Telehealth reduces patient costs, greenhouse gas emissions
Telehealth use for ambulatory services had positive impacts on patient travel distances, time and costs as well as greenhouse emissions, a study published in Telemedicine and e-Health found.
According to Sristi Sharma, MD, MPH, a preventive medicine physician at the University of California, Davis, and colleagues, pre-COVID-19 pandemic studies found associations between telehealth, travel and environmental reductions, the latter being a notable finding when considering the role that health care plays in climate change.
“With an estimated 30% increase in the U.S. health care greenhouse emissions between 2006 and 2016 contributing to 9.8% of the total national emissions, the impact of the country’s health care system continues to escalate,” they wrote.
A 2019 Health Care’s Climate Footprint report found that the United States was the greatest contributor of greenhouse gases from health care activities, making up 27% of global emissions in health care. The report also found that 17% of health care emissions come from health care facilities and vehicles.
Prior research has focused on the impact of smaller telehealth programs and not the overall impact of telehealth use for ambulatory care during a time when remote care has become a crux, Sharma and colleagues wrote. Telehealth services under Medicare alone increased from around 840,000 in 2019 to more than 53 million in 2020, according to HHS data.
“Our study attempts to do both by focusing on the environmental impact of the increased use of telehealth in a large, statewide university health system for ambulatory care during the pandemic,” the researchers wrote.
Sharma and colleagues evaluated the combined ambulatory telehealth visits of five university health care systems within the University of California from March 1, 2020, to Feb. 28, 2022. They then analyzed several outcomes, including reductions in travel time, distance and costs, the number of incidents and fatalities avoided, and reductions in greenhouse gas emissions.
Of the total 3,043,369 visits, 59.3% (n = 1,803,327) of patients were women, while 29.1% (n = 893,600) were aged 65 years and older.
Sharma and colleagues found that for the average patient, ambulatory telehealth saved them:
- 17.6 miles of travel;
- 35.5 minutes of travel;
- $11.02 for travel per visit.
In total, the researchers estimated that telehealth saved 53,664,391 miles, 1,788,813 hours and $33,540,244 in travel-related costs, and avoided 42.4 vehicle-related injuries and 0.7 fatalities over the course of the study period.
“For perspective, the travel distance saved by using telehealth for ambulatory visits during the pandemic from this university system alone equals close to 113 round-trip journeys from the earth to the moon,” the researchers wrote.
With the reduced travel, around 21,466 metric tons of CO2 emissions were also avoided, “equivalent to 1-year CO2 emissions from annual electricity use by 4,177 average homes in the United States,” Sharma and colleagues wrote.
There were several limitations to the study, which include the retrospective design, the assumption that patients would have traveled to in-person services had remote care not been available and the assumption that patients would have utilized light-weight gasoline vehicles for travel, according to the researchers.
“This study has confirmed and will contribute to evidence for continuing telehealth ambulatory services as a cost-effective, safe, and environmentally friendly mode of care even after the pandemic is over,” Sharma and colleagues concluded.
They also noted that future research should “evaluate the additional costs incurred by the patients using telehealth services and by the health care systems implementing these programs, the benefits of continuing the in-person ambulatory consultations, and greenhouse gas emissions from care-based activities not related to patient travel.”
References:
- Health care’s climate footprint. https://noharm-uscanada.org/content/global/health-care-climate-footprint-report. Accessed Jan. 13, 2023.
- Medicare beneficiaries’ use of telehealth in 2020: Trends by beneficiary characteristics and location. https://www.aspe.hhs.gov/sites/default/files/documents/a1d5d810fe3433e18b192be42dbf2351/medicare-telehealth-report.pdf?_ga=2.263152908.1288477598.1638811694-1417522139.1637192937. Accessed Jan. 13, 2023.
- Sharma S, et al. Telemed J E Health. 2022;doi:10.1089/tmj.2022.0396
- Telehealth cuts health care’s carbon footprint and patient’s costs during pandemic. https://www.newswise.com/coronavirus/telehealth-cuts-health-care-s-carbon-footprint-and-patient-s-costs-during-pandemic/?article_id=784924&sc=mwhr&xy=10023643. Published Jan. 10, 2023. Accessed Jan. 13, 2023.