The U.S. healthcare sector accounts for an estimated 8.5 % of national greenhouse gas emissions and addressing healthcare emissions is a critical priority to mitigate their negative impacts on human and planetary health. Most are indirect emissions from upstream supply chains such as construction and manufacturing, but downstream reforms can be easier to implement and can deliver meaningful, near-term reductions. For example, increased digitization and reduced dependency on paper in healthcare have potential to improve patient care, safety, equity, and experience while reducing environmental impacts and costs. If implemented at scale, the potential reductions are substantial. A promising area for decarbonization is the transition of Prescribing Information (PI) from a dual system to a digital-first system. In the dual system both digital and printed information must be provided with the 6.7 billion prescriptions dispensed by U.S. retailers annually. To produce printed PIs requires 1.8 million trees and generates 640 kt of CO ₂ e—equivalent to the annual emissions of 128,000 cars. In a digital-first system, digital information is always available and printed when needed, significantly reducing resources, waste, and emissions. Moreover, this transition would align the U.S. with the rest of the world, the recommendations of the Food and Drug Administration (FDA), and standard prescriber practice. Here, we discuss the background to the current policy, the challenges, opportunities, and impacts of changing to digital-first Prescribing Information, and outline a transition roadmap that includes provision of simplified, approved Patient Medication Information.