The Sustainable Healthcare Podcast

Hosted by Care Pathway Consulting Aps

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Oct 2026

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Learn the dos and don'ts of green innovation from experienced industry leaders. Your hosts are Frederik Dam van Deurs and Joachim Almdal.

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October 26, 2026Episode 11137 min

111 - Giving Sustainability a Home: Merz Therapeutics' Journey with Cornelia Keller

What happens when a company's lawyer is handed sustainability? Cornelia Keller, General Counsel at Merz Therapeutics, describes how she gave a "homeless" topic a home: mapping what colleagues were already doing, building an impact report out of spreadsheets, getting the whole executive board to sign it, and discovering which doors an EcoVadis medal opens, and which it does not. About the guest: Cornelia Keller is General Counsel at Merz Therapeutics, the Frankfurt-based specialty neurology company, where she heads Legal & Governance: Legal, Compliance, Privacy, Intellectual Property and Sustainability. She sits on the executive board. Merz Therapeutics has around a thousand employees and distributes its products in 28 countries. Three things you'll take away: "Homeless" did not mean absent. Colleagues across the company were already working on sustainability; what was missing was consistency. The first job was mapping initiatives, owners and evidence, not writing a strategy from scratch. The impact report is a spiderweb. One sustainability manager sits in the middle, starts the day the previous report is published, collects everything in spreadsheets, and the whole executive board reviews and signs off before release. A medal is not a passport. Bronze to silver in EcoVadis gave Merz data, documentation and firmer supplier conversations, but tender authorities in some countries asked for other systems, such as SBTi, instead. And after buying in a product with an outsourced value chain, sustainability is now part of due diligence. Timestamps: 00:00 "Sustainability was homeless, and you offered it a home" 01:50 The practical side of sustainability at a specialty neurology company 04:05 Scale: Frankfurt, around a thousand employees, 28 countries 07:00 Before the first impact report: what was inherited, what was missing 09:05 Own trials, own botulinum toxin site, and a bought-in product with an outsourced chain 12:35 How the impact report is made: one manager, spreadsheets, a spiderweb 16:15 Reaching the executive board: every third week, a CEO one-on-one, everyone signs 19:55 Surprisingly easy, and the wall: consistency across markets 22:25 Bronze to silver in EcoVadis, and where the medal counts for less 25:10 Sustainability in due diligence, and a hospital-chain acquisition 28:40 Access to Health with the World Stroke Organization: the question, the setbacks, the numbers 35:45 What gives Cornelia hope References mentioned: Merz Therapeutics Impact Report 2025: https://merztherapeutics.com/wp-content/uploads/2026/08/Merz_Therapeutics_Impact-Report-2025_final_260803.pdf Merz Therapeutics and World Stroke Organization, Access to Health initiative (press release, October 2024): https://www.businesswire.com/news/home/20241024293623/en/Merz-Therapeutics-and-World-Stroke-Organization-Launch-Access-to-Health-Initiative-to-Improve-Stroke-Care-in-Africa EcoVadis sustainability ratings: https://ecovadis.com Science Based Targets initiative (SBTi): https://sciencebasedtargets.org World Stroke Organization: https://www.world-stroke.org Earlier episode Frederik refers to on ESG due diligence: episode 017a, "How to make an ESG due diligence" (May 2022): https://carepathwayconsulting.com/podcast/podcast-episode-017a/ Links: Cornelia Keller on LinkedIn: https://www.linkedin.com/in/cornelia-keller-74a14476/ Merz Therapeutics management team: https://www.merztherapeutics.com/about/management-team/ Merz Therapeutics sustainability: https://merztherapeutics.com/sustainability/ You might also enjoy: Episode 099, Integrating Sustainability into Business: a Pharma Supplier Perspective, with Marwin Krull (Körber Pharma): https://carepathwayconsulting.com/podcast/podcast-episode-099/ Episode 096, Recycling Pharmaceutical Transport Packaging, with Arne Kloke (SCHOTT Pharma): https://carepathwayconsulting.com/podcast/podcast-episode-096/ Episode 017a, How to make an ESG due diligence: https://carepathwayconsulting.com/podcast/podcast-episode-017a/ Host links: Joachim Almdal on LinkedIn: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/ Frederik van Deurs on LinkedIn: https://www.linkedin.com/in/frederikvandeurs/ Care Pathway Consulting: https://carepathwayconsulting.com "What was missing was not the commitment of all the people working with sustainability. It was the consistency." Cornelia Keller

