Healthcare Group Releases AI Procurement Guide Focused on Climate

A nonprofit organization is urging healthcare systems and payers to leverage their collective purchasing power to push artificial intelligence vendors toward greater environmental accountability.

Health Care Without Harm (HCWH) published a U.S. Artificial Intelligence Procurement Guide designed to help healthcare organizations evaluate AI vendors on environmental criteria and incorporate sustainability requirements into contracts. The guide was developed with input from health system and payer partners who requested the framework.

Why it matters

As healthcare rapidly scales AI adoption, the technology's environmental footprint—from energy-intensive data centers to water consumption—creates public health risks that directly contradict the sector's mission. Healthcare organizations collectively wield significant purchasing influence that could reshape how AI companies operate, potentially setting industry standards that extend beyond healthcare itself.

Environmental risks of AI deployment

The guide identifies multiple environmental impacts associated with AI systems, including air pollution, energy grid disruptions, rising electricity costs, community displacement, reduced water availability, noise pollution, waste generation, and diminished access to green space.

"We want to be able to leverage the buying power of the healthcare sector to make all Americans, all people in this country, healthier," Jenny Keroack, director of climate solutions for HCWH's U.S. Climate Program, told Fierce Healthcare. "We want to see AI companies become net assets for their communities."

Practical framework for vendor evaluation

The guide includes 10 specific environmental disclosure questions covering three areas: the vendor's company practices, AI model efficiency, and data center operations. Healthcare organizations receive boilerplate contract language and a scoring system for vendor responses.

In the first year, vendors can earn 25% of available points simply by committing to provide requested data within 12 months—acknowledging that some companies may need time to gather information about third-party infrastructure. After the initial year, only actual data disclosure receives points.

The framework recommends healthcare organizations ask vendors to measure and reduce greenhouse gas emissions, disclose their energy sources, increase renewable energy use, improve data center efficiency, account for community health impacts, and help healthcare customers reduce their own AI footprint.

"Procurement is not only a tool for gathering this data. It's also a tool for eventually putting obligations into contracts," HCWH CEO Emily Bancroft told Fierce Healthcare.

Strategies for reducing AI's environmental impact

The guide references the Sustainably Advancing Health AI (SAHAI) Framework, published in The New England Journal of Medicine in 2025 by researchers from Stanford and Cornell Tech. SAHAI proposes practical solutions including scheduling non-urgent AI processing during off-peak energy demand hours and using mixed-quality models that reserve complex processing for high-stakes tasks while handling routine work with simpler, less energy-intensive models.

For products with optional AI features, organizations can request to disable those capabilities to avoid unnecessary emissions and costs. Keroack noted that energy efficiency improvements should reduce expenses for both healthcare organizations and vendors.

Addressing industry imbalances

The guide highlights a significant gap in climate commitments between healthcare organizations and AI companies. More than 940 U.S. companies have validated science-based climate targets through the Science Based Targets initiative, including many large healthcare organizations. AI companies, particularly smaller firms, have lagged in making similar commitments.

Bancroft pointed to successful precedents in healthcare supply chain transformation, such as eliminating harmful chemicals from furnishings and phasing out mercury in medical devices, as evidence that collective action can drive industry-wide change.

"Healthcare has the opportunity, but also an obligation because of its mission, [to say] health isn't optional," Bancroft said, "and AI vendors must guard the environment and wellbeing if they want to get our business."

These details were first reported by Fierce Healthcare.