Expanded during pandemic, virtual medical care offers big climate benefits: researchers

Online medical visits or telephone appointments can reduce costs, travel and time in the waiting room, but virtual health care may also have environmental benefits, researchers in B.C. and N.S. have found.

With fewer people travelling tomedical appointments by car or public transit, some say online or telephone appointments could continue to helpreduce greenhouse gas emissions post-pandemic.

"Virtual care has been a priority of people working in this space for a long time,"said Dr. Andrea MacNeill, surgical oncologist at Vancouver General Hospital and associate professor in the Department of Surgery at the University of British Columbia.

"We recognize thatfrom an environmental perspective, it's a high-yield area of focus to avoid not only travel emissions, but moreemissions-intensive interactions with the health-care system."

A Canadian Medical Association (CMA) survey released last June suggested 47 per cent of Canadians used virtual care such as calls, email, texts or video during the pandemic. Of these, 91 per cent said they were very satisfied with the experience.

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Vancouver Coastal Health (VCH) staff wanted to know how some of their patients felt about telemedicine.

After surveying about 100 people who had appointmentsbetween April andJuly of last year in five departments, they found that virtual visits helped patientssave time while reducing emissions.

Many of the surveyed patients said they would have driven 15 kilometres or less to get to the appointment.

VCH staff then calculated how much travel emissions were avoided, using theB.C. government's methodologyfor quantifying greenhouse gas emissions.

"For each avoided in-person appointment that is now a virtual appointment, we ended up avoiding anywhere between two to five kilograms of carbon dioxide equivalent per appointment," said Marianne Dawson, a sustainability consultant withhealth organizations in the Vancouver area, including VCH.

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Dawson said the numbers may seem small but scaled up to include patients across the region,"we can see how quickly those avoided emissions will add up."

Health sector and greenhouse gases

Canada's health sector is among the worst in the world in terms of greenhouse gases, according to a 2019article in the Canadian Medical Association Journal.

When compared to health-care systems in 47 countries,Canada has the third-highest per capita emissions, according to a post by the Canadian Medical Association.

Creating a greenerhealth-care system is something Dr. Sean Christie and colleagues in Halifax are working on.

"At this point in time, it's probably not front and centre for the majority of people," saidChristie, a neurosurgeon and co-lead for a feature project through the Healthy Population Institute at Dalhousie University.

"I think that that's largely because it's not out there that broadly healthcare has an impact on the environment."

Christie and colleagues are currently collecting data on the carbon footprint ofdifferent approaches to patient care, both in-person and virtual, in addition to patient surveys,he said.

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He's expecting to seeresults in late summer.

"A lot of health care, particularly in Canada but worldwide, has been really geared towardcost-effectiveness and care," he said.

"We're not trying to get rid of that, but include in that consideration what is the cost to the environment for our care."

Environmental benefits of telemedicine

Even before the pandemic, studies have shown thattelemedicine can reduce greenhouse gas emissions.

A March review of 14 studies on telemedicine and carbon emissions published in the Future Healthcare Journal found the studies "unanimously report that telemedicine does reduce the carbon footprint of healthcare, primarily by reduction in transport-associated emissions."

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The review's authors said the carbon footprint savingsranged between 0.70 to 372 kilograms of carbon dioxide equivalent per appointment.

The review found the carbon footprints of both telephone and video telemedicine were low in comparison to emissions saved from a decrease in travel.

"This could have wide implications in reducing the carbon footprint of healthcare services globally," the reviewers wrote, adding that more research is still needed.

The challenge now, Christie said, is making the environmental benefits of telemedicine more widely known so that it can continue to some degree post-pandemic.

"I don't think that this is front and centre of a lot of patients' minds when confronted with healthcare. But if nobody tells you about a problem, you don't necessarily think about it. So raising awareness, I think, will go a long way," he said.

"If there's a big public demand for something that has a lot of positive impact, then we're going to make hopefully good decisions."