October 19, 2026Episode 11041 min

110 - Deprescribing as a Decarbonisation Lever with Lisa-Marie Smale and Nicole Hunfeld

Most work on greener medication starts with the waste bin. This episode goes one step upstream, to the moment a medicine is prescribed at all, and in which form. Lisa-Marie Smale and Nicole Hunfeld explain what 63 Dutch doctors and pharmacists agreed to change about prescribing, why a tablet can beat a drip, and where a stop date gets lost on the way home. About the guests: Lisa-Marie Smale is a pharmacist and postdoctoral researcher in sustainable medicine use at Erasmus MC in Rotterdam, and first author of the Delphi study behind this episode. Nicole Hunfeld is a clinical pharmacist at the Erasmus MC intensive care unit, chair of its green team and Associate Professor in Sustainable Healthcare. Both work in Samen de zorg vergroenen (Greening Healthcare Together), the Dutch national programme implementing sustainability measures in almost all 69 hospitals. Nicole was last on the show in episode 088. Three things you'll take away: Not treating beats switching. Visible medicine waste is the easy start, but the bigger gain sits before the prescription: up to 70% of guidelines say nothing about when to stop, so medicines run on because nobody asks whether they are still needed. A tablet beats a drip only when the dose is equivalent. Oral paracetamol has a far lower footprint than IV, but the switch only holds where bioavailability is high enough (a rule of thumb of 70 to 80%). By Nicole's account, her ICU went from a 25% target to a 50% cut within a month, with nurses in the lead. Follow the proton pump inhibitor home. One pill a day, often started inside a standard pain package, with no owner for the stop date. In Dutch primary care, roughly nine in ten are taken without a current indication. References mentioned: Smale EM, van der Giessen JL, Appels CWY, et al. Advancing sustainable medication use in healthcare: a Delphi study on (de)prescribing interventions. BMJ Open 2026;16:e115383: https://doi.org/10.1136/bmjopen-2025-115383 Samen de zorg vergroenen (Greening Healthcare Together), medication guide with the eight interventions: https://samendezorgvergroenen.nl/en/vergroeningsgids/geneesmiddelen Samen de zorg vergroenen, stopping proton pump inhibitors without a current indication: https://samendezorgvergroenen.nl/en/interventie/staken-van-protonpompremmers-zonder-actuele-indicatie Hunfeld, Tibboel, Gommers. The paracetamol challenge in intensive care. Intensive Care Medicine 2024: https://pure.eur.nl/ws/portalfiles/portal/174421991/s00134-024-07679-y.pdf Groene Zorg Alliantie, Duurzame Paracetamol Challenge: https://groenezorgalliantie.com/initiatief/duurzame-paracetamol-challenge/ Smale and Hunfeld. The clinical trade-offs of the "eco-pharma dilemma". Sustainable Chemistry and Pharmacy 2025: https://www.sciencedirect.com/science/article/abs/pii/S2352554125003559 Links: Lisa-Marie Smale, Erasmus MC research portal: https://pure.eur.nl/en/persons/lisa-marie-smale/ Nicole Hunfeld, Erasmus MC: https://www.erasmusmc.nl/en/research/researchers/hunfeld-nicole Samen de zorg vergroenen: https://samendezorgvergroenen.nl/en You might also enjoy: Episode 088, Circular material flow of medication in the intensive care unit, with Nicole Hunfeld and Jasper Klasen (ESCH-R): https://carepathwayconsulting.com/podcast/podcast-episode-088/ Episode 109, What's Up With the Single-Useness? Inside Hospital Routines, with Heidi Annala: https://carepathwayconsulting.com/podcast/podcast-episode-109/ Episode 103, LCA in Surgery and Specialty-Level Carbon Literacy, with Anna Roe Rasmussen: https://carepathwayconsulting.com/podcast/podcast-episode-103/ Host links: Joachim Almdal on LinkedIn: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/ Frederik van Deurs on LinkedIn: https://www.linkedin.com/in/frederikvandeurs/ Care Pathway Consulting: https://carepathwayconsulting.com "In terms of circularity, not treating can provide bigger environmental gains than switching to another treatment. As long as it's still safe for the patient." Lisa-Marie Smale

