Each day, as an internal medicine specialist who practices primary care, I care for patients who are experiencing the brunt of climate change. These patients have various medical conditions due to different causes. However, it is evident that greenhouse gas emissions, air pollution, extreme weather, and heat-related illnesses are major contributors to the development and worsening of chronic medical conditions in the adult population. Electronic health record (EHR) systems are critical tools that help facilitate efficient and effective patient care. They aid in physician documentation, quick screening for serious medical conditions, and providing patient education at the point of care for additional guidance after each visit.
An excellent example of how EHRs assist in patient education is by providing examples of stretches for rotator cuff tendinitis, low-sodium diets for hypertension, and information about prescribed medications for weight loss. Some systems even automate the provision of handouts based on patients’ visit diagnoses, allowing tangible forms of education to be taken home after the visit, based on the discussed and planned information. I personally utilize these resources for every patient, ensuring they have access to high-quality, evidence-based disease education to improve their overall health outcomes and quality of life. Comprehensive patient education on preventive health and chronic medical conditions is crucial in primary care.
However, despite their numerous advantages, EHRs do have significant limitations. They lack educational materials on climate and health, and despite my thorough searches within my health system’s version of EPIC, I have not found this information. The climate crisis significantly contributes to the development of diseases linked to climate change and environmental inequities. It is a leading cause of worsening health outcomes for all individuals. Black and Brown communities, as well as vulnerable populations such as the elderly and those with physical and mental disabilities, are disproportionately impacted by the climate crisis, experiencing higher rates of asthma exacerbations, heat-related illnesses, allergic and chronic inflammatory conditions, maternal-fetal complications, respiratory diseases linked to air pollution, and a lack of access to sustainable food sources. These disparities exist across all levels of socioeconomic status.
To improve health outcomes for patients affected by environmental injustices and climate change, patient education and engagement are crucial. Physicians can achieve this through the use of EHR systems that contain preformulated patient education documents. However, the existing materials are limited in addressing how climate change affects health by causing and worsening diseases.
Patients I see daily with seasonal and non-seasonal environmental allergies would benefit from these materials. Patients struggling to avoid triggers contributing to increased asthma exacerbations would also benefit. Additionally, patients at risk for heat-related illnesses, such as farm workers and those occupationally exposed to extreme heat, could benefit from these resources. With the increased threat of severe weather due to global temperature rises, there is also a greater risk of vector-borne diseases, making these educational materials valuable for those at higher risk. I encounter patients who could benefit from these resources every day.
Prime examples of educational materials I would like to see provided by EHRs include a general handout on how climate change affects health, information on leveraging financial incentives and tax breaks to create greener environments and communities, a patient handout highlighting vulnerable populations, and disease-specific resources on heat-related illness, asthma, and seasonal allergies.
Despite this need, some argue that EHRs have already fulfilled their role. Since 2011, it has been suggested that EHRs play a critical role in decarbonizing health care delivery. Compared to paper options for charting, EHR use alone helps lower carbon dioxide emissions by as much as 1.7 million tons nationwide. Furthermore, EHRs provide a wealth of patient data that can be used to study how environmental degradation and climate change affect communities. However, there are still limitations in how EHRs directly deliver climate and environmental change education to patients. One of the significant benefits of EHRs is their ability to provide patient education, so until they effectively integrate knowledge of climate change’s effects on individual patient health, there is still work to be done to fulfill their purpose. To accomplish this effectively, EHR companies should develop a framework that embraces diversity, equity, and inclusiveness, partnering with local medical professional organizations and government agencies dedicated to educating patients and communities about the climate crisis and its threat to individual health and the longevity of our planet.
Climate change represents the greatest health crisis we currently face. Air pollution, greenhouse gas emissions, fossil fuel accumulation, increased floods, and extreme heat waves are just a few examples of this crisis, posing threats to both individual health and entire communities. Every single person is at risk, and the urgency to improve public education on the health effects of this crisis in health care delivery is pressing. We must take action now, not in two or ten years. This crisis impacts everyone, everywhere, at this very moment. Therefore, it is the ideal time for EHRs to fully support health care professionals and act accordingly.
Earl Stewart, Jr. is an internal medicine physician in Atlanta, Georgia, a 2023 Doximity Digital Health Fellow, and a 2023 Climate and Health Equity Fellow (CHEF) with the Medical Society Consortium on Climate and Health. He can be reached on E.S.J., M.D., LinkedIn, Twitter @EarlStewartJr, and Doximity.
