AMDR Fall 2023 Reprocessing Newsletter

Reprocessing has been a “best kept secret” for most of my professional career. For over 20 years, we’ve focused on the tremendous cost savings opportunity reprocessing offers. But the urgent need to build stronger, more resilient supply chains and reduce greenhouse gas emissions has fueled clinician and healthcare provider interest in maximizing their medical device reprocessing programs. Our inboxes and voicemails are filled with journalists, policymakers, and healthcare thought leaders wanting to learn more. This makes for truly exciting work here at AMDR.

In the last quarter, news outlets covered the UK’s incredible commitment to achieve net zero at the NHS in part with reprocessing; U.S. provider group Kaiser Permanente focusing on reprocessing as part of its commitment to reducing greenhouse emissions; and the National Academy of Medicine leveraging its reputation to advise listeners on a webinar to expand the use of reprocessed devices.

Our support is behind the scenes, working with those afforded public speaking opportunities, helping journalists, and presenting to prestigious organizations – often privately – to answer questions and convert more thought leaders into reprocessing advocates.

But we still have work to do. AMDR is working hard to encourage policies that require the use of as many reprocessed devices as possible to drive a circular economy – while simultaneously lowering costs and strengthening the supply chain. The Joint Commission and Joint Commission International are now, at least on a voluntary basis, seeking to promote hospital sustainability. We think this opens up an opportunity to further highlight the low-hanging fruit solution medical device reprocessing programs offer and we appreciate working with our allies to help make this happen!

Stay tuned.

Best Wishes,

Dan Vukelich, Esq., CAE
President & CEO
Association of Medical Device Reprocessors
www.amdr.org 

Engage: Companies marketing ‘polluting’ medical devices will be penalised under the French Social Security Financing Bill for 2024.
October 19, 2023
The French Government continues its desire to implement ecological transition through measures introduced in Article 29 of the French Social Security Financing Bill for 2024, one of which will have a significant impact on reimbursable medical devices. The first part of Article 29 is a step in the right direction, as it allows healthcare establishments to experiment with the reprocessing of medical devices, which was previously prohibited by the French Public Health Code. This measure is based on the experience of our European neighbours and will have to be accompanied by an appropriate traceability system. However, the second part of the article is far from unanimous. It introduces a mandatory clawback mechanism for branded medical devices that have a negative environmental impact, particularly due to their packaging or the additional waste they may generate compared to their competitors. This negative impact will be evaluated in the opinion issued by the Medical Device and Health Technology Evaluation Committee (“CNEDiMTS”) when the devices are assessed for reimbursement. Medical device companies will therefore have to monitor this new environmental criterion as part of the French National Authority for Health (“HAS”) assessment of their product, as well as the improvement in expected service, which is a key criterion for pricing.

Yale News: Sounding the alarm about disposable plastic in the health care industry
October 10, 2023
To Jodi Sherman’s way of thinking, the Hippocratic Oath’s vow of doing no harm includes doing no harm to the planet — particularly when it comes to the sea of single-use plastic flooding the health care industry. Dr. Sherman, an associate professor of anesthesiology at Yale School of Medicine and of epidemiology in environmental health sciences at Yale School of Public Health, has spent the past decade promoting sustainability in the U.S. health care industry and documenting the need for more stringent regulation and mandatory reporting of sustainability efforts by health care organizations. New data on the rise in single-use plastic items — everything from blood pressure cuffs and complex surgical instruments to pillows and sheets — has prompted Sherman and colleagues from the University of Iowa Carver College of Medicine and Baylor College of Medicine to sound the alarm once again. In a new commentary article in the Journal of the American Medical Association (JAMA), Dr. Sherman offers a series of policy changes that would begin to address the problem. In an interview with Yale News, Dr. Sherman spoke about the issue and her efforts to bring it to the attention of the public. The interview has been edited and condensed.

The BMJ: How to make “single use” surgical items more sustainable
October 2, 2023
Surgery is a major medical contributor to the United Kingdom’s carbon emissions. Progress is being made on reusing surgical instruments and reducing hospital stays by increasing day case rates, but inertia and a lack of incentives are stalling further steps towards sustainability.

MedCity News: Medtech Manufacturers Thrive While Hospitals Shutter—and Patients Suffer. Here’s What Needs to Be Done
September 29, 2023
This is the bottom line: Hospitals in general, and electrophysiology labs specifically, will not fix the cost-income problem without addressing how medical devices and instruments are used. This means reducing waste in the supply chain. It means demanding manufacturers design reusable products or products that can be reprocessed. It means maximizing reprocessing savings (which can reduce device costs by 30 percent per procedure). And it means using advanced instrument repair companies to ensure the lab is not unnecessarily purchasing new equipment. These are examples of deliberate resource utilization, and it is a critical strategy in the hospital’s ability to remain profitable and provide the best possible care for as many patients as possible. Right now, manufacturers are thriving. Hospitals are failing. And patients are suffering. We must stop this trend in its tracks by becoming better stewards of hospital resources and supply chains.