October 5, 2026Episode 10941 min

109 - What's Up With the Single-Useness? Inside Hospital Routines with Heidi Annala

Hospitals use many single-use products. So why do the disposables stay? Heidi Annala studies the routines and protocols that keep single-use in place, and explains why reaching for a single-use item is often not really a choice. About the guest: Heidi Annala is a PhD candidate in the Environmental Policy Group at Wageningen University & Research. She works in "How we act", the work package on hospital culture and care professionals' practices in ESCH-R (Evidence-based Strategies to create Circular Hospitals), a Dutch research consortium coordinated by Erasmus MC, the university medical centre in Rotterdam. Her fieldwork takes her inside hospital departments, from a dialysis ward in Utrecht to obstetrics in Rotterdam. Three things you'll take away: Single-use is often not a choice. In the wards Heidi observed, there is often one product for a given clinical need, so the disposable is simply how the job gets done. As some staff told her: "Well, I don't have a choice." Ask about practices, not individual behaviour. Instead of "why is somebody not doing what I want them to do?", Heidi asks "why is this way of doing things normal?", which opens cultural, material and organisational routes to change. Nobody changes a protocol alone. Microbiologists and infection prevention specialists tend to come up, and because protocol work sits on top of clinical work, change can meet friction even when nobody opposes it. Timestamps: 00:00 Cold open 00:36 Welcome, and the link to episode 088 with Nicole Hunfeld 02:08 Meet Heidi: Wageningen, ESCH-R and the "How we act" work package 04:48 What is a hospital protocol? 06:26 When going against protocol is good practice 07:48 The problem statement: what's up with the single-useness? 09:53 Practices versus behaviour versus products 12:28 Fieldwork on a dialysis ward 17:25 Low-hanging fruit? Dialysate bags and specialist knowledge 20:34 Is reaching for single-use really a choice? 23:09 What might be driving single-use, and a detour into the US reuse market 30:28 Where protocols come from, and who can change them 35:10 When protocol work sits on top of clinical work 37:23 What gives Heidi hope References mentioned: ESCH-R consortium: https://esch-r.org Dutch national clinical guidelines (Richtlijnendatabase), the kind of database Heidi describes: https://richtlijnendatabase.nl Clifford Geertz, "Deep Hanging Out", The New York Review of Books, 1998: https://www.nybooks.com/articles/1998/10/22/deep-hanging-out/ M.C. Escher's work: https://mcescher.com Links: Heidi Annala on LinkedIn: https://www.linkedin.com/in/heidiannala Heidi's profile at Wageningen University & Research: https://www.wur.nl/en/persons/h-heidi-annala Environmental Policy Group, Wageningen University & Research: https://www.wur.nl/en/chair-groups/wageningen-sustainability-governance-hub/environmental-policy You might also enjoy: Episode 088, Circular material flow of medication in the intensive care unit, with Nicole Hunfeld and Jasper Klasen (ESCH-R): https://carepathwayconsulting.com/podcast/podcast-episode-088/ Episode 087, Sustainability insights from 290 nurses and clinicians, with Michael Maagaard: https://carepathwayconsulting.com/podcast/podcast-episode-087/ Episode 097, Visualizing Circular Healthcare: A Taxonomy for Sustainable Medical Device Flows, with Tamara Hoveling: https://carepathwayconsulting.com/podcast/podcast-episode-097/ Host links: Joachim Almdal on LinkedIn: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/ Frederik van Deurs on LinkedIn: https://www.linkedin.com/in/frederikvandeurs/ Care Pathway Consulting: https://carepathwayconsulting.com "I think what is a more interesting question that a practice perspective lets you ask is: why is this way of doing things normal? Why is this routine there, and why does it look the way it does?" Heidi Annala

July 27, 2026Episode 10814 min

108 - Hospital at Home: Moving Acute Care Into the Patient's Home with Maria Normand Larsen

