Due to 24/7 operations, heating and cooling needs, and extensive use of medical equipment, hospitals are inherently energy-intensive. Effectively managing energy consumption allows Texas Health to lower costs and reduce greenhouse gases, which can impact human health and the environment.

Improving Efficiency

We seek ways to build and operate facilities and equipment more efficiently and annually invest in projects that reduce costs and our carbon footprint. Some of these include:

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Reduce energy consumption by 3 percent per square foot.
2018 Performance

We invested about $5 million in 32 projects that helped us maintain efficient electricity and natural gas consumption this year.

Numerous construction projects systemwide and other events led to an increase in overall energy consumption. Had this growth not occurred, we would have reduced energy use between .5 and 3 percent. Despite this, we have curtailed consumption by 2.56 percent over the last five years, which has saved our system $15 million. In 2019, we aim to reduce energy use by 3 percent.

Energy Use kBtu/sqft

Hospitals consume large amounts of water from its use in sanitation, medical processes, cooling, food service, laundry, plumbing, landscaping and other activities. With the state’s ongoing risk of drought and rising water rates, it is essential to reduce water consumption to save money and responsibly steward this natural resource.

Water Availability

North Texas’s population is projected to grow substantially in the coming years and water is needed to sustain these communities. We meet with water utility officials to understand restrictions, forecasts and the region’s long-term storage capabilities. We also take steps to conserve water, such as:

Water Quality

To keep wastewater and stormwater discharges from exceeding local and state limits, we routinely inspect and test our water delivery systems as required by code.

2018 Performance

We installed smart irrigation systems that allowed us to water more efficiently and stop irrigation when it was raining. While this helped reduce water used in landscaping, due to the construction of new buildings and expansion of others, we did not meet our consumption goal. Water and sewage consumption increased by almost 4 percent.

Once the growth of our system levels out, we believe we can make greater progress toward this reduction goal.

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We set a systemwide goal to reduce water consumption by 10 percent in 2018. We always seek to comply with local wastewater regulations.
Water & Sewage Consumption Mkgal

The health care sector produces medical, pharmaceutical, supply, food and other types of waste, which can cause environmental and health impacts.

Reduction Strategies

Texas Health proactively assesses the materials we use so we can determine if we can procure less, improve disposal practices and identify cost-reduction opportunities. We also designed our waste management policies, protocols and training programs to reinforce safe handling, storage and disposal while complying with local laws and regulations. Each hospital also develops pollution-reduction plans as required by the state of Texas’ Waste Reduction Policy Act.

To manage hazardous waste, we contract with a national waste disposal company that trains our staff. The company also removes chemicals, pharmaceuticals and medical waste directly from our facilities to ensure content and containers are correctly disposed.

Each year, we also host community shredding and recycling drives to allow neighbors to keep paper, cardboard and other materials out of landfills.

2018 Performance

We successfully diverted about 108,000 pounds of pulse oximeters and other devices from landfills and avoided $750,000 in disposal costs as a result. Next year, we intend to quantify the impact of other waste streams.

We recycle, reuse or reprocess:
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Each entity sets site-specific goals to reuse and recycle materials.

Unhealthy levels of ozone and particle pollution in the air can aggravate asthma and other health conditions of people living in the communities we serve. As a health care system, we must do our part to improve air quality and reduce emissions from our operations.

Minimizing Emissions

We invest in controls to keep air emissions below permitted limits and comply with local laws and regulations. We also do not incinerate our waste.

2018 Performance

We did not exceed permitted limits and maintained compliance with air quality standards.

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Keep air emissions below permissible levels and comply with regulations.

Supply costs are the second-largest expense after labor, making it critical that we conscientiously manage procurement processes to maintain competitiveness, financial viability and operational efficiency.

We manage our supply chain to reduce costs and waste, ensure the availability of medical supplies, streamline efficiencies and increase our competitiveness.

Procurement Strategy

Texas Health procures cost-effective products and services that meet our quality, safety and satisfaction standards. We require our business partners to operate ethically, abide by our business practices, and comply with laws and regulations. We also examine what they are doing to reduce their own environmental and social impacts.

Each year, we evaluate supplier performance on approximately 30 criteria including cost, quality, responsiveness and assurance of supply. If improvements are needed, we help create action plans. If we see little change in resolving issues, we may terminate a contract.

Within our system, we standardized ordering processes to drive consistency and lower costs. As a member of a group purchasing organization, we can source better, healthier and environmentally friendly products at a lower price. We also purchase locally when feasible, as well as from minority and women-owned enterprises (MWBEs) to stimulate regional economic growth.

To help non-acute care providers and smaller organizations streamline their supply chain management, we created Texas Health Supply Chain Services (THSCS), a for-profit subsidiary that gives companies access to our discounted purchasing contracts, robust materials management information system and operational expertise. This innovative service is helping to financially sustain not only these organizations but also our own.