The Sustainable Healthcare Podcast: The Future of Reprocessing in Healthcare with Lars Thording @ Innovative Health
September 18, 2023
In this podcast, Lars Thording and Frederik van Deurs discuss the benefits of reprocessing and remanufacturing in the medical technology industry. Lars explains how reprocessed devices can significantly reduce costs for hospitals while also decreasing the environmental footprint of healthcare. They address obstacles to widespread adoption and provide insights into regulatory considerations. The conversation highlights the potential of reprocessing in reducing costs and environmental impact in the healthcare sector. With valuable insights from Lars Thording, this podcast offers a compelling discussion on sustainable healthcare practices.

Forbes: The Joint Commission Launches Certification In Sustainability For U.S. Hospitals
September 18, 2023
In April, facing heavy industry backlash, the Joint Commission announced that their proposed standards for sustainability in hospitals and healthcare facilities would be optional. Although the Commission noted enthusiasm for sustainability measures among younger physicians and staff, senior administrators said they were “overwhelmed with workforce shortages, financial challenges and patient disposition concerns.” Now, the Joint Commission has formally announced that the voluntary “sustainable healthcare certification” program will be launched in January 2024. It will not be required for certification, but is meant to encourage hospitals and health systems to pursue sustainability measures of their own accord.

Sleep Review: Sleep Medicine’s Path to Environmental Sustainability
September 13, 2023
Several studies comparing disposable versus reusable equipment show that single-use disposables typically result in severalfold higher energy use and greenhouse gas emissions on a life-cycle basis. According to Daniel J. Vukelich, Esq, CAE, president and CEO of the Association of Medical Device Reprocessors (AMDR), device reprocessing is an option for some categories of single-use devices, including pulse oximeter and EKG leads. US Food and Drug Administration-regulated reprocessing refers to the cleaning, testing, and repackaging of “single-use” medical devices for clinical reuse. It is done at commercial reprocessing facilities, not within medical centers themselves. “The devices are reprocessed to the exact same standards and safety required of new devices,” Vukelich says. Sleep disorders centers can purchase reprocessed devices and/or offload their single-use devices to commercial reprocessors. “The use of reprocessed single-use devices can reduce greenhouse gas emissions, cost, and waste, and they strengthen supply chain resilience,” Vukelich says. (The AMDR lists its members’ contact information on its website, which is a great place to start.)

National Academy of Medicine: Webinar – Decarbonizing Health Care: Taking the Next Step to Reduce Your Organization’s Emissions
August 29, 2023
This free event featured decarbonization stories from health systems and highlighted resources from each respective organization to assist health leaders in advancing their efforts to reduce greenhouse gas emissions and foster sustainable practices within their health care institutions. Shane Dunne, Sustainability Program Lead at the Memorial Sloan Kettering Cancer Center, briefly advocated medical device reprocessing, saying, “[R]eprocessing programs have an immediate return on investment [and drive a circular mindset into purchasing].”

AMDR – What Are LCAs and What do They Say about Reprocessing
August 25, 2023
A Life Cycle Assessment (LCA) is a systematic analysis of the environmental impacts associated with all the stages of a product’s life from cradle to grave. This starts with the extraction of raw materials, materials processing, manufacturing, distribution, use, repair and maintenance, and disposal or remanufacturing or recycling. LCAs provide a comprehensive view of the environmental impacts associated with all stages of a product’s life cycle. This can prevent a narrow outlook on environmental concerns and help to avoid shifting problems from one life stage to another. This page is a summary of LCAs comparing reprocessed single-use devices (R-SUDs) with their virgin alternative. In every case, reprocessed devices are found to reduce greenhouse gas emissions compared to using an original device for each patient procedure.

Health Care Business News: Healthcare climate accountability starts with suppliers
July 28, 2023
“To create climate accountability in healthcare, we need carbon emissions calculators, and we need more LCA studies,” writes Innovative Health’s Lars Thording. “And since hospitals today have zero visibility into Scope 3 carbon emissions, good approximations are better than nothing. It’s time for more suppliers in healthcare to stop making excuses and start providing real solutions to carbon footprint measurement and reduction in healthcare.”

ReMed: ReMed Conference 19th December 2023
July 27, 2023
The ReMed Conference ‘Transdisciplinary Perspectives on a Circular Economy for Small Medical Devices’ will take place in person at Loughborough University on 19th December 2023. The conference aims to provide an overview of the latest research and current industrial initiatives in support of the application of the Circular Economy in the healthcare sector. We invite practitioners and leaders working within the NHS and healthcare sector, industry professionals from across the healthcare supply and recovery chain, and academic researchers working within multidisciplinary fields encompassing sustainability within the healthcare sector, to join the conference and contribute to this vibrant and active community. Click here to register to attend the conference.

