SUS 2 Telemedicine for diagnosis of Surgical Site Infection (SSI): Feasible, safe and sustainable

Abstract

Abstract Background In 2019, the NHS contributed to around 25 million tonnes of CO2 equivalent, equating to around 7% of the total UK carbon footprint (CO2e) that year. A significant contributor is CO2e attributable to patient travel, which has almost doubled since 1990. Aim To assess the feasibility and sustainability of telemedicine for diagnosis of SSI. Methods Patients were reviewed remotely at 30 days with a combined outcome measure (photographs and validated questionnaire). If wound complications were identified, face-to-face review or remote management were arranged. The SusQI method of emissions calculations were used with DEFRA conversion factors based on the minimal material and equipment usage and cost in clinic. Patient postcodes were applied to conversion factors based upon mode of travel to calculate kgCO2e for patient travel. Total CO2e per remote review were subtracted from the model clinic emissions for potential savings. Results 25 patients (M:F 1.78, 65.1±11.1 years) were reviewed remotely. The median return distance for patient travel was 26.4 miles (3.4-71.4 miles). The estimated CO2e of clinic was 13.1kgCO2e per patient. Mean emissions per patient travel was 9.7kgCO2e, giving the average simple clinic carbon footprint of 22.8 kgCO2e. Mean carbon footprint of remote follow-up was 0.47kgCO2e per patient, estimating the potential savings at 22.3kgCO2e. Four patients had wound infections, but were diagnosed and managed remotely. Conclusions This model shows that implementation of an asynchronous digital follow-up model is effective in substantially reducing carbon footprint of a tertiary surgical centre.