Health systems and climate change mitigation through an applied health informatics and sustainability perspective.

Climate change poses a growing threat to U.S. healthcare systems, which are uniquely positioned to mitigate its impacts while addressing their own greenhouse gas emissions from energy use, supply chains, clinical operations, and waste. Clinical informaticists can advance mitigation by integrating environmental data into health system operations and decision-making. Tracking emissions across scopes enables data-informed strategies, while frameworks such as I-CLIMATE and One Digital Health can help coordinate disparate data streams and reduce healthcare's environmental impact. Integrated dashboards can support renewable energy adoption, energy efficiency, and operational decision-making, while telehealth can reduce transportation-related emissions. Artificial intelligence may also reduce resource use when applied judiciously through narrowly scoped, task-specific models, with frameworks such as SAHAI guiding sustainable implementation. Financial approaches such as New York University's Return on Sustainability Investment framework can quantify the financial value of decarbonization initiatives. Effective governance, including vertical alignment and horizontal integration, is essential to operationalizing these strategies. Emerging opportunities include climate-conscious hardware design and carbon accounting applications. Ultimately, informatics can provide the data, tools, and governance infrastructure needed to translate climate mitigation goals into measurable health system action and establish carbon neutrality as an organizational performance priority.