MedTech Dive: FDA adopts new sterilization standard to support switch from ethylene oxide
July 26, 2023
The U.S. Food and Drug Administration has adopted an international sterilization standard to give medical device manufacturers another alternative to ethylene oxide (EtO). Manufacturers can now make declarations of conformity to the International Organization for Standardization’s recommendations on low-temperature vaporized hydrogen peroxide in submissions to the FDA. The FDA framed the addition of the ISO test to its Recognized Consensus Standards database as a response to pressure to reduce EtO use and the need to support supply chain resiliency.

Kaiser Permanente: Catalyzing Collective Action to Decarbonize Healthcare
May 2023
Kaiser Permanente published this resource to advocate ways to decarbonize, with medical device reprocessing well placed and featured. “Engaging clinicians in reprocessing pilots can lead to increased adoption of reprocessed devices, resulting in cost savings, waste reduction, and the potential for improved access to medical devices in resource-constrained settings,” the resource states. “Hospitals save approximately 50% for every reprocessed device purchased and spend less on disposal of waste.”

Diagnostic and Interventional Cardiology: Innovative Health Brings EP Labs’ Carbon Emissions into Focus with New Sustainability Calculator
September 22, 2023
Innovative Health, Inc.  launched a new educational initiative and free online tool to help hospital leaders better understand, quantify, and improve environmental sustainability within their electrophysiology (EP) labs. Specifically, the initiative includes a new online calculator, available here, that enables hospitals to see how much they could reduce their annual carbon footprint via EP device reprocessing. “In the electrophysiology lab, complex devices have a substantial carbon footprint,” said Innovative Health CEO Rick Ferreira. “Using reprocessed devices in the EP lab can reduce that carbon footprint by more than 50 percent.”

Medica: Sustainability: What is the carbon footprint of a hospital bed?
September 22, 2023
Researchers from the University of Waterloo completed the first-ever assessment of a Canadian hospital to reveal its total environmental footprint and specific carbon emission hotspots. Studying a hospital in British Columbia during its 2019 fiscal year, the researchers identified energy and water use and purchasing of medical products as the hospital’s primary hotspots, accounting for over half of the yearly footprint, totaling 3500-5000 tons of CO2 equivalent. One hospital bed is roughly equivalent to the carbon footprint of five Canadian households.

Risk Management and Healthcare Policy: Evaluating the Environmental Impact of Single-Use and Multi-Use Surgical Staplers with Staple Line Buttressing in Laparoscopic Bariatric Surgery
August 4, 2023
Operation rooms have a large environmental impact. Single-use staplers (SUS) are widely used surgical instruments that contribute to resource consumption and waste generation, whereas multi-use staplers (MUS) can greatly reduce the environmental impact of surgery. MUS with pre-attached buttressing resulted in a reduction of waste, material consumption, and greenhouse gas emissions compared to SUS with separate buttressing: they reduced product waste by 40% (SG and RYBG), packaging waste by 60% (SG) and 57% (RYGB), resource consumption by more than 90%, and greenhouse gas emissions related to the lithium in the batteries by 99.7%.

Conference: Going Green – Care Innovation 2023: A Circular Economy for Medical Devices; Barriers and Opportunities for Laparoscopic Instruments
May 2023
Laparoscopic procedures are performed over 13 million times per year to help us prevent, diagnose and treat diseases in a minimally invasive manner. However, they make an unnecessary contribution to globally increasing (e-) waste. Practices that help devices loop back into the economy, such as reuse, remanufacturing, and recycling, seem promising but are challenging endeavors in this context. In this paper, we aimed to uncover why this is particularly challenging by exploring the barriers to these circular practices for laparoscopic instruments that more and more often contain electronic components. We did this by synthesizing data from literature and expert interviews with healthcare professionals, medical device manufacturers, decontamination experts, hospital procurement, and others. All barriers were sorted based on a thematic analysis for each different circular recovery flow, resulting in an overview of existing barriers and opportunities to overcome them.

Clinical Pharmacy and Medical Devices: Reprocessing single-use medical devices
March 7, 2023
In the April edition of Clinical pharmacy and medical devices, a team of French researchers examined the history and regulatory situation of medical device reprocessing in France, Europe, and around the world. With an eye towards recommending policy change in France – which bans reprocessing – the authors recommended regulated, third-party reprocessing as the best option for the country’s health system. “The application of the new European regulation concerning medical devices is an opportunity to question the regulatory restrictions on the practice of reprocessing medical devices in France,” the authors write. “Given the lack of experience [with reprocessing] in France, the authors recommend [third-party reprocessing], because it reconciles high safety for the patient and less risk-taking for the hospital.” Click here for AMDR’s English translation.

