Telehealth's potential to bridge the services gap for people without ready transportation access is well-documented. Less explored, however, is virtual care's possible role in reducing carbon emissions, specifically by allowing patients to connect with providers without relying on a car.

The Ohio State University Wexner Medical Center built a dashboard to estimate the environmental impact of the medical facility's telehealth offerings. By examining the reduced travel enabled by virtual care, the center's IT and sustainability team calculated gasoline usage and carbon emissions. 

Aparna Dial, senior director of Sustainability and Strategic Services at OSU, sat down with Healthcare IT News to discuss the team's findings, along with how the healthcare industry can be environmentally sustainable in the long term.

Q. What were some of your findings regarding telehealth and environmental impact during the COVID-19 pandemic? 

A. These last couple of years have been unusual, to say the least, with a global pandemic that was unlike anything we have experienced before. That said, there were some positive aspects that have resulted in sustainability gains, such as the more widely adopted practices of telehealth and telework.

To track those gains, The Ohio State University Wexner Medical Center invested considerable efforts into building a dashboard. IT and Sustainability worked together with a regional transportation authority to calculate the travel distance avoided, gasoline usage reduction and carbon emissions avoided. Additionally, an estimate for appointment-related waste – such as printed after-visit summaries or exam room table paper – avoided was also developed.

To provide some context, 800 telehealth appointments occurred between July 2019 and February 2020. Since the onset of the pandemic in March 2020, the medical center has delivered 768,970 telehealth visits. This has avoided an estimated 50 million miles of travel, 2.2 million gallons of gas savings, 25 tons of appointment-related waste and over 17,500 metric tons of carbon dioxide – or the equivalent of enough power for 2,500 homes' energy use for a year. Extremely high patient satisfaction scores were also achieved.

Q. Were there any benefits from providers' reduced travel?  

A. The medical center has not yet tracked gains from a provider perspective, as providers can deliver telehealth from home, from the hospital or clinic locations.   

Research indicates that barriers to transportation can result in poor access to healthcare. Given the importance of health equity to our providers, it would not be surprising if providers experienced high satisfaction rates from being able to use an alternative way to provide care. We expect to track provider outcomes and telework savings for applicable staff soon.

Q. Were any of these benefits offset by electricity usage for telehealth and connectivity?

A. While the dashboard currently does not track this, an increase in electricity usage is not anticipated, since the provider would have been using a computer for the visit in-person as well. Even if electricity usage were to increase, it would not be large enough to offset the gains from avoided travel mileage.

We are currently collaborating with another health system to learn from their findings on this topic. Our intent is to use that learning to update our dashboard to track telehealth-associated electricity usage.  

For providers utilizing the medical center-owned space to deliver telehealth services, we are working to make our facilities more energy-efficient and to power them with renewable and carbon neutral electricity.  

As stated earlier, a critical barrier to healthcare access is often transportation, and telehealth is one way to overcome that barrier. Additionally, technology and WiFi can also be barriers to care, which is why our Partners Achieving Community Transformation program’s Connected Communities initiative offers both free technology and access to WiFi for individuals and families in need.

Q. How can the environmental benefits be sustainable in the long term? What should policymakers keep in mind?

A. To guarantee long-term sustainability, telehealth offers should be adopted as an institutional goal – as we have done at the Wexner Medical Center. This ensures its place as a key strategy for patient-care delivery. It is equally important to track and publicize key programmatic metrics such as patient care satisfaction and sustainability gains.

Building on the lessons and the success of telehealth, the medical center is expanding to additional robust forms of virtual health, such as remote patient monitoring and “hospital at home” strategies. The goal of these strategies is to replace some of the appointments related to clinical monitoring that traditionally would have been conducted at an outpatient appointment.  

Support from policymakers is key to ensure that telehealth appointments continue to be reimbursed.

Q. What are other ways the healthcare industry can be environmentally sustainable?

A. The U.S. health sector is responsible for an estimated 10% of annual emissions, which demonstrates that the healthcare industry has tremendous opportunity to reduce its environmental impact. This is why we’re working towards a carbon neutral goal, in addition to other resource-stewardship goals such as zero waste and environmentally preferred purchasing.

The medical center has improved sustainability through investment in energy efficient practices such as LED retrofits, switching to anesthesia gasses with a lower global warming footprint and working with the supply chain to identify and purchase more environmentally preferable products, such as a bedpan made out of 90% recycled materials.

For hospitals looking to engage in sustainability, peers are a great place to start. Other resources include Practice Greenhealth and the American Society for Health Care Engineering.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.