For all the challenges COVID-19 introduced to the world, it did offer some relief in one respect: carbon emissions.
Throughout the early days of the pandemic, researchers highlighted a temporary drop in daily global carbon dioxide emissions tied to lockdowns and a reduction in physical travel. The decline has narrowed as individuals and organizations return to normal life, yet the adoption of telecommuting and similar changes in behavior could still support a long-term shift in macro-level energy consumption.
Healthcare has had its own virtual revolution as many providers ramped up their use of telehealth technologies to keep in touch with their patients during the pandemic.
Now more than a year on, one of the country’s largest health systems has quantified some of the environmental impacts resulting from the rapid shift to online care.
“We have a virtual visit dashboard in which we track the percentage of virtual visits that are being done across CommonSpirit—which is a pretty large organization, 1,100 ambulatory sites across 21 states,” Marijka Grey, M.D., system vice president of ambulatory transformation and innovation at CommonSpirit Health, told Fierce Healthcare.
“We took the information from that dashboard and our IT guys … [went] down to the patient level to say ‘What’s the average travel to and from our appointments if our patient is traveling from here to that provider?’”
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CommonSpirit calculated that 1.5 million virtual visits conducted through its clinic settings between March 8, 2020, and April 2, 2021, had prevented 1,678,956 gallons of fossil fuels from being burned and 15,092 metric tons of carbon dioxide from being released.
What’s more, the system estimated that its patients saved close to $11 million by no longer having to drive to these appointments.
Advocates have stressed the potential environmental benefits of telehealth for some time, but there are relatively few papers or other studies that have quantified its actual impact, Grey said.
Among those are a 2017 study out of the University of California, Davis that examined nearly 20,000 outpatient and inpatient interactive video-based consultations between 1996 and 2013. Here, the researchers said that patients had avoided more than 5 million total miles and prevented nearly 2,000 metric tons of carbon dioxide and 50 metric tons of carbon monoxide, among other noxious emissions.
Another study, published in late 2019, looked at more than 12,000 telemedicine referrals made between January 2018 and January 2019 by primary care centers in the central Catalan region of Spain. Researchers tied these to 192,682 kilometers (119,727 miles) of saved travel, 11,754 liters (3,105 gallons) of unused fuel and a reduction of 29.4 tons of carbon dioxide and 36.6 tons of carbon monoxide.
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Addressing environmental impact
For CommonSpirit Health, having data on hand and ready to quantify is a major boon to the company’s ambulatory unit, whose environmental efforts can be more difficult to measure against other business units, according to Grey.
“We are a big company, [and] it’s very easy to count what we do in the hospitals when we decrease the amount of plastic or increase the amount of recycling or so on,” she said. “But for us in the ambulatory setting, this is a great way to show how we are also contributing to CommonSpirit’s efforts in decreasing our ecological impact as we provide care to our patients.”
Looking outward, CommonSpirit’s numbers add a substantial number of virtual visits to the analysis pool and come at a time when organizations are weighing just how much of a presence telehealth will have among their services going forward.
“I’m hoping that highlighting this gets folks to focus a little beyond what virtual visits bring in terms of care and macro trends,” she said. “[Due to] the pandemic, unfortunately, all of us have been struggling to keep our heads above water and keep patients safe, so people may not have made this kind of research leap yet.”
Still, swapping out a portion of in-person care with virtual visits is unlikely to shift the scales on its own. A recent review suggests that areas affected by the pandemic have actually increased their waste generation, and hospitals treating COVID-19 patients were no exception.
Alongside the telemedicine visits, Grey highlighted broader efforts her organization has made to cut down its environmental footprint. These included a 20% reduction in overall energy use across its California, Arizona and Nevada operations prior to and during the pandemic, a one-third reduction in greenhouse gas emissions and the elimination of more than 11 tons of single-use operating room plastics.
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Grey said that each of these metrics represents opportune areas for other providers to target as they work to go green. She placed a particular spotlight on thousands of pounds of paper and other materials organizations dispose of to remain sterile along with the cumulative energy it takes to keep a hospital illuminated through the night.
“We tend to use a lot of lights and energy within a hospital system, mainly because hospitals run 24/7,” she said. “So whatever ways we can decrease energy consumption with smart lights and so on is just a small way to really make an impact on the overall energy use for your organization and assist the planet.”
Regardless of how it comes about, sustainability is as much about the environment as it is the patient, Grey said. To help push ecological initiatives forward, organizations and physicians alike should think about these efforts as complementary to the broader goals of improving human health.
“Transforming healthcare depends not just on what we do within the four walls of the clinic, but also in the part we play to further the health and wellbeing of the community and planet,” she said. “There’s so much of healthcare that’s dependent on the environment—asthma rates are worse in areas where there is more pollution or higher exposure from gases from highways, and so on. The more we can do to help the planet overall actually helps our health overall and furthers the wellbeing of all humans.”