Across the world, healthcare systems are facing a profound and urgent challenge: As populations age, the demand for medical care—and therefore, more hospitals—is rising sharply. The U.S. offers a clear illustration of the scale of the problem: By 2050, the number of Americans aged 60 and over will reach 110 million, up from 85 million today. Meeting the healthcare needs of this older population using current delivery models would require around 600 new facilities, each averaging 150 beds.
However, hospitals are among the most energy-intensive buildings. Their carbon footprint extends far beyond their walls, making up around 4.5% of the world's GHG emissions. They’re the fifth-largest contributor to global emissions. In fact, the conventional construction and operation of 600 new healthcare facilities will generate more than 9 million metric tons of carbon by 2050. That’s equivalent to the annual energy use of 2 million U.S. homes, or taking 24 million transatlantic flights!
The risk of building as we always have
If healthcare infrastructure continues to be designed and built using traditional approaches, the consequences will be dire. Inefficient buildings will lock in high operational costs and carbon emissions for decades. Local energy grids—already under pressure in many regions—will struggle to accommodate the additional load. And the financial burden of maintaining outdated models of care will grow, even as patient needs evolve.
The ‘predict and provide’ model of building more to meet rising demand is no longer viable. It risks creating stranded assets, misaligned with future care models, and incompatible with climate goals.
The challenge is not just to build enough, but to think and build differently.
Smarter, more sustainable solutions
Sidara companies, such as Perkins&Will, Currie & Brown, Dar, Introba and CopperTree analytics, are helping healthcare providers around the world rethink how care is delivered and how infrastructure is designed. Their work demonstrates that it is possible to meet the needs of aging populations while reducing environmental impact and improving patient outcomes. Combining analysis and innovative design, they provide health system operators with the information needed to rethink how they approach healthcare and the buildings that support delivery.
One of the most promising shifts is the move away from centralized mega-hospitals toward decentralized networks of clinics and specialist centers. These hub-and-spoke systems improve access, reduce travel emissions, and allow for more targeted investment. They also align better with emerging models of care, which increasingly rely on digital tools and remote monitoring.
Digital transformation in care delivery
Digital service strategies are already reshaping healthcare. Virtual wards and telehealth enable patients to receive treatment at home, reducing the need for physical beds and improving comfort.
In some systems, these approaches have cut bed demand by up to 25%, easing pressure on facilities and lowering operational carbon while enabling patients to stay at home where they feel comfortable and close to family. This is not just a technological upgrade; it’s a fundamental rethinking of how healthcare interacts with people’s lives.
Designing for efficiency and resilience
Design innovation also plays a critical role. All-electric hospitals, passive design techniques, and smart energy management systems are helping to drive down energy use and emissions. Perkins&Will is collaborating with clients to capture the abundant waste heat from hospitals to offset demand in neighboring buildings, including multi-family housing, thereby reducing demand on local utilities. This kind of district-level energy planning turns healthcare infrastructure into a community asset, reducing household bills as well as easing the strain on aging energy grids.
Technology and Operational Optimization
Technology is enabling more distributed, data-driven care. Diagnostic imaging, patient records, and treatment plans can be shared instantly across networks, reducing the need for centralized infrastructure. While partnerships with tech firms bring new challenges around operational carbon, they also unlock models of care that are more flexible, efficient, and environmentally responsible.
Operational optimization is another key lever. Tools from firms like CopperTree help facilities monitor energy use, identify inefficiencies, and improve performance. Hospitals are increasingly investing in smart systems that allow them to manage energy more effectively, reduce maintenance costs, and improve patient comfort. By ensuring buildings perform to their potential, these systems allow facilities to respond dynamically to changing conditions, improving resilience and reducing cost.
A global movement
These innovations are not just theoretical. They are being implemented across the Sidara group, in projects that span continents and climates. From climate-resilient hospitals in Australia to electrified campuses in the U.S., the group is demonstrating that sustainable healthcare is both essential and achievable.
A call to leadership and action
This is not just a technical challenge; it’s a leadership opportunity. Healthcare providers, city planners, and policymakers must work together to develop integrated strategies that reflect changing demographics and align infrastructure with environmental goals. The decisions made today will shape the health and well-being of future generations.
Rather than viewing the demographic shift as a burden, we ought to see it as a catalyst for innovation. With the right approach, we can build a healthcare system that serves people throughout their longer lives while protecting the planet. Sidara companies are already showing the way forward.
