Impact of telemedicine use on outpatient-related CO2 emissions: estimate from a national cohort

Abstract

Objective: The US health care system contributes to approximately 9% of domestic US greenhouse gas emissions, exacerbating climate change and threatening human health. By substituting for in-person visits, telemedicine may represent a means of emission avoidance.

Study design: Leveraging multipayer claims data, we developed models based on various assumptions to estimate ranges of emissions from travel averted by telemedicine utilization between April 1, 2023, and June 30, 2023.

Methods: We estimated the carbon dioxide (CO2) emissions averted from the avoidance of travel by patients using telemedicine as a substitute for their usual source of in-person care at post-public health emergency rates through a modeling analysis of nationwide multipayer claims data representing 19% of US insured adults; findings were extrapolated to the entire US insured adult population.

Results: We quantified a monthly average of 1,481,530 US telemedicine visits (65,733 rural) during the study period. Between 740,765 and 1,348,192 of these were estimated to have substituted for in-person visits. Using inputs of 2021 electric vehicle (EV) production share and emissions per mile, we estimated that between 4,075,065 and 7,489,486 kg of CO2 are averted due to telemedicine use each month. Estimates accounting for different assumptions including EV and public transportation use produce a range of 4 million (most conservative) to 8.9 million (least conservative) kg of CO2 averted per month. Extrapolating to the entire US adult population, we estimate that monthly emissions averted range from 21.4 to 47.6 million kg of CO2-roughly equivalent to the monthly emissions of 61,255 to 130,076 gasoline-powered passenger vehicles.

Conclusion: Our results suggest that telemedicine use at 2023 rates modestly decreases the carbon footprint of US health care delivery.