The healthcare industry contributes about 8.5% of greenhouse gas emissions (GHG) in the U.S., according to the Commonwealth Fund, and more than 70% of the emissions stem from the supply chain, including the manufacturing and disposal of medical devices, according to a report on GreenBook.org.
As a result, U.S. hospitals are facing growing pressure to reduce their environmental impact, even as they deal with rising costs and decreasing revenue. Reprocessing single-use medical devices can be a valuable tool, creating a more circular economy, extending the life of medical devices and reducing both product cost and waste.
“The increased focus on reducing healthcare’s carbon footprint has dramatically increased demand for the services of Sustainable Technologies™, and led us to a significant expansion of its facility near Tampa, Florida, completed last year,” said Pete Bennett, senior vice president of Global Logistics. Sustainable Technologies™ is a leading provider of single-use device (SUD) collections, reprocessing and recycling services in the U.S. As reported in Cardinal Health's most recent ESG Report, the Sustainable Technologies™ business, which serves more than 2,000 U.S. hospitals and ambulatory service centers, collected 18.3 million SUDs in fiscal 2022 alone, diverting more than 5.6 million pounds of waste from landfills.
The expanded facility is twice the size of the original, providing the space to reprocess a larger number of SUDs as well as for testing new ways of reprocessing medical products that aren’t yet in the Sustainable Technologies™ portfolio.
Robert Rajalingam, president of Cardinal Health’s U.S. Medical Products and Distribution (U.S. MPD) business, said, “In addition to its positive environmental impact, reprocessing SUDs adds resiliency to the supply chain: It gives hospitals another source for the same product, and reprocessed products typically can be acquired more quickly than products from original equipment manufacturers (OEMs).”
In addition, hospitals that purchase reprocessed SUDs rather than new products can achieve significant savings. A report by the Association of Medical Device Reprocessors (AMDR), a nonprofit trade organization, noted that in 2021, U.S. hospitals and surgical centers saved more than $412 million through reprocessing.
“Our investment in Sustainable Technologies™ aligns with Cardinal Health’s commitment to helping reduce the sector’s environmental impact as we work to be healthcare’s most trusted partner,” Bennett said. “We continue to bring on new reprocessed products, and better meet the increasing demand for existing products, as we help reduce costs and waste for customers.”
How Sustainable Technologies™ works
“When we talk with hospital leaders, we share how our reprocessing program can help meet their sustainability goals – because it’s now top of mind for many to identify ways to reduce waste,” said Meg McClanahan, global portfolio director of Sustainable Technologies and board chair of AMDR. “Reprocessing requires minimal change in clinical workflow, so it is one of the best and easiest solutions for hospitals to implement to reduce waste.”
Once a customer commits to reprocessing, the team at Sustainable Technologies™ maps the hospital to ensure that the SUD collection bins are placed in the best locations for efficient collections. The team offers single-stream collections, meaning that all products within a single area of care can go into one bin. Sustainable Technologies™ offers a white glove collection service that picks up collection bins on a schedule customized to the hospital, or a mailback collections program. Devices are shipped from hospitals to our reprocessing facility in Florida. Once there, the devices are sorted, then cleaned, tested, inspected, packaged and either high-level disinfected or sterilized. Many SUDs can be reprocessed multiple times, and when they can no longer be reprocessed, they can be recycled.
“Our work is closely regulated by the U.S. Food and Drug Administration (FDA), which requires that reprocessed devices are substantially equivalent to their original counterparts,” McClanahan explained. “Every device we reprocess is 100% functionally tested to confirm safety and quality before being redistributed to our healthcare customers.”
Sustainable Technologies™ reprocesses a wide array of products, including compression sleeves, electrocardiogram lead wires and cables, air transfer mats (used to transfer and reposition patients), pneumatic tourniquet cuffs, pressure infusion bags, pulse oximetry sensors, and many products used in surgery, including ablation wands and electrodes, arthroscopic abraders and shavers, orthopedic manual devices and more. (You can find the full list of products Sustainable Technologies reprocesses here.)
The Florida facility operates on a unique zero waste-to-landfill model for end-of-life disposition. Lithium-ion and alkaline batteries, for example, are melted down into a commodity for the metals market; corrugated cardboard is recycled and reprocessed into more corrugated cardboard or chipboard; and regulated medical waste and plant trash are turned into energy through a waste to energy program. Since launching its zero waste-to-landfill initiative in 2016, Sustainable Technologies™ has diverted 99.9% of waste from landfills.
The blended-code (B-code) model
Cardinal Health created a blended code (or B-code) model for customers, which combines both new and reprocessed products in one kit. The B-code model delivers the products at one price point and one sku – all of which meet the same specifications as new products.
Rajalingam explained the model’s benefits: “One customer is not going to get 100% of a particular product from a reprocessor; they’re going to need to augment that supply with products from an OEM. But the unit price for all the products within a single kit is the same; three may be brand new and the fourth may be reprocessed. All meet the same quality standards as a new product. They’re equally safe and effective, but each is less expensive than a new product.”
The B-code model also means there is a single point of contact for a specific product, whether new or reprocessed, simplifying communications and purchasing. Products currently offered with the blended model include compression sleeves, electrocardiogram lead wires and cables and air transfer mats.
“Our data and analytics capabilities are very important to this business,” McClanahan said. “Customers want to understand the impact of their reprocessing program, and analytics help healthcare systems to maximize their reprocessing program and their savings.”
Sustainable Technologies™ provides a sustainability value report to customers each month, which details to the unit level within the facility the number of devices collected, the savings achieved through their reprocessing program, and the regulated medical waste savings customers can achieve because we are removing and disposing that waste – at no cost to our customers.
The reporting is also important to the Sustainable Technologies™ team, McClanahan said. “It helps us to quickly identify any dips within a unit or facility, which might indicate staff changes and a need for reeducation about the collections program.” Our sales team consistently engages with our customers to ensure every aspect of the reprocessing program is successful, and provides the most value.
“Our biggest growth potential is in expanding our portfolio,” McClanahan said. “Though we’re among the top reprocessors in the U.S., there are devices that we don’t yet reprocess. As we expand the number of products that we reprocess, we’ll be able to increase savings and reduce waste for customers.”
The Sustainable Technologies™ team continually seeks innovative ways to become more sustainable in our processes, as well, she said. “We're currently working on several exciting projects that will help to increase supply resiliency, reduce water consumption and extend the life of single-use devices.”
Under site director Natalia Quintero’s guidance, the team is working to improve process efficiencies and increase productivity while maintaining quality. “We have a good road map and a great team,” Quintero said. “We’re all very excited about the progress we’ve made and the future of our site.”
Ultimately, McClanahan said, “Sustainable Technologies™ aims to grow its portfolio of both Cardinal brand and other manufacturers' products to provide the most value. Expanding our product offerings makes us a better partner to our healthcare customers, and aligns with our mission to reduce the impact of healthcare delivery on the environment.”