What happens when you move acute hospital care into the patient's own home? Maria Normand Larsen shares the results of Denmark's first hospital-at-home randomised trial. About the guest: Maria Normand Larsen is a medical doctor and researcher at Herlev Hospital who recently completed her PhD on remote care. Her randomised trial, run at Nordsjaellands Hospital, tested whether acutely ill patients treated at home do better than those admitted to a conventional ward. Three takeaways: Patients treated at home were measurably more physically active than those in hospital, which matters because the drop in activity during admission drives functional decline and slower recovery. - They were also more satisfied with their treatment, so the better-for-recovery option was also the one patients preferred. - Hospital at home is a complex intervention, not just a change of location. It only works when hospital teams, municipalities, patients and relatives are aligned, and a model proven in one department cannot simply be lifted onto the shelf elsewhere. Timestamps: 00:00 - Intro and why remote care 02:00 - What is a care model, and the trial's goal 05:00 - The findings: more active, more satisfied 09:00 - Why it's a complex intervention 12:00 - Which patients it suits 17:00 - A first step for teams who want to try it References: Hybrid Hospital at Home and Physical Activity RCT (JAMA Network Open): https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2850565 - Informal caregivers in a hybrid hospital-at-home model (BMC Health Services Research): https://research.regionh.dk/en/publications/caring-beyond-hospital-walls-informal-caregivers-experiences-in-a/ - Nordsjaellands Hospital: https://www.nordsjaellandshospital.dk - Maria Normand Larsen on LinkedIn: www.linkedin.com/in/maria-normand-larsen You might also enjoy: Telemedicine: Reaching Drawdown with a Decentralised Healthcare System (Ep 016) - The Transition From the Sick Care System to a Preventive Care System (Ep 008) Hosts: Joachim Almdal: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/ Frederik van Deurs: https://www.linkedin.com/in/frederikvandeurs/ Care Pathway Consulting: https://carepathwayconsulting.com "It's not just a shift of location. It's more complex than that. Just because we showed we could do it at one hospital doesn't mean everyone else can take it off the shelf and implement it."

July 20, 2026Episode 10750 min

107 - Melissa Pegg on Sustainability in HTA

If we want to fix sustainability in healthcare, one of the most powerful levers sits at the gate where new health technologies get approved: Health Technology Assessment (HTA). In this episode of the Sustainable Healthcare Podcast, Frederik Dam van Deurs speaks with Melissa Pegg, Senior Research Consultant in Environmental Sustainability in HTA at the York Health Economics Consortium (YHEC), University of York, and co-lead of the first HTAi Working Group on environmental sustainability in HTA. Disclosure: All opinions are Melissa's own and not the opinions of York Health Economics Consortium (YHEC) and the National Institute for Health and Care Excellence (NICE). About the guest: Melissa Pegg leads YHEC's environmental sustainability work, bringing environmental impact methods into HTA and health economics for the NHS, government bodies and industry. She holds a master's in HTA (University of Glasgow), spent 18 years in industry before academia, and was a fellow in sustainable surgery for the BMJ. Three things you'll take away: HTA works as a "gatekeeper", and adding environmental impact alongside safety, efficacy and cost could reshape which technologies reach patients. - The "information conduit" and "parallel" approaches: getting environmental data into HTA now, reported alongside health-economic data, without waiting for agencies to build new capacity. - A real case study with the Scottish Health Technologies Group: reusable vs single-use endoscopes came out around 50% less environmentally impactful, with a more favourable budget impact and QALY, and still held up when the 3,000-use assumption was quartered under sensitivity analysis. Timestamps: 00:00 Introduction 01:00 Life in York: yoga, two boys, philosophy 03:00 What HTA is, and why it's a gatekeeper 07:00 National vs global: WHO, NICE and the devolved-nation agencies 09:00 The "reference case" and how agencies differ 15:00 Adding the environmental and planetary-health perspective 17:00 Safety for whom? Bringing the environment into the safety domain 22:00 Can it work? The information-conduit approach 24:00 Case study: reusable vs single-use endoscopes with SHTG 30:00 The figures: around 50% lower impact, favourable budget and QALY 33:00 The "just transition" and the classic objections to reusables 39:00 Sensitivity analysis and the 3,000-use assumption 45:00 What makes Melissa hopeful References mentioned: Green Surgery report (UK Health Alliance on Climate Change, 2023): https://ukhealthalliance.org/sustainable-healthcare/green-surgery-report/ Cliff Goodman, HTA 101: Introduction to Health Technology Assessment: https://www.inahta.org/wp-content/uploads/2014/09/HTA-101_Goodman_2004.pdf HTAi Environmental Sustainability in HTA (ESHTA) Working Group: https://htai.org/engage-with-us/working-groups/htai-eshta/ Toward including environmental sustainability in HTA (Cambridge, IJTAHC): https://www.cambridge.org/core/journals/international-journal-of-technology-assessment-in-health-care/article/toward-including-environmental-sustainability-in-health-technology-assessment/2FF6BA84AC3E7FB280DA2DF3F17D6130 Environmental sustainability in diabetes (Cambridge, IJTAHC): https://www.cambridge.org/core/journals/international-journal-of-technology-assessment-in-health-care/article/environmental-sustainability-in-diabetes-improving-the-quality-of-diabetes-management-through-hta-and-systemlevel-change/E9B3804A2EB373D31752F6A2587C084A How Can HTA Shape a More Sustainable Future for Healthcare? (YHEC): https://www.yhec.co.uk/resource/how-can-hta-shape-healthcare-sustainability/ Scottish Health Technologies Group (SHTG): https://shtg.scot/ NICE: https://www.nice.org.uk/ Links: Melissa Pegg on LinkedIn: https://www.linkedin.com/in/melissapegg1/ Melissa's email: melissa.pegg@york.ac.uk Melissa's publications (YHEC Environmental Impact): https://www.yhec.co.uk/what-we-do/environmental-impact/ York Health Economics Consortium: https://www.yhec.co.uk/ You might also enjoy: Episode 103, LCA in Surgery and Specialty-Level Carbon Literacy with Anna Roe Rasmussen: https://carepathwayconsulting.com/podcast/podcast-episode-103/ Host links: Joachim Almdal on LinkedIn: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/ Frederik van Deurs on LinkedIn: https://www.linkedin.com/in/frederikvandeurs/ Care Pathway Consulting: https://carepathwayconsulting.com "HTA is a gatekeeper. The opportunity right now is to get environmental data into HTA and report it alongside everything else, without yet expecting agencies to act on it. That alone would be a huge step forward." - Melissa Pegg

