, sustainable practices aren’t a feel-good add-on. They’re a practical lever for reducing waste, lowering total costs and building organizations that hold together when disruption arrives (which it most certainly always does).

The risk is treating sustainability as its own silo, where it tends to lose every budget conversation. When it gets baked into how value is defined in the first place – sitting inside the same conversation as finance, patient outcomes and operational risk – it stops competing and starts contributing.

Philips has been explicit about this integration through its 2030 Impact Ambitions, which include improving 2.5 billion lives by the end of the decade, 400 million of them in medically underserved communities, while cutting scope 1 and 2 emissions by 90%, reducing scope 3 by 42% and reaching net-zero by 2045. [1] The ambition behind those numbers is to demonstrate that access to care, emissions reduction, circular design and responsible supply chains aren’t separate missions. They’re the same mission, described from different angles.

The most practical sustainability conversation in healthcare right now is happening in procurement.

Medical equipment is expensive, resource-intensive and rarely evaluated for what it truly costs across a full lifecycle. The sticker price is the easy part. The harder calculation involves energy consumption, maintenance demands, consumables, service requirements, downtime risk, disposal and waste handling – everything that follows the purchase order but rarely appears on it.

Dr. Omary puts the distinction plainly: “Price is not the same thing as cost,” he says. “The moment we shift from thinking about price to thinking about cost, we open up so many new opportunities for sustainability without actually needing to use that word.” That reframe, he argues, changes the entire procurement conversation.

MRI upgrades is one of his go-to examples. Extending the working life of expensive imaging equipment can widen patient access, reduce demand for new materials, cut carbon impact and save money at the same time. Upgrading the scanner with new technology while preserving the existing magnet, reduces costs compared with replacement, keeps high-quality technology in service and useful materials out of the waste stream. At that point, the more sustainable decision and the smarter financial decision are the same decision.

Total cost of ownership (TCO) helps procurement teams look beyond the purchase price and consider the full cost of a product over its lifecycle, including energy use, maintenance, service, downtime, disposal and end-of-life options. Philips has built this thinking into its circular portfolio: refurbished long-lifetime equipment, product take-back programs, upgrade pathways and designs built explicitly for longevity, all of which keep quality technology in service rather than replacing it earlier than needed.

Indiveri is a strong advocate for scaling this approach beyond individual health systems. When hospitals, suppliers and group purchasing organizations share what really works – procurement criteria, supplier expectations, lifecycle assessment methods and measurement frameworks – sustainable practices move much faster from pilot projects to standard operations. “There are incredible case studies and best practices found in pockets throughout the country, throughout the globe,” she says. “Now it’s about leaning in, collaborating, sharing those, operating and leading differently so that we can scale and innovate together.”

Sustainability conversations in healthcare often drift toward the operational (what a building consumes, what a supply chain emits). Those are real concerns. But they can obscure something more fundamental: the conditions that shape human health long before anyone enters a clinical setting.

Vu is direct about this connection. “You all know the interconnection of environmental degradation leads to more harmful health effects,” he says. “That’s everything from our waste, the toxicity, our emissions…and these are all connected to things like respiratory disease, cardiovascular disease.” But knowing the link exists isn’t enough. “Yes, they’re connected,” he adds, “but you have to be very intentional about that.” Policies, processes and purchasing decisions all need to be deliberately designed around them, not left to chance.

He also draws a connection that’s easy to miss. Value-based care and sustainable care are, at their core, asking the same questions. Both aim to reduce harm and prevent unnecessary illness. Both measure success by long-term outcomes rather than short-term transaction volume. “Value-based care is sustainable care,” Vu says – a line he credits to a colleague and has made his own.

Regional collaboration is where that logic leads. Many sustainability challenges are simply too large for any single institution to solve alone. Waste infrastructure, transportation emissions, supplier networks, climate risk and community health needs all spill across organizational boundaries. Vu is candid about the gap. “In Northern California, in Denver Metro, we have a bunch of providers dealing with waste streams in single ways,” he says. “We can actually come together, understand and learn better – and we’re just not.”

His ask is pointed: health systems in the same region should be pooling knowledge, coordinating infrastructure and preparing together for climate disruptions instead of running parallel solo efforts that duplicate both the work and the cost.

