How Telemedicine Reduces Healthcare’s Carbon Footprint

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Healthcare’s Dual Challenge

As climate change intensifies, healthcare faces a dual challenge: delivering quality care while reducing its massive carbon footprint. Could telemedicine be the solution? Healthcare requires enormous amounts of energy. We use energy to transport patients, family members, healthcare providers, and staff. We use additional energy to heat, cool, and illuminate buildings, and to power medical equipment. Supplies are delivered through an energy-consuming supply chain, and we use energy to dispose of the resulting waste. This energy use results in greenhouse gas emissions, exacerbating climate change and negatively impacting health. Is telemedicine a green solution to healthcare’s environmental impact, or does it consume more energy than it saves? New research shows that under the policy conditions of the COVID-19 pandemic era, telemedicine reduced healthcare’s carbon footprint, saving approximately 1.44M tons of CO₂ annually.

The Environmental Impact of Healthcare

Healthcare systems and services are responsible for approximately 4.4% of global carbon emissions and 8.5% of US carbon emissions. Where does healthcare’s energy come from? The energy used to power healthcare activities is primarily obtained by burning fossil fuels, which produce greenhouse gases, including carbon dioxide (CO2). Greenhouse gas emissions exacerbate poor air quality, which has been associated with multiple health problems, from breathing difficulties to miscarriages and worsened dementia symptoms. Greenhouse gas emissions also contribute to climate change, resulting in additional environmental exposures, including intensely hot weather, storms, floods, and wildfires that cause injury, illness, and death.

Seemingly, telemedicine has the potential to reduce healthcare’s energy use by reducing the need for transportation and the need for building infrastructure that is equipped and staffed for in-person visits. However, telemedicine also requires the energy to operate the necessary computers and devices. Our team, composed of researchers from the University of Utah, the Medical University of South Carolina, the University of South Florida, and Doxy.me, Inc., conducted a nationwide study of the travel distance between patients and providers participating in telemedicine sessions to better understand the environmental impact of telemedicine. Then, using the results, we estimated the carbon emissions savings realized through telemedicine. The findings, recently published in the Journal of Medical Internet Research, shed light on how telemedicine can substantially reduce healthcare-related emissions while maintaining crucial access to healthcare services.

Estimating Carbon Emissions Savings of Telemedicine

Our team conducted a nationwide observational study using data from over 79,000 telemedicine sessions facilitated through the doxy.me platform from January 2022 to February 2023. Our first task was estimating the automobile travel distance between providers and patients participating in real-world telemedicine sessions. We used analytic tools, including geospatial analysis software and Google distance matrix, to determine the travel distance between patients and healthcare providers by automobile, using the best route available when the telemedicine session occurred. Only some people travel to healthcare appointments by car, so we used national survey data about commuting patterns to estimate the proportion of travel that would have used automobiles. 

While telemedicine often saves energy used for transportation, it also consumes energy. Each time a patient and provider connect, energy is required to power the devices and data transmission, partially offsetting any reduction in automobile transportation energy use. We accounted for this energy use conservatively, assuming all connections involved the use of high-definition (HD) video. 

Key Findings: Telemedicine’s Environmental Savings

Our findings include the median automobile travel distance associated with telemedicine sessions during the study time period, an estimate of the associated reduction in CO₂ emissions, and the approximate annual emissions savings.

• Median Travel Distance Avoided. Each telemedicine session saved a median of 49 miles in round-trip automobile travel.
• Emission Reductions. Considering the US transportation and fuel efficiency metrics, this corresponds to a median reduction of 20 kilograms of CO₂ per session.
• Annual Impact. When scaled to national telemedicine usage under the policy conditions of the COVID-19 public health emergency, which was in effect during the study period, telemedicine eliminated 1.44 million metric tons of CO₂ emissions annually. This savings is equivalent to removing about 165 million gallons of gasoline consumption—a meaningful reduction in healthcare’s carbon footprint.

Challenges and Opportunities

While the results are encouraging, telemedicine alone is not the solution to reducing US CO₂ emissions. The estimated annual emissions savings represented just 0.02% of the total US CO₂ emissions in 2021. Telemedicine must complement broader US sustainability efforts within and outside healthcare, including energy-efficient built infrastructure and cleaner transportation options. Additionally, the study highlights the need for more policy, research, and practice to further optimize the use of telemedicine from a sustainability perspective:

• Policy and Access. Long-term, stable telemedicine licensure and reimbursement policies and equitable access to digital health technologies are critical to sustaining telemedicine’s availability and environmental impact.
• Research. A more detailed understanding of patient perspectives and preferences related to healthcare transportation and telemedicine could enable optimal planning of healthcare visits to reduce environmental impact. Similarly, a more robust understanding of the quality and outcomes of telemedicine could enable more confident use of telemedicine in appropriate clinical scenarios.
• Practice. We can reduce healthcare’s environmental impact through thoughtful integration of telemedicine into clinical workflows and patient-driven choice of telemedicine vs. in-person appointments when feasible and clinically appropriate.

Telemedicine: A Green Path Forward

The results of our study evidence telemedicine’s dual role in improving healthcare access and mitigating climate change. As healthcare organizations work to achieve carbon neutrality, telemedicine can be a powerful strategy for environmentally sustainable care. Organizations, including Kaiser Permanente and UCSF, have already achieved aggressive decarbonization goals, in part by using telemedicine. By systematically employing telemedicine when it is clinically appropriate, the healthcare sector can progress toward a future where quality care and sustainability go hand in hand. This study serves as both a validation of telemedicine’s current impact and a call to action for its broader adoption as a tool for climate change mitigation.

A complete report of our study findings is available here.

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