Reducing Health Care's Carbon Footprint: The Environmental Impact of Telephone Clinic Visits for Hand Surgery.

Abstract

The health care sector contributes substantially to global greenhouse gas emissions. Telehealth presents an opportunity for reducing health care-associated emissions and patient transportation burden. This study analyzed the environmental and clinical outcomes of telephone encounters conducted at a Veterans Affairs Medical Center Hand Clinic between June 2022 and June 2023. We hypothesized that telehealth would reduce carbon emissions while maintaining effective patient care. We conducted a retrospective review of 416 telephone encounters involving 295 patients. Patient demographics, travel distances, and emissions data were collected. Carbon dioxide (CO₂) emissions and gasoline savings were calculated based on avoided travel distances. Encounters were categorized as telephone-managed (concerns addressed via telephone) or telephone-facilitated escalation of care (recommendation for in-person follow-up). Of the encounters evaluated, 88.1% were telephone-managed, and 11.9% identified the need for an in-person evaluation. The study demonstrated a reduction in travel-related CO₂ emissions (51,920 kg total, 54 kg per encounter) and gasoline savings (5841 gallons), with a median driving distance saved of 129.9 miles per encounter. The environmental impact of telehealth was equivalent to recycling 2258 bags of waste or growing 866 tree seedlings for 10 years. Moreover, telephone encounters saved patients over 2180 hours of travel time and $29,847 in gasoline costs. Most telephone encounters were successfully managed without further intervention, whereas a subset appropriately resulted in an in-person evaluation. These findings highlight the value of telehealth in supporting clinical decision-making and demonstrate its potential to reduce travel distance, time, and fuel consumption, particularly for patients living far from specialty care. Telephone encounters offer a means of managing hand conditions and postoperative care remotely, reducing travel burdens and environmental impact while still facilitating timely in-person evaluations when necessary.