Artificial intelligence has arrived in the sustainability conversation with considerable fanfare and some genuinely important caveats. The opportunities are real. AI can sharpen procurement decisions, model sustainability trade-offs, anticipate supply chain disruptions and help organizations act earlier on patterns that would otherwise stay invisible until they became problems.

Philips offers a concrete example in MR SmartSpeed, an AI-enabled imaging tool that can accelerate scan speeds by up to a factor of three while cutting power consumption per patient scan by roughly 53%. [2] Faster scans improve patient throughput and reduce exam stress. Lower power consumption shrinks the environmental footprint per exam. In a high-volume imaging department, those gains quickly add up.

But AI also carries obligations that often get underemphasized in the enthusiasm. Dr. Omary has introduced the concept of “healthy AI” to directly address this — a framework asking whether AI, as it reshapes care delivery, might quietly create new problems while solving old ones. He wants healthcare leaders to think beyond the clinical applications everyone celebrates and ask harder questions about the infrastructure behind them: “How do we make the process of using AI not use as many resources, water, energy? How do we involve communities in the build out of data centers?” For him, the stakes are especially high in healthcare. “According to Pew Research, the place that the American population trusts AI the most is actually in healthcare [3],” he says. “We cannot squander that.”

None of that is an argument against AI. These tools can help healthcare become smarter, more efficient and more accessible but only when built and deployed with intention. Without it, the risk is real: impressive systems that consume too many resources, widen existing gaps or solve problems nobody actually had. Healthy AI keeps its focus where it belongs – better care, better outcomes and the responsible use of everything it takes to get there.

There’s a version of the sustainability conversation that gets so absorbed in carbon accounting and circular design that it forgets to ask who, exactly, is being served. That version produces metrics that look impressive and miss the point.

Sustainability in healthcare has to include whether people can receive timely, quality care. Vu is clear-eyed about the two-sided obligation: the interconnectedness of environmental harm and poor health outcomes is well established but so is the risk of sustainability work that loses sight of the people it’s meant to serve. A health system that cuts its emissions while failing to reach underserved communities hasn’t solved the problem. And one that expands access with no regard for resource use, environmental impact or long-term resilience is building on an unstable foundation. Both dimensions need to hold at once.

Philips has been translating this dual commitment into concrete programs – bringing vital care across 38 provinces in Indonesia [4], advancing stroke care in Ukraine [5], developing maternal care innovations and providing personalized cardiovascular guidance through HeartPrint in India. [6] These aren’t side projects to the sustainability agenda; they are the sustainability agenda, expressed as the kind of care that reaches people who need it most.

Circularity supports this, too, in ways that often go unrecognized. When circular models, like refurbishment, take-back and longevity-focused design, reduce the cost of high-quality technology, they make that technology more accessible in settings where capital budgets are thin.

Healthcare already has the tools, strategies and partnerships needed to make care more resilient, more efficient and more accessible. The gap is integration.

Sustainability built into core operations changes what health systems can achieve. That means bringing sustainability criteria into procurement decisions alongside quality and cost, evaluating technology on total cost of ownership rather than purchase price, prioritizing circular models where they make clinical and financial sense, and collaborating regionally on challenges too large to solve institution by institution.

It also means holding AI to a standard of efficiency, accessibility and genuine usefulness rather than assuming innovation is inherently sustainable. And it means remembering what all three experts kept returning to: that reducing pollution and waste is, at its core, a health intervention. As Indiveri put it, “sustainability improves upstream drivers of health – decarbonization practices reduce pollution, asthma and cardiovascular events and harmful chemicals of concern in procurement, which unfortunately are linked to endocrine disruptors and cancers.” Vu made the same case from a systems level, noting that hospitals are “big polluters” whose emissions directly connect to respiratory and cardiovascular disease in the communities around them. Reducing that harm isn’t a secondary benefit of sustainability work. It is the work.

The most actionable version of this is also the simplest: start where decisions are already being made. Your next procurement evaluation, your next technology planning cycle, your next supplier conversation – those are the places where sustainability either becomes the default or gets deferred again. The levers are already in your hands.

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