Although medical treatments benefit our health in various ways, the provision of healthcare has also potentially detrimental effects on the environment. Furthermore, the interconnectedness between environmental damage and human health is apparent, with environmental factors contributing to 12-18% of all deaths in Europe. Notwithstanding this footprint, healthcare delivery has of course also a beneficial impact for patients, the so-called handprint. Health Technology assessments (HTAs), traditionally designed to evaluate the clinical and economic aspects of healthcare technologies, are now at the forefront of a paradigm shift. By integrating environmental sustainability considerations into HTAs, we can evaluate the trade-offs between health gain, cost effectiveness and environmental considerations,. The overall approach of this study is to advance our recently developed pioneering sustainability framework (https://doi.org/10.1016/j.jclepro.2024.142978) and to establish a standardized methodology to incorporate environmental impact assessments as part of HTAs, both in both preventive and curative medicine.