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. 2022 Jun 18;19(12):7474.
doi: 10.3390/ijerph19127474.

A Transparency Checklist for Carbon Footprint Calculations Applied within a Systematic Review of Virtual Care Interventions

Oliver Lange  1   2 , Julian Plath  3 , Timo F Dziggel  3 , David F Karpa  4 , Mattis Keil  1 , Tom Becker  3 , Wolf H Rogowski  1   2
Affiliations

A Transparency Checklist for Carbon Footprint Calculations Applied within a Systematic Review of Virtual Care Interventions

Oliver Lange et al. Int J Environ Res Public Health. .

Abstract

Increasing concerns about climate change imply that decisions on the digitization of healthcare should consider evidence about its carbon footprint (CF). This study aims to develop a transparency catalogue for reporting CF calculations, to compare results, and to assess the transparency (reporting quality) of the current evidence of virtual care (VC) intervention. We developed a checklist of transparency criteria based on the consolidation of three established standards/norms for CF calculation. We conducted a systematic review of primary studies written in English or German on the CF of VC interventions to check applicability. Based on our checklist, we extracted methodological information. We compared the results and calculated a transparency score. The checklist comprises 22 items in the aim, scope, data and analysis categories. Twenty-three studies out of 1466 records were included, mostly addressing telemedicine. The mean transparency score was 38% (minimum 14%, maximum 68%). On average, 148 kg carbon dioxide equivalents per patient were saved. Digitization may have co-benefits, improving care and reducing the healthcare CF. However, the evidence for this is weak, and CF reports are heterogeneous. Our transparency checklist may serve as a reference for developing a standard to assess the CF of virtual and other healthcare and public health services.

Keywords: carbon dioxide equivalents; carbon footprint; digital health; digital public health; e-health; greenhouse gas; systematic review; telehealth; telemedicine; virtual care.

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Conflict of interest statement

All authors completed the ICMJE uniform disclosure form and declare that they have no competing interests with regard to this project. D.F.K., J.P. and T.B. did not receive any funding. OL and WR report public grants, funded by the Leibniz Association (W4/2018), the Federal State of Bremen and the Leibniz Institute for Prevention Research and Epidemiology–BIPS, supporting OL’s work for the study. T.F.D. reports personal fees from Agder Energi outside the submitted work. No funding body had any influence on the design, conduct or publication of the study.

Figures

Figure 1
Figure 1
Consolidation of transparency catalogue.
Figure 2
Figure 2
Result of review process based on (modified) PRISMA flow chart [24].
Figure 3
Figure 3
Overview of study results reported by item.
See this image and copyright information in PMC

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