Carbon footprint of telemedicine solutions-unexplored opportunity for reducing carbon emissions in the health sector
Open accessAbstract
BACKGROUND: The healthcare sector is a significant contributor to global carbon emissions, in part due to extensive travelling by patients and health workers. OBJECTIVES: To evaluate the potential of telemedicine services based on videoconferencing technology to reduce travelling and thus carbon emissions in the healthcare sector. METHODS: A life cycle inventory was performed to evaluate the carbon reduction potential of telemedicine activities beyond a reduction in travel related emissions. The study included two rehabilitation units at Umeå University Hospital in Sweden. Carbon emissions generated during telemedicine appointments were compared with care-as-usual scenarios. Upper and lower bound emissions scenarios were created based on different teleconferencing solutions and thresholds for when telemedicine becomes favorable were estimated. Sensitivity analyses were performed to pinpoint the most important contributors to emissions for different set-ups and use cases. RESULTS: Replacing physical visits with telemedicine appointments resulted in a significant 40-70 times decrease in carbon emissions. Factors such as meeting duration, bandwidth and use rates influence emissions to various extents. According to the lower bound scenario, telemedicine becomes a greener choice at a distance of a few kilometers when the alternative is transport by car. CONCLUSIONS: Telemedicine is a potent carbon reduction strategy in the health sector. But to contribute significantly to climate change mitigation, a paradigm shift might be required where telemedicine is regarded as an essential component of ordinary health care activities and not only considered to be a service to the few who lack access to care due to geography, isolation or other constraints.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The evidence base for achieving greener health services by means of remote care is limited and contested, but one study suggests that a substantial reduction in carbon footprint could be made.
“The evidence base for achieving greener health services by means of remote care is limited and contested, but one study suggests that a substantial reduction in carbon footprint could be made (66).”
From Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics (2021) · cites this paper as [66]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
(2013) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/103.1437-1588 · Cited by 11,769 · see citing works
The Effectiveness of Telemental Health: A 2013 Review
Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013) · Telemedicine and e-Health · doi:10.1089/tmj.2013.0075 · Cited by 1,048 · see citing works
Globalization, Climate Change, and Human Health
McMichael, A. J. (2013) · New England Journal of Medicine · doi:10.1056/nejmra1109341 · Cited by 622 · see citing works
Eco-driving: An overlooked climate change initiative
Barkenbus, J. N. (2009) · Energy Policy · doi:10.1016/j.enpol.2009.10.021 · Cited by 603 · see citing works
Kairy, D., Lehoux, P., Vincent, C., & Visintin, M. (2009) · Disability and Rehabilitation · doi:10.1080/09638280802062553 · Cited by 587 · see citing works
Determinants of successful telemedicine implementations: a literature study
Broens, T. H. F., Huis in't Veld, R. M. H. A., Vollenbroek-Hutten, M. M. R., Hermens, H. J., van Halteren, A. T., & Nieuwenhuis, L. J. M. (2007) · Journal of Telemedicine and Telecare · doi:10.1258/135763307781644951 · Cited by 466 · see citing works
Home telehealth—Current state and future trends
Koch, S. (2005) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2005.09.002 · Cited by 410 · see citing works
Climate change and health: on the latest IPCC report
Woodward, A. J., Smith, K. R., Campbell-Lendrum, D., Chadee, D. D., Honda, Y., Liu, Q., Olwoch, J., Revich, B., Sauerborn, R., Chafe, Z. A., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60576-6 · Cited by 311 · see citing works
Telerehabilitation in stroke care – a systematic review
Johansson, T., & Wild, C. (2011) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2010.100105 · Cited by 288 · see citing works
Malmodin, J., Moberg, Å., Lundén, D., Finnveden, G., & Lövehagen, N. (2010) · Journal of Industrial Ecology · doi:10.1111/j.1530-9290.2010.00278.x · Cited by 225 · see citing works
Mistry, H. (2012) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2011.110505 · Cited by 215 · see citing works
Time-adjusted global warming potentials for LCA and carbon footprints
Kendall, A. M. (2012) · The International Journal of Life Cycle Assessment · doi:10.1007/s11367-012-0436-5 · Cited by 179 · see citing works
The carbon footprints of home and in‐center maintenance hemodialysis in the United Kingdom
Connor, A., Lillywhite, R., & Cooke, M. W. (2011) · Hemodialysis International · doi:10.1111/j.1542-4758.2010.00523.x · Cited by 153 · see citing works
Wootton, R., Bahaadinbeigy, K., & Hailey, D. (2011) · BMC Health Services Research · doi:10.1186/1472-6963-11-185 · Cited by 125 · see citing works
Total requirements of energy and greenhouse gases for Australian transport
Lenzen, M. (1999) · Transportation Research Part D Transport and Environment · doi:10.1016/s1361-9209(99)00009-7 · Cited by 123 · see citing works
The energy and emergy of the internet
Raghavan, B., & Ma, J. (2011) · ACM Workshop on Hot Topics in Networks (HotNets) · doi:10.1145/2070562.2070571 · Cited by 93 · see citing works
Telemedicine Can Make Healthcare Greener
Yellowlees, P., Chorba, K., Parish, M. B., et al. (2010) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2009.0105 · Cited by 90 · see citing works
Service transformation—managing a shift from business travel to virtual meetings
Arnfalk, P., & Kogg, B. (2003) · Journal of Cleaner Production · doi:10.1016/s0959-6526(02)00158-0 · Cited by 86 · see citing works
Christensen, M. C., & Remler, D. (2009) · Journal of Health Politics, Policy and Law · doi:10.1215/03616878-2009-034 · Cited by 72 · see citing works
Climate change and eHealth: a promising strategy for health sector mitigation and adaptation
Holmner, Å., Rocklöv, J., Ng, N., & Nilsson, M. (2012) · Global Health Action · doi:10.3402/gha.v5i0.18428 · Cited by 60 · see citing works
Self-citationEnvironmental aspects of health care in the Grampian NHS region and the place of telehealth
Wootton, R., Tait, A., & Croft, A. (2010) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2010.004015 · Cited by 47 · see citing works
Incorporating Time-Corrected Life Cycle Greenhouse Gas Emissions in Vehicle Regulations
Kendall, A. M., & Price, L. (2012) · Environmental Science & Technology · doi:10.1021/es203098j · Cited by 47 · see citing works
The impact of medical informatics on patient satisfaction: A USA-based literature review
Rozenblum, R., Donzé, J. D., Hockey, P., Guzdar, E., Labuzetta, M. A., Zimlichman, E., & Bates, D. W. (2013) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2012.12.008 · Cited by 46 · see citing works
Zapka, J., Simpson, K., Hiott, L., Langston, L., Fakhry, S. M., & Ford, D. W. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-33 · Cited by 43 · see citing works
Business meetings at a distance – decreasing greenhouse gas emissions and cumulative energy demand?
