For Gundersen Health System, La Crosse, Wisconsin, energy efficiency and sustainability nirvana is within sight. Gundersen projects that before the end of the year it will achieve total energy independence, making it the first U.S. healthcare system to do so, its leaders say. Gundersen, which includes four hospitals and about 75 medical and specialty clinics serving patients in three states, started a program called Envision that provided a broad strategy to offset its energy consumption through conservation and renewable energy projects, most involving local businesses.