Abstract
Health systems make a sizeable contribution to national emissions of greenhouse gases that contribute to global climate change. The UK National Health Service is committed to being a net zero emitter by 2040, and a potential contribution to this target could come from reductions in patient travel. Achieving this will require actions at many levels. We sought to determine potential savings and risks over the short term from telemedicine through virtual clinics. During the severe acute respiratory syndrome coronavirus 2 (SARS-2-CoV) pandemic, scheduled face-to-face epilepsy clinics at a specialist site were replaced by remote teleclinics. We used a standard methodology applying conversion factors to calculate emissions based on the total saved travel distance. A further conversion factor was used to derive emissions associated with electricity consumption to deliver remote clinics from which net savings could be calculated. Patients' records and clinicians were interrogated to identify any adverse clinical outcomes. We found that enforced telemedicine delivery for over 1200 patients resulted in the saving of ~224000km of travel with likely avoided emissions in the range of 35000-40000kg carbon dioxide equivalent (CO2 e) over a six and half month period. Emissions arising directly from remote delivery were calculated to be <200kg CO2 e (~0.5% of those for travel), representing a significant net reduction of greenhouse gas emissions. Only one direct adverse outcome was identified, with some additional benefits identified anecdotally. The use of telemedicine can make a contribution toward reduced emissions in the health care sector and, in the delivery of specialized epilepsy services, had minimal adverse clinical outcomes over the short term. However, these outcomes will likely vary with clinic locations, medical specialties and conditions.
Highlights
On October 1, 2020 the UK National Health Service (NHS) adopted formal plans to move from being responsible for 4% of the UK’s carbon emissions to being net zero by 2040, with an ambition for an interim 80% reduction by 2028–2032, and with further targets for its extensive supply chain to be net zero by 2045.1 Achieving such an ambitious target will require significant actions across the NHS.[2]
Telemedicine for epilepsy has been well-documented over the course of the pandemic
We show that telemedicine can contribute net greenhouse gas (GHG) emissions savings
Summary
On October 1, 2020 the UK National Health Service (NHS) adopted formal plans to move from being responsible for 4% of the UK’s carbon emissions to being net zero by 2040, with an ambition for an interim 80% reduction by 2028–2032, and with further targets for its extensive supply chain to be net zero by 2045.1 Achieving such an ambitious target will require significant actions across the NHS.[2] The interventions proposed include care delivery at or closer to home, with fewer patient journeys to hospitals: Of the extended NHS carbon footprint, 5% is attributable to patient travel This proportion is small, patient travel amounts to ~1.25 megatonnes carbon dioxide equivalent (CO2e)/year.[3]. We gathered data from a unique site providing adult epilepsy services, and calculated the marginal carbon emissions savings from enforced telemedicine, and documented adverse clinical outcomes
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