Borggren, C., Moberg, Å., Räsänen, M., & Finnveden, G. (2012) · Journal of Cleaner Production · doi:10.1016/j.jclepro.2012.09.003 · Cited by 42 · see citing works
Use of videoconferencing in Wales to reduce carbon dioxide emissions, travel costs and time
Lewis, D., Tranter, G., & Axford, A. T. (2009) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2009.003010 · Cited by 41 · see citing works
Leduc, G., Mongelli, I., Uihlein, A., et al. (2010) · Transport Policy · doi:10.1016/j.tranpol.2010.04.008 · Cited by 40 · see citing works
Health sector leadership in mitigating climate change: experience from the UK and NSW
Pencheon, D., Rissel, C. E., Hadfield, G., et al. (2010) · New South Wales Public Health Bulletin · doi:10.1071/nb09044 · Cited by 26 · see citing works
Complete life-cycle assessment of the energy/CO2 costs of videoconferencing vs face-to-face meetings
Ong, D., Moors, T., & Sivaraman, V. (2012) · IEEE Online Conference on Green Communications (OnlineGreenComm) · doi:10.1109/greencom.2012.6519615 · Cited by 18 · see citing works
Proceedings of the 14th ACM Workshop on Hot Topics in Networks
(2015) · doi:10.1145/2834050 · Cited by 7 · see citing works
Versorgungsforschung zu telemedizinischen Anwendungen
Schmidt, S., & Grimm, A. (2009) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-009-0794-8 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
International comparison of health care carbon footprints
Pichler, P.-P., Jaccard, I. S., Weisz, U., & Weisz, H. (2019) · Environmental Research Letters · doi:10.1088/1748-9326/ab19e1 · Cited by 812 · see citing works
The green print: Advancement of environmental sustainability in healthcare
Sherman, J. D., Thiel, C., MacNeill, A., Eckelman, M. J., Dubrow, R., Hopf, H., Lagasse, R., Bialowitz, J., Costello, A., Forbes, M., et al. (2020) · Resources, Conservation and Recycling · doi:10.1016/j.resconrec.2020.104882 · Cited by 327 · see citing works
Greenhalgh, T., Rosen, R., Shaw, S. E., Byng, R., Faulkner, S., Finlay, T., Grundy, E., Husain, L., Hughes, G., Leone, C., et al. (2021) · Frontiers in Digital Health · doi:10.3389/fdgth.2021.726095 · Cited by 173 · see citing works
“The evidence base for achieving greener health services by means of remote care is limited and contested, but one study suggests that a substantial reduction in carbon footprint could be made (66).”
BackgroundLi, Z., Xiang, L., Ning, J., Li, W., Huang, Y., & Xiao, X. (2025) · Journal of Medical Internet Research · doi:10.2196/63927 · Cited by 7 · see citing works
- Authors
- Holmner, Å., Ebi, K. L., Lazuardi, L., & Nilsson, M.
- Affiliations
- Umeå University (SE)
- Universitas Gadjah Mada (ID)
- Corresponding author
- Holmner, Åsa
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-09-04
- Volume
- 9
- Issue
- 9
- Pages
- e105040
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4154849
- OpenAlex
- W1979447023
- Cited by
- 222
- References
- 31
- Citations by year
- 2026: 13 · 2025: 40 · 2024: 40 · 2023: 37 · 2022: 29 · 2021: 31 · 2020: 15 · 2019: 4 · 2018: 6 · 2017: 4 · 2016: 1 · 2015: 2
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DiVA at Umeå University (Umeå University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Styrelsen för Internationellt Utvecklingssamarbete
- Forskningsrådet för Arbetsliv och Socialvetenskap (2006-1512)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Physical Sciences › Environmental Science › Environmental Engineering › Environmental Impact and Sustainability
- Physical Sciences › Engineering › Electrical and Electronic Engineering › Green IT and Sustainability
- Keywords
- telemedicine, carbon footprint, CO2 emissions, videoconferencing, rehabilitation units, life cycle assessment, climate change mitigation
- MeSH terms
- Cost-Benefit Analysis, Delivery of Health Care, Hospitals, University, Humans, Sweden, Travel, Telemedicine, Health Care Sector, Videoconferencing, Climate Change, Carbon Footprint
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
