ESCRS - PP20.18 - Systematic Review On Methods For Calculating Carbon Footprint In Telemedicine And Development Of A Personalized Carbon Footprint Calculator

Systematic Review On Methods For Calculating Carbon Footprint In Telemedicine And Development Of A Personalized Carbon Footprint Calculator

Published 2023 - 41st Congress of the ESCRS

Reference: PP20.18 | Type: Free paper | DOI: 10.82333/r3q8-j152

Authors: Casper van der Zee* 1 , Jennifer M Chang-Wolf 1 , Marc A Koopmanschap 2 , Redmer van Leeuwen 3 , Robert P L Wisse 4

1Ophthalmology,UMC Utrecht,Utrecht,Netherlands, 2School of Health Policy and Management,Erasmus University,Rotterdam,Netherlands, 3Ophthalmology,UMC Utrecht,Utrecht,Netherlands;National network Green Surgery Room,Utrecht,Netherlands, 4Ophthalmology,UMC Utrecht,Utrecht,Netherlands;Easee B.V.,Amsterdam,Netherlands

Purpose

To aim of this paper is to conduct a systematic review on how carbon footprint of telemedicine is evaluated. Additionally, we report the impact on our telemedicine program in post-operative catarct eye care and propose a simplified open-access calculator to roughly estimate emissions for individual healthcare suppliers.

Setting

The healthcare environment accounts for 4-10% of carbon dioxide emissions worldwide, of which travel-related emissions contribute about 22%. Remote care through telemedicine is a potential solution for reducing these emissions. However, literature on telehealth footprint is scarce and often lacks a comprehensive approach on emission estimations. Therefore, a systematic way to report the environmental impact is essential.

Methods

We searched according to the PRISMA guidelines in PubMed, Medline, Embase and Scopus for articles that estimated the carbon footprint savings of telemedicine. Publications were evaluated in categories, of which the most important were travel distance and streamlined life cycle assessment (LCA). Travel by train and air are excluded. 

Results

The search found 1,117 records and included 23 articles about ground travel, mainly from North America and Europe. The median savings per visit were 131 km (IQR:52-386), translating to 26.3 kilograms CO2 (kgCO2) (IQR:10.6-94.4). Calculations that included LCA had a mean emission of 2.5% less than estimates that excluded LCA. We estimate in our remote eyecare example that 411,000 kgCO2/year could be saved from travel alone, or 401,000 kgCO2/year when accounting for LCA.

Conclusions

Travel distance as a variable is the biggest contributor. To prevent overestimation of carbon emission savings due to telemedicine, a life cycle assessment should be included. The precision of our estimate is limited by the number of studies. However, our model is a preliminary attempt to roughly capture the carbon footprint difference and opens a scientifical debate for structural measurement and calculation of carbon footprint in telemedicine. By defining the contribution of telemedicine to carbon footprint savings, we gain perspective on its role in working towards our collective climate goals.