Sustainability is an issue that medical device companies need to embrace, however, it is not always the most straightforward process. Healthcare industries in western countries account for 4-8% of their respective greenhouse gas emissions. There is an interesting paradox within healthcare in which the pollution and global warming produced by the service increases the need for services in response to pollution related diseases.

In a bid to achieve its net zero campaign, NHS England asks Trusts to consider the ‘5 Rs’ when selecting equipment for contracts.

  • Reduce
  • Reuse
  • Reprocessed
  • Renewable
  • Recyclable


The healthcare industry relies heavily on single use medical devices that are manufactured, used once and disposed of (known as a linear economy). This is an unsustainable model of production and consumption responsible for excessive waste and the associated greenhouse gas emissions involved in manufacturing.


Reusable medical devices create a circular economy where products are maintained and used at their highest value application as long as possible. The acquisition costs are initially higher than single use devices but this cost can be distributed over many uses thus resulting in lower lifetime costs which can be passed on to the customer. Furthermore, increasing the number of uses of devices can lessen the environmental impact.


At ECG On-Demand, we use reusable devices alongside environmentally friendly packaging in order to provide a cost effective and sustainable service to help Trusts work towards the goal of net zero. This is made possible by the supplier of our devices, Bittium, who are committed to environmental sustainability. The monitors are designed to have an extended life cycle as well as being repairable and recyclable.

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Admittedly, there are some instances where sustainable options are not an option. To ensure quality of recording, ECG On-Demand uses electrodes that require a plastic foil packaging to keep the electrodes in usable condition.


It can be argued that reusable medical devices pose an infection control risk therefore disposable monitors are safer for patients. As it stands, there is no compelling evidence that single use monitors reduce healthcare associated infections such as prion disease. At ECG On-Demand we include a thorough clean as part of our processing once monitors are returned. Infection control is a multifactorial process and therefore ruling out one single factor can still result in a patient acquiring infection from the infrastructure of the hospital itself. By providing a service that can be carried out in the patient’s own home without travelling to and from a medical facility, it could help to reduce exposure for clinically vulnerable patients.


Reliance on single-use medical devices can leave device companies, and indeed their clients, vulnerable to supply chain disruptions, already witnessed during the pandemic. Whilst reusable devices can be lost by users or have delayed return, there still remains a good stock that can be reused and repaired and returned back to the system. Our hybrid approach of having both point-of-care and direct to patient services allows us to reliably provide a service for our customers.



Large healthcare organisations can embrace reusable devices over single use devices during their procurement processes to send out a signal to the market that they want to be more environmentally conscious and in turn give a competitive edge to those manufacturers that put reusability at the forefront of their values.



Keil M, Viere T, Helms K, Rogowski W. The impact of switching from single-use to reusable healthcare products: a transparency checklist and systematic review of life-cycle assessments. Eur J Public Health. 2023 Feb 3;33(1):56-63. doi: 10.1093/eurpub/ckac174. PMID: 36433787; PMCID: PMC9898010.

MacNeill AJ, Hopf H, Khanuja A, Alizamir S, Bilec M, Eckelman MJ, Hernandez L, McGain F, Simonsen K, Thiel C, Young S, Lagasse R, Sherman JD. Transforming The Medical Device Industry: Road Map To A Circular Economy. Health Aff (Millwood). 2020 Dec;39(12):2088-2097. doi: 10.1377/hlthaff.2020.01118. PMID: 33284689.