“‘There’s clear evidence that reusing [medical equipment] has a much lower carbon footprint than single use,’ says Andrew Stevenson, consultant trauma and [orthopedic] surgeon at Somerset NHS Foundation Trust and co-chair of the Royal College of Surgeons of England’s sustainability in surgery group… ‘[Some equipment] can be reprocessed reasonably cheaply, but there isn’t a pathway available in the UK because the company just wants to sell you new stuff,’ says Stevenson. ‘That’s an ongoing battle.’”

Learn about the growing movement among surgeons in the UK to expand research-based, #climatesmart innovations that cut harmful carbon emissions, protecting the health of populations and the environment.

LinkedIn: The Future of Reprocessing in Healthcare with Lars Thording @ Innovative Health
October 4, 2023
More Life Cycle Assessments (LCAs) now show that the environmental footprint of using #reprocessed devices, including cardiology devices, is about half the carbon emissions of using disposable ones, Innovative Health’s Lars Thording, PhD, said in a new interview on The Sustainable Healthcare Podcast.

Listen now to learn about the benefits of reprocessing, which can also help hospitals reduce their device cost by about 50%.

LinkedIn: AMDR joins the Portuguese Council on Health and Environment in celebrating World Environmental Health Day
September 28, 2023
AMDR joins global leaders, including the Portuguese Council on Health and Environment, in celebrating World Environmental Health Day this week and beyond by urging Portugal to “opt-in” to the use of remanufactured or commercially reprocessed single-use devices. A growing body of research shows this environmentally friendly, cost-saving solution cuts #ghgemissions in half –- and is a simple step that #hospitals can start taking right now.

Learn how we can work together to accelerate green innovations crucial in building a #circulareconomy that protects #publichealth and the planet from toxic supply chain waste. Join João Queiroz e Melo, Co-founder and Vice President of Conselho Português para a Saúde e Ambiente at the Global Health Forum as he explores the connection between “Healthcare, Globalization and Sustainability” at session 18 on September 30.

LinkedIn: Sleep Medicine’s Path to Environmental Sustainability
September 18, 2023
The sleep medicine industry can take steps now to advance environmental sustainability by accelerating use of reprocessed “single-use” medical devices (R-SUDs), because they “can reduce greenhouse gas emissions, cost, and waste, and they strengthen supply chain resilience,” AMDR President Daniel J. Vukelich says in Sleep Review‘s new story: https://ow.ly/5V7950PMVuV

A growing number of studies show that reprocessing and other green technologies can help hospitals build a circular economy by maximizing the product life cycle while minimizing waste disposal that harms the health of populations and the planet. Read about innovations that can help sleep medicine cut its #carbonfootprint, with insights from Jodi D. Sherman, MD, founding director of the Yale Program on Healthcare Environmental Sustainability, along with other experts from Health Care Without Harm, Practice Greenhealth, The Ann & Robert H. Lurie Children’s Hospital of Chicago, and Wake Forest Medical Center.

LinkedIn: What Others Say About Reprocessing
August 22, 2023
Health sector leaders must seize the moment, start reducing their dependence on disposable products, and shift to innovations like “single-use” #medicaldevice (SUD) reprocessing that build a more sustainable #circulareconomy in healthcare while strengthening the medical supply chain.

Over 140 peer-reviewed articles and policy statements support this easy, immediate solution to help #hospitals cut their giant #carbonfootprint, create a #netzero future, and lower spiraling costs. Meet the experts, including a growing list of researchers and regulators, who back SUD reprocessing.

Explore and share “What Others Say About Reprocessing”.

LinkedIn: Catalyzing Collective Action to Decarbonize Healthcare
August 15, 2023
Check out this fantastic roadmap, developed by Kaiser Permanente and Health Care Without Harm, to learn how health systems, suppliers, and group purchasing organizations can collaborate to identify areas for collective action that will drive greater sustainability throughout #healthcare and beyond: https://ow.ly/46eB50PzcNS

“Single-use” #medicaldevice reprocessing creates new opportunities for #hospitals and #medtech suppliers to cut deadly levels of #ghgemissions by reducing waste from the medical supply chain — also saving costs for providers in a time of great financial strain.

“Engaging clinicians in reprocessing pilots can lead to increased adoption of reprocessed devices, resulting in cost savings, waste reduction, and the potential for improved access to medical devices in resource-constrained settings. Hospitals save approximately 50% for every reprocessed device purchased and spend less on disposal of waste.”

Learn more in “Catalyzing Collective Action to Decarbonize Healthcare”.