July 13, 2026Episode 10629 min

106 - Alejandra Medina from Quipment on Circular Clinical Trials

How do you cut 40% of the carbon out of a clinical trial without changing the price? You rent the equipment instead of buying it. In this episode of the Sustainable Healthcare Podcast, part of our mini-series with the Sustainable Healthcare Coalition's Community of Practice for Clinical Trials, Frederik Dam van Deurs speaks with Alejandra Medina, Chief Sustainability Officer at Quipment, the French, B Corp-certified provider of equipment solutions for clinical trials. About the guest: Alejandra Medina is Chief Sustainability Officer at Quipment SAS, a Nancy-based company founded in 2010 that equips and maintains clinical trial sites across 110+ countries. She joined as quality director and led Quipment through its B Corp certification. Three things you'll take away: An equipment-rental ("equipment-as-a-service") model is circular by design: returning, reprocessing and redeploying devices keeps them in near-constant use across the value chain. - Quipment's benchmark, built for B Corp certification, shows a 40% carbon-footprint reduction moving from a linear to a circular model, comparable to the saving the Sustainable Markets Initiative estimates from more digital trials. - The real bottleneck for circularity isn't the technology, it's convincing the actors in the trial supply chain that circular is just as safe, compliant and high-performance as linear. Timestamps: 00:00 Introduction 02:00 Meet Alejandra: from Mexico to Nancy 03:00 What Quipment does: equipping and maintaining trial sites 05:00 The portfolio: ECGs, infusion pumps, data loggers and 3,000+ products 07:00 Becoming a B Corp: how the assessment revealed a circular model 09:00 Circular by design: rent, return, reprocess, redeploy 13:00 Where circularity breaks down in clinical trials 16:00 The cost question: services at the same price 18:00 Informing the choice: tools over mandates 19:00 The Quipment Carbon Compass: a comparator, not a calculator 20:00 40% carbon reduction, linear vs circular 23:00 The new seven-pillar B Corp standard 25:00 What gives Alejandra hope References and links: Sustainable Healthcare Coalition, Community of Practice for Clinical Trials: https://shcoalition.org/sustainable-clinical-trials-knowledge-hub/ B Corp certification (B Lab): https://www.bcorporation.net/ Quipment B Corp profile: https://www.bcorporation.net/en-us/find-a-b-corp/company/quipment-sas/ Alejandra Medina on LinkedIn: https://fr.linkedin.com/in/alejandra-medina-3315185 Quipment: https://www.quipment.com/ You might also enjoy: Episode 102, Sustainable Clinical Trials (1): Convien & myoncare with Christian Hieronimi: https://carepathwayconsulting.com/podcast/podcast-episode-102/ Host links: Joachim Almdal on LinkedIn: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/ Frederik van Deurs on LinkedIn: https://www.linkedin.com/in/frederikvandeurs/ Care Pathway Consulting: https://carepathwayconsulting.com "Quipment Carbon Compass isn't a calculator, it's a comparator. We didn't change anything; we just changed the way we explain our business. We were circular by design from the beginning." - Alejandra Medina

