The healthcare sector plays an important role in the climate crisis. It is responsible for 7% of the Dutch CO2 footprint and 4.6% of total CO2 emissions worldwide. Researchers from the Dana-Farber Cancer Institute, Harvard Medical School in Boston and Massachusetts General Hospital decided to investigate whether the use of telehealth can reduce the CO2 emissions of hospital visits.
Telehealth is digitally delivered healthcare, for example via an app patients use to stay in contact with doctors or nurses, if needed with added photos or to have a video consultation. The potential of this form of digital care to help people with transportation problems is already well documented. However, the fact that patients do not have to use a car when visiting healthcare providers and therefore use significantly less petrol, diesel or gas due to virtual care, has hardly been investigated in depth.
Analysis of all aspects
To determine the difference in carbon emissions, researchers analyzed data from more than 120,000 cancer patients treated at Dana-Farber Cancer Institute between May 2015 and December 2020. Using a life cycle analysis, they assessed the environmental impact of various aspects of hospital visits, such as travel to and from the hospital and electricity used for elevators, lighting, and computers.
The research team then analyzed the difference in carbon emissions between two periods: May 2015 to February 2020, when patients were still frequently in the hospital, and March 2020 to December 2020, when remote care was the focus. The results showed that Dana-Farber Institute’s carbon emissions during the telehealth period were 36.4 kg per day lower than during the in-person hospital visit period, a reduction of 81.3%.
Fewer deaths
Extrapolating these numbers to the 10.3 million Americans diagnosed with cancer during the same period, the researchers found that decentralized telehealth could reduce the national carbon footprint by 75.3 million kg of carbon equivalents annually. That’s equivalent to an estimated annual reduction in the number of healthy life years lost to disease for the entire U.S. population from 62.7 to 47.7 years.
The researchers then concluded that telehealth could reduce the carbon footprint of hospital visits by about a third. And that reduction would lead to a small but direct reduction in global deaths.
Inequality
Andrew Hantel, who co-led the study, noted that the use of telehealth could potentially increase inequalities in access to cancer care. While it could potentially make it easier to get expert care with less travel time, it could also lead to virtual appointments being added to, rather than partially replacing, in-person appointments.
Hantel: “That can be difficult for the elderly and people who don’t have a good internet connection. In some cases, it also makes it harder for doctors to diagnose and treat the patient. Our finding that telehealth reduces carbon emissions adds another layer to the discussion about this.”
Results confirm previous research
The results of this study are consistent with previous reports that telehealth has a positive effect on carbon emissions. For example, a few years ago, Wexner Medical Center built a dashboard to estimate the environmental impact of the medical facility’s telehealth offering. The numbers were impressive: between July 2019 and February 2020, 800 digital appointments were held. In the two years since, that number has increased to 768,970. This has prevented an estimated 50 million miles of travel, saved 2.2 million gallons of gasoline, prevented 25 tons of “appointment-related waste,” and avoided more than 17,500 metric tons of carbon dioxide.
It was notable that patient satisfaction scores remained high, as digital care was appreciated. The additional use of electricity during digital sessions was not included in the calculations, but it is unlikely that this had a significant effect. The Wexner Medical Center is also working on sustainability in other areas, as is explicitly stated on the website.
