The Circular Economy: What It Means for Healthcare

By Averill Brewer

In the United States, the typical operating room contributes 5.4 tons of medical waste to landfills each year, translating to costs of $5,234 per operating room, according to Practice Greenhealth’s 2015 Sustainability Benchmark Report. The standard procedure for a surgical device, for example, has been the 'make, take, dispose' model for decades.

It seems like the circular economy model is slowly penetrating all major sectors — first waste management, building and construction, transportation, and now, even those in healthcare are beginning to reexamine and question the way in which medical devices are disposed of.

Understanding the opportunity to champion a product-level, circular-system approach in the healthcare industry, involving original equipment manufacturers (OEMs), customers and reprocessors, Intermountain Healthcare and Ethicon have partnered to address challenges facing the healthcare industry: delivering quality products, establishing reliable supply and service, restoring clinician confidence, driving more predictable spend, and keeping up with the pace of product innovation.

Through their partnership, Ethicon and Intermountain Healthcare have exemplified that those who produce medical devices and those who use the devices can work together to sterilely reprocess those items and bring them back “to the original equipment manufacture standards, so they are essentially new, and we can then reuse them again and again,” stated Dr. Mark Ott, chief medical director of the central region of Intermountain Healthcare.

Intermountain Health and Ethicon have deployed a comprehensive reprocessing program (the Performance Certified Harmonic Program) that addresses key clinician and supply chain resistance points that ensure device performance, reliable device supply and predictable financial savings. Their program generated the following results in 2014:

• Devices diverted from the landfill in Utah: 225,456


• Pounds diverted from the landfill: 80,712


• Savings on the devices: $2.3 million

Imagine if this circular healthcare system took place on a national scale.

The FDA is also taking steps to reduce the risk from reprocessed reusable devices by reviewing pre-market and post-market information from all manufacturers and reprocessed devices types, to communicate clear regulatory requirements, to promote good manufacturing equipment and to work with manufacturers to address public health concerns that arise after a device has entered the market and in March 2015 published a report, Final Guidance’s for Industry and FDA Staff: Reprocessing Medical Devices in a Health Care Settings.

When Ethicon surgical devices come back from the original equipment manufacturer and sterile processing manufacturer, they are like brand new devices. Tim Lessek of Ethicon says: “Ethicon, in collaboration with Sterilmed, has partnered with Stericycle, the leader across the United States in regulated medical waste collections, to improve and streamline device collections as part of the Performance Certified Harmonic Program.” The program’s aim is to move away from a fragmented and uncoordinated effort to drive sustainability impact at scale and to enhance the system to achieve better economic and environmental outcomes by improving collections, reprocessing infrastructure and clinical experience.

Lessek believes the key to developing a collaborative effort like this one is: “one that increases the economic attractiveness of keeping quality materials in the system through this comprehensive collections program, significant environmental impact and economic savings — delivering what is best for the patient, the provider and the manufacturer.” The medical waste stream is also an opportunity for the entire industry to rethink the technical nutrients, which are used to produce a medical device, and to re-manufacture these devices so they can continuously be recycled in the industry as a quality, sterile product of equal or better utility than the original device. Making medical devices so that they are as productive for as long as possible lowers costs to patients without compromising quality and service to clinical adoption.

Ethicon and Intermountain Health are leading the way in producer responsibility and the promotion of circular health systems — an approach that is restorative and regenerative, adopts systems optimizations, preserves resources yields, diverts waste by creating an after-use value chain and a second life for products.

The success of the Harmonic Program shows the limitless application of circular systems is one of the main reasons the circular economy is being embraced so enthusiastically. Once we re-imagine how to re-make products that remain in a closed loop system in one area, it’s even easier to apply this mindset to all industries. The only question that arises at this point is: Why did it take us so long to realize this?

Image from Intermountain Health and Ethicon

Averill Brewer is a writer covering the circular economy. You can email her at averill.brewer [at]gmail [dot]com. You can also find her on Twitter @AverillBrewer.