July 6, 2026Episode 10526 min

105 Lucas Pianegonda Structured Material Selection: Building Sustainable Medical Devices with PlasticsSustainability Healthcare Podcast

Structured Material Selection: Building Sustainable Medical Devices with Plastics How do you make a medical device more sustainable without blowing up the business case? Lucas Pianegonda breaks down the structured way to choose plastics, and why the first win is usually deleting a requirement, not changing a material. ABOUT THE GUEST Lucas R. Pianegonda is founder and lead plastic expert at Gradical (Switzerland), a consultancy that helps medtech companies select materials that are technically sound, compliant, and lower-footprint. Material scientist by training, he also hosts the podcast now called MedTech Sustainability by Design. KEY TAKEAWAYS - Over-requirement is the biggest hidden source of cost and carbon. Challenge every "must be medical grade" before you reach for a greener material. - The plastic pyramid: moving down from high-performance plastics (PEEK) to engineering or commodity grades, where the part allows, cuts footprint and cost at once. Twenty years ago we just called it optimising. - You don't need a 50,000 euro LCA to decide. A rough Excel or OpenLCA estimate gets you within ~20-25%. The certified LCA is for making public claims, which the EU's Empowering Consumers Directive now requires you to back with data. TIMESTAMPS (adjust to audio) 00:00 - Intro and Lucas's path into materials 04:00 - Four forces driving sustainability in medtech 12:00 - Why SME device makers struggle to specialise 18:00 - Structured material selection and the value analysis 24:00 - The plastic pyramid and downgrading 30:00 - Rough vs. certified LCA, and what an LCA really costs 38:00 - Selling sustainability: the commercial translation gap REFERENCES - OpenLCA, free life cycle assessment software: https://www.openlca.org - Empowering Consumers for the Green Transition Directive, Directive (EU) 2024/825 (applies from 27 September 2026) - Pharmapack Europe: https://www.pharmapackeurope.com - Science Based Targets initiative (SBTi): https://sciencebasedtargets.org - Lucas's podcast, MedTech Sustainability by Design: https://www.buzzsprout.com/2389989 LINKS - Lucas R. Pianegonda on LinkedIn: https://www.linkedin.com/in/lucas-r-pianegonda-81142b110/ - Gradical: https://gradical.ch YOU MIGHT ALSO ENJOY - Episode 096 - Recycling pharmaceutical transport packaging, with Arne Kloke (SCHOTT Pharma) - Episode 097 - Visualizing Circular Healthcare: A Taxonomy for Sustainable Medical Device Flows, with Tamara Hoveling (TU Delft) HOSTED BY - Joachim Almdal on LinkedIn: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/ - Frederik van Deurs on LinkedIn: https://www.linkedin.com/in/frederikvandeurs/ - Care Pathway Consulting: https://carepathwayconsulting.com "Sustainability can't be a strategic advantage if you can't sell the device." - Lucas Pianegonda

