AI Telephone Call to Reduce Carbon Footprint

Especially in cataract and refractive surgery, the environmental impact of ophthalmology is an ever-growing concern. According to Aisling Higham MSc, one of the driving changes that can alleviate the carbon footprint of health services can be found in the use of AI-based telephone assistance.

“In the British National Health Service, 25 million tonnes of CO₂e are emitted every year, and we are driven to reduce that to a net zero by 2045,” Dr Higham said. “However, this is all on the backdrop of an ever-increasing number of cataract surgery operations.”

With this purpose in mind, she noted recent papers suggest how AI can really be a potential solution to reduce the environmental burden.^1,2 She explained that the NHS is already using AI as a conversational assistant—a regulated medical device called Dora (Ufonia). It is a telephone assistant program that automates conversations between the patient and the clinic or hospital, an interaction previously held solely between the patient and the clinician, Dr Higham noted. This, for example, reduces the need for face-to-face visits in the earliest parts of the patient’s clinical pathway, or at the pre-assessment.

Dr Higham, the Medical Director at Ufonia, says the AI assistant identifies patients who are interested in surgery and saves them from having to visit the clinic for cataract assessment. Moreover, this system avoids repetitive visits by enhancing the referral phase. In the following phase, Dora can call to confirm patients are able to come on the day of surgery.

The AI-based telephone assistant comes in handy again during follow-up. Rather than having every patient attend a face-to-face visit, an automated telephone call can help identify those patients who really have an issue, filtering those who need a follow-up visit in person while managing the others through a virtual pathway. This can help reduce the carbon footprint, she explained.

A study using the Dora pathway as a standard of care reported that each conventional outpatient appointment produced a carbon footprint of 12.78 kg of CO₂e, equivalent to 91 km of driving.¹ Comparatively, the carbon footprint for using Dora is 0.10 to 0.14 kg of CO₂e per call, equivalent to 0.8 km of driving. Dr Higham explained that the emissions are based on the server utilisation, so the relative cost per call decreases as the volume of calls managed by AI increases. Of the 14,000 operations performed in the study, the aggregate carbon footprint was 16,037 kg of CO₂e saved per year.

“AI can really be used to support that pathway transformation, and we can see a real difference in carbon footprint doing that,” she said. “Higher use of these systems can paradoxically reduce the carbon footprint per patient.”

Dr Higham spoke at the 2025 ESCRS Annual Congress in Copenhagen.

Aisling Higham MSc, FRCOphth is a consultant ophthalmologist at Oxford University Hospitals NHS Foundation Trust and Medical Director of Ufonia, both of the UK. aisling.higham@nhs.net

1. Meinert E, et al. Lancet, 2024 July; 73: 102692.

2. Hatamnejad A, et al. BMJ Ophth, 10; 9(1).