How telemedicine helps

Last year Stott and Godlee asked what we as health professionals can do about climate change.1 Traditional medical practice generates considerable carbon dioxide (CO₂) and other greenhouse gases through travel. Yet many medical interactions can be delivered by telephone, videoconferencing, or email (telemedicine) as effectively as face to face. The balance between environmental benefits (and costs) of telemedicine is being examined in a new area of research—environmental e-health (R E Scott et al, sixth annual Canadian Society of Telehealth conference, Halifax, Nova Scotia, October 2003).

Three examples show how doctors can reduce their carbon footprint. A telepaediatric service in Queensland, Australia, provides a broad range of specialist services to children living remotely.2 Telemedicine is used to manage 17% of paediatric outpatients with burns. Over six years, 1000 videoconference consultations eliminated about 1.4 million km of patient travel,3 which reduced CO₂ emissions by 39 tonnes each year. If the analysis included all telepaediatric activity (around 1300 consultations a year), the benefits would be even greater.

In the United Kingdom a neurologist now carries out half of his rural clinics via videoconferencing.4 This eliminates 2560 km of travel each year, and reduces greenhouse gas emissions by 705 kg. Even a 20% reduction in travel of all UK specialists would eliminate tonnes of greenhouse gas emissions annually.

A recent study estimated that about 36% of the 32 241 092 annual home nurse visits across Canada could be performed virtually (R E Scott et al, unpublished data). This would eliminate 120 710 648 km of travel each year and reduce greenhouse gas emissions by 33 220 tonnes each year.

Despite the feasibility and value of virtual health techniques in many clinical situations, uptake remains slow. Our examples show the environmental benefit of telemedicine, which accrues each year. This should encourage doctors and professional bodies to become more socially and environmentally responsible by asking whether they could perform some of their current practice virtually.