May 11, 2026Episode 10429 min

104 - Small Revolution: Stories About Upcycling in Hospitals

What if the plastic waste from a hospital's clinical areas could come back as the ID card holders every nurse and doctor wears every day? That is what SMALLrevolution is doing, and it is one of the more elegant circular economy stories I have come across in healthcare. About the guest: Arendse Ekegren Baggesen is the Founder of SMALLrevolution, a Danish design-to-manufacturing company that collects plastic waste from hospitals, municipalities, and companies, transforms it into recycled raw material, and produces furniture and functional products that go back to the original waste producer. Three key takeaways: According to Arendse, only 8-10% of plastic collected in Denmark is actually recycled. Sorting quality in the waste stream, not collection, is the primary bottleneck. SMALLrevolution's closed-loop model: they collect a facility's waste, produce products from it, and return those products to the same facility, along with full LCA and ESG data. According to Arendse, producing one kilo of virgin plastic requires two kilos of crude oil. Redirecting to recycled material reduces both CO2 emissions (around 30% vs. virgin plastic, based on SMALLrevolution's own LCAs) and crude oil demand. Timestamps: 00:00 - Introduction and origins of SMALLrevolution 02:00 - Why recycled plastic for outdoor furniture? 05:00 - Finding the first factory willing to work with household plastic waste 07:00 - How COVID pivoted SMALLrevolution from B2C to B2B 08:00 - The closed-loop model: collect, produce, return 09:00 - LCAs and ESG data on every product 10:00 - What actually happens to plastic in the "normal" waste stream? 12:00 - Why sorting quality, not collection, is the real bottleneck 14:00 - How hospitals can get started: two live case studies 18:00 - The "not another bucket" problem in surgical theatres 21:00 - CO2 impact: around 30% reduction vs. virgin plastic (based on SMALLrevolution's own LCAs) 23:00 - According to Arendse: 2 kg of crude oil per 1 kg of plastic, and what that means for resource resilience Pull quote: "All vases in the world should be produced in a recycled material. There is demand, and there is a lot of waste, so why not connect those two dots?" Contact Arendse: Website: smallrevolution.dk LinkedIn: Arendse Ekegren Baggesen You might also enjoy: Episode 088: Circular Material Flow of Medication in the Intensive Care Unit (Nicole Hunfeld, Erasmus UMC) Episode 074: The Future of Reprocessing in Healthcare (Lars Thording, Innovative Health) Episode 096: Recycling Pharmaceutical Transport Packaging (Arne Kloke, SCHOTT Pharma)

May 4, 202644 min

103 - Anna Roe Rasmussen - What happens when a doctor applies the rigour of clinical research to the carbon footprint of surgery?

What happens when a doctor applies the rigour of clinical research to the carbon footprint of surgery? In this episode, Frederik speaks with Anna Roe Rasmussen, MD, MSc Health Policy — a scientific researcher at the Regional Unit for the Green Transition in Region Zealand. Anna recently defended her PhD at the University of Copenhagen and the Technical University of Denmark, where she applied lifecycle assessment (LCA) to total hip replacement surgery, working towards the integration of environmental impact into clinical decision-making. About Anna: Anna has spent over a decade at the intersection of climate and health — as a co-founder of Doctors for Climate Denmark (Læger for Klimaet), as part of the working group that drafted the Danish Medical Association's climate and health policy (published 2022), and as a scientific researcher applying LCA methodology to surgical care pathways. Three things you'll take away: Why the field needs to distinguish more clearly between carbon footprint screenings and full ISO-compliant LCAs — and what gets lost when clinicians can't tell the difference. Why specialty-level carbon literacy is the missing link between organisational sustainability targets and meaningful action on the ground in clinical departments. Why acting — finding someone to act with — is Anna's personal antidote to climate anxiety. Timestamps: 00:00 — Introduction 03:00 — Anna's PhD: applying LCA to total hip replacement surgery 08:00 — From medical student at COP to co-founding Doctors for Climate Denmark 10:00 — The Danish Medical Association's 2022 climate and health policy 13:00 — A passionate but fragmented global movement of healthcare workers 17:00 — The publication explosion in healthcare LCA — and why quality must keep pace 21:00 — Carbon screening vs. ISO-compliant LCA: the precision vs. direction trade-off 27:00 — Specialty-level carbon literacy as the next step for healthcare decarbonisation 33:00 — Carbon budgets and financial budgets: an uncomfortable but necessary analogy 38:00 — The hard conversations healthcare systems avoid 41:00 — What makes Anna hopeful: engaged colleagues and the power of acting together References and links mentioned: ISO 14040/14044 standards for lifecycle assessment (see iso.org) DTU Centre for Absolute Sustainability Doctors for Climate Denmark / Læger for Klimaet — Facebook [Joachim/Frederik: add official website if available] Danish Medical Association climate and health policy 2022 [Frederik: add direct link] International Federation of Medical Students' Associations: ifmsa.org Guest links: Anna Roe Rasmussen on LinkedIn Sjællands Universitetshospital DTU Centre for Absolute Sustainability You might also enjoy: Episode 097: Visualising Circular Healthcare — Tamara Hoveling (TU Delft) on LCA methodology in healthcare Episode 101: Sustainable Healthcare: Implementation and Hope — Maria Gaden Episode 088: Circular Material Flow in the ICU — Nicole Hunfeld (Erasmus UMC) [Episode Spotify/platform links to be added by Frederik] Hosts: Joachim Almdal on LinkedIn Frederik van Deurs on LinkedIn Care Pathway Consulting Pull quote: "If you want to do something — act. And find someone to do it with. That's always both more fun and more productive." — Anna Roe Rasmussen

