The Environmental Impact of Telemedicine
Telemedicine can be part of a strategy to help mitigate healthcare’s impact on the environment
The healthcare sector is one of the largest emitters of greenhouse gases (GHG) — a leading cause of climate change
Climate change is a threat to the health and wellbeing of our society, which is contrary to the goals of our healthcare system
June 04, 2020 — In 2019 ARUP and Health Care Without Harm published data on the impact of healthcare GHG emissions and climate change (1). Here are some key highlights from the report:
Healthcare’s climate footprint is equivalent to 4.4% of global net emissions
The global healthcare climate footprint is equivalent to the annual GHG emissions from 514 coal-fired power plants
If the health sector were a country, it would be the fifth-largest emitter on the planet
The top three GHG emitters globally are: the United States, China, and the European Union — which together account for 56% of the total world’s health care climate footprint
The US healthcare system uses vast amounts of energy in the form of heating, electricity, and energy-intensive goods and services, and it has been estimated that this sector contributes 8% of the nation's GHG emissions (2). GHG emissions impact the environment globally, leading to climate change. I turn, climate change threatens the health of our communities through different pathways (3):
Changes in vector ecology (mosquitoes)
Severe weather (flooding, drought)
Water and food quality and supply
Air pollution
Extreme heat
Read more: CDC & Climate Effects on Health
Read more: WHO & Climate Change and Health
There are strategies healthcare systems can implement to mitigate the hazards leading to GHG emissions: from efficient green buildings and trash management/recycling to sustainable operations and sustainable transportation. A telemedicine program can be part of these strategies. Telemedicine and health information technology may help save time, energy, raw materials (such as paper and plastic), and transportation-related expenses — thereby lowering the carbon footprint of the health industry (4) .
A 2017 study estimated travel-related and environmental savings resulting from the use of telemedicine at UC Davis Health System (5). The study demonstrates the positive impact of a telemedicine program on patient travel time, patient travel costs, and environmental pollutants. Some of the key points of the study include:
Telemedicine visits resulted in a total travel distance savings of 5,345,602 miles, a total travel time savings of 4,708,891 minutes or 8.96 years, and a total direct travel cost savings of $2,882,056
The mean per consultation round-trip distance savings were 278 miles, average travel time savings were 245 minutes, and average cost savings were $156.
Telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO2, 50 metric tons of CO, 3.7 metric tons of NOx, and 5.5 metric tons of volatile organic compounds
GHG emissions from the US healthcare sector account for a significant portion of the nation’s overall GHG emissions and of the resulting global health impact. Our calling is to "do no harm". If providing healthcare imposes a heavy carbon footprint — and if that in turn threatens health — we need to know so we can reduce the burden (3).
In 2017 the American Telemedicine Association (ATA) launched a task force on telemedicine and climate change with the following goals (6):
Encouraging ATA members to use “green” outcomes as part of their routine measures, and describing such measures and outcomes
Developing tools and guidelines for how ATA members can reduce fossil fuel use and carbon dioxide (CO2) production through less travel
Demonstrating how telemedicine can create more environmentally sustainable practices and health systems
Showing how telemedicine can mitigate and respond to health crises arising from both sudden and long-term climate change related events, such as warming, disasters and the spread of infectious diseases
Healthcare–related pollution represents a notable portion of total US emissions, and telemedicine is a strategy that can help mitigate these hazards. The national healthcare sector emission-disease burden could serve as a new global health metric (7). Telehealth value measures could include metrics such as travel-related expenses, travel-related time loss, total miles traveled, total estimated healthcare life cycle GHG emissions.
If you have any question about this article, feel free to contact me.
References:
Karliner J, Slotterback S. Health Care's Climate Footprint: How the Health Sector Contributes to the Global Climate Crisis and Opportunities for Action. Health Care Without Harm; 2019. https://bit.ly/3dpG1oO
Kashef Z. Environmental and health impacts of U.S. healthcare system. Yale News. https://bit.ly/3eblft9. Published: 2016. Accessed: 2020.
Frumkin H. The US Health Care Sector's Carbon Footprint: Stomping or Treading Lightly? Am J Public Health. 2018;108(S2):S56-s57. https://doi.org/10.2105/ajph.2017.304160
Yellowlees PM, Chorba K, Burke Parish M, Wynn-Jones H, Nafiz N. Telemedicine can make healthcare greener. Telemed J E Health. 2010;16(2):229-232. https://doi.org/10.1089/tmj.2009.0105
Dullet NW, Geraghty EM, Kaufman T, et al. Impact of a University-Based Outpatient Telemedicine Program on Time Savings, Travel Costs, and Environmental Pollutants. Value Health. 2017;20(4):542-546. https://doi.org/10.1016/j.jval.2017.01.014
American Telemedicine Association. ATA Leadership Launches New Task Force Focused on how Telemedicine Impacts Climate Change. ATA News. https://bit.ly/2XV36t4 Published 2017
Eckelman MJ, Sherman JD. Estimated Global Disease Burden From US Health Care Sector Greenhouse Gas Emissions. Am J Public Health. 2018;108(S2):S120-s122. DOI: https://doi.org/10.2105/ajph.2017.303846