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Save $20 million on supply expenses.
2018 Performance

Texas Health, like many health systems across the nation, faced a shortfall of medications, IV solutions and other supplies during the year. Fortunately, manufacturers’ contingency plans helped to mitigate impacts and we were able to share inventory across the system.

Additionally, we reduced drug costs in the last two years despite inflation, shortages and expensive new therapies. Our pharmacies standardized many clinical programs to help achieve the best outcome at the lowest cost. We also provided a way for hospitals to bring previously outsourced IV products back to our system more affordably.

By year-end, we had saved $24 million on all expenses, exceeding our goal by 20 percent. We also spent approximately $5 million with MWBEs. Over the last five years, we have saved almost $100 million in costs and awarded $1 million in contracts to MWBE suppliers. At THSCS, we added dozens of members to its network and increased revenue by 32 percent.

To offer healthier food choices, we partnered with a vending machine vendor that is stocking items that are low-to-no sugar, low sodium and low fat. Our food services team continually reviews the nutritional content of foods provided to patients and offers healthier options including salads and vegetarian meals.

In 2019, we plan to install software that will help modernize and automate many facets of sourcing. Our goal is to save an additional $20 million in expenses.

Maintaining business functions at all times is critical to protecting the health and well-being of Texas Health’s employees and patients, managing business risks, and preserving the organization’s reputation and long-term sustainability.

Planning and Preparedness

Texas Health’s System Preparedness and Response team leads planning related to emergency management, business continuity, safety, physical security and enterprise risk management. Additionally, teams from each hospital and Texas Health Physicians Group:

We leverage the National Incident Management System framework, which provides a common approach to managing threats and hazards regardless of type or size. We also incorporate the Federal Emergency Management Agency’s training resources into our continuity and emergency response planning. This allows us to swiftly respond and quickly recover in case of disaster, delayed shipment of supplies, technology outages or other unforeseeable adverse events.

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Maintain the continuity of operations for all critical clinical, financial and operational functions at all times.
2018 Performance

As part of our commitment to becoming a high reliability organization, we:

Information technology systems are essential for improving operational efficiencies, delivering clinical information at the point of care and for sharing data that can improve care quality and lower costs. Texas Health secures these systems to maintain compliance with privacy laws while giving employees continuous access to information needed to perform their jobs effectively.

Our comprehensive communications networks include electronic health records, health information systems, robust Internet and intranet sites, department-specific portals and a web-based emergency notification system. We designed them to:

Share Clinical Information

Placing patients’ medical history and treatment plans at physicians’ fingertips helps them quickly and decisively deliver safe and effective patient care, which is why Texas Health was one of the first health systems in the U.S. to deploy a health information management system. It includes:

Streamline Operations

Texas Health invests in billing, scheduling, coding and other business technologies to keep the health system operating efficiently. Using technology to automate or expedite tasks reduces the time needed to complete them as well as associated costs. It also helps drive compliance with rules and regulations.

Secure Data

Health care is one of the top industries at risk for cyberattack because medical records fetch a premium price on the Dark Web. To repel daily threats, our Cyberthreat and Incident Response Team continuously monitors our network, builds firewalls, deploys intrusion protection tools, and encrypts and restricts access to information. To test our systems, we conduct internal audits and contract with independent specialists. When we discover deficiencies, we immediately put correction plans in place.

To protect medical devices from threats, we monitor new and emerging risks that could potentially impact patient care and safety. We also map how devices communicate so that we can provide protection mechanisms.

Be Accessible

Given the critical and continuous nature of our work, we must be able to access our information systems at all times. Should a power outage or a network disruption occur, users can securely access critical systems from any location with Internet access. We also have backup power supplies, data centers and alternative telecommunications channels in place to continually share and receive information. Having redundant systems in place protects critical applications and data from major natural disasters or physical security threats.

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Provide continuous and secure access to information management systems.
2018 Performance

Texas Health migrated 212 primary care practices in Texas Health Physicians Group (THPG) to CareConnect, which now makes patient information accessible anywhere in the system and supports the continuum of care. Also during the year, we:

As a recognized leader in the deployment and use of health information management systems and technologies, the College of Healthcare Information Management Executives named Texas Health to its Healthcare’s Most Wired® ranking for the 18th year.

Also during the year, hackers accessed some of Texas Health’s emails that contained personally identifiable information. The breach impacted about 4,000 patients, but there has been no indication of misused information to date. We have implemented additional security measures to prevent this from reoccurring.

In 2019, we plan to deploy artificial intelligence-enabled protection and monitoring technologies to reduce viruses and cyberattacks. We also will add authenticating techniques that only grants access to protected information to authorized users.