April 27, 2026Episode 10227 min

102 - Sustainable Clinical Trials (1): Christian Hieronimi on Convien & myoncare

The first episode of our Sustainable Clinical Trials mini-series, produced in partnership with the Sustainable Healthcare Coalition (SHC), following up on the Community of Practice conference in London on 4 November 2025. Each episode brings one of the CoP speakers back to share their story in long form. GUEST Christian Hieronimi, Founder & CEO of ONCARE (myoncare) and co-founder of Convien. A serial healthcare entrepreneur based in Munich, with previous exits to Elekta (Medical Intelligence) and Varian (humediq). WHAT YOU WILL LEARN How Convien's meeting-point optimiser can cut around 30 to 35% of travel cost and 40% of the CO2 footprint of investigator meetings, by jointly optimising ticket price, travel time and carbon per kilogram. Why roughly half of corporate travel spend in international organisations is driven by meetings, not customer visits, and why that makes meetings the biggest under-addressed decarbonisation lever in clinical operations. How myoncare uses wearable data, symptom questionnaires and guideline-based thresholds to "fill the void" between doctor visits, and how the same platform can decentralise a trial by routing blood work, imaging and eligibility checks to local providers. TIMESTAMPS 00:00 Introduction by Nathalie Preiswerk (Sustainable Healthcare Coalition) and series framing 02:00 Meet Christian: serial founder, robotics and oncology background 03:30 Convien origin story: Beijing vs. Barcelona, 2010 06:00 The three-variable optimisation: cost, time, carbon 10:00 How big is the meetings prize inside corporate travel 11:00 Applying Convien to investigator meetings and site selection 13:00 Introducing myoncare: a care orchestration platform 16:00 A chronic kidney disease use case, end to end 20:00 Decentralised trials: bringing the site to the patient 22:00 Bring-your-own-device and the International Patient Summary 25:00 Care pathways that trigger the next step automatically REFERENCES MENTIONED Sustainable Healthcare Coalition Community of Practice conference (London, 4 Nov 2025): https://shcoalition.org/cop-conference/ SHC Sustainable Clinical Trials Knowledge Hub: https://shcoalition.org/sustainable-clinical-trials-knowledge-hub/ Convien Smart Meeting Location Planner: https://www.convien.com/ myoncare Virtual coordinated care: https://www.myoncare.com/ Convien Meeting Point Optimiser (Siemens partnership, Microsoft AppSource): https://marketplace.microsoft.com/en-us/product/office/wa200001588 EU MDR 2017/745 (myoncare is classified as MDR Class IIa) International Patient Summary (ISO 27269) CONNECT WITH THE GUEST Christian Hieronimi on LinkedIn: https://www.linkedin.com/in/christian-hieronimi-066a394/ ONCARE / myoncare: https://www.myoncare.com/ Convien GmbH: https://www.convien.com/ YOU MIGHT ALSO ENJOY 091 SHC: the Sustainable Healthcare Coalition (Fiona Adshead, Keith Moore, Nathalie Preiswerk), the backstory to this mini-series. 089 Koen Kas on transforming healthcare and clinical trials, another conversation on reimagining the trial operating model. 083 Sustainability requirements in public procurement, relevant if you are thinking about where the buy-side pressure lands. HOSTS Joachim Almdal on LinkedIn: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/ Frederik van Deurs on LinkedIn: https://www.linkedin.com/in/frederikvandeurs/ Care Pathway Consulting: https://carepathwayconsulting.com PULL QUOTE "In between two doctor's visits, nobody looks after the patient, because the patient's pretty much invisible. We are filling up that void." Christian Hieronimi Produced in partnership with the Sustainable Healthcare Coalition.