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      Carbon Footprint of Telemedicine Solutions - Unexplored Opportunity for Reducing Carbon Emissions in the Health Sector

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          The healthcare sector is a significant contributor to global carbon emissions, in part due to extensive travelling by patients and health workers.


          To evaluate the potential of telemedicine services based on videoconferencing technology to reduce travelling and thus carbon emissions in the healthcare sector.


          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.


          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.


          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.

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          Most cited references 14

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          Globalization, climate change, and human health.

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            Determinants of successful telemedicine implementations: a literature study.

            Telemedicine implementations often remain in the pilot phase and do not succeed in scaling-up to robust products that are used in daily practice. We conducted a qualitative literature review of 45 conference papers describing telemedicine interventions in order to identify determinants that had influenced their implementation. The identified determinants, which would influence the future implementation of telemedicine interventions, can be classified into five major categories: (1) Technology, (2) Acceptance, (3) Financing, (4) Organization and (5) Policy and Legislation. Each category contains determinants that are relevant to different stakeholders in different domains. We propose a layered implementation model in which the primary focus on individual determinants changes throughout the development life cycle of the telemedicine implementation. For success, a visionary approach is required from the multidisciplinary stakeholders, which goes beyond tackling specific issues in a particular development phase. Thus the right philosophy is: 'start small, think big'.
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              Climate change and health: on the latest IPCC report.


                Author and article information

                Role: Editor
                PLoS One
                PLoS ONE
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                4 September 2014
                : 9
                : 9
                [1 ]Department of Radiation Sciences, Umeå University, Umeå, Sweden
                [2 ]ClimAdapt, LLC, Seattle, Washington, United States of America
                [3 ]Department of Public Health, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
                [4 ]Department of public health and clinical medicine, epidemiology and global health, Umeå University, Umeå, Sweden
                US Army Engineer Research and Development Center, United States of America
                Author notes

                Competing Interests: ClimAdapt, LLC is a sole proprietorship consulting company working on health and global change issues. Clients are predominantly international organizations, such as WHO and UNEP, and national institutions, such as Health Canada. Dr. Kristie Ebi conducts research on the impacts of and adaptation to climate change, including on extreme events, thermal stress, foodborne safety and security, and vectorborne diseases. Her work focuses on understanding sources of vulnerability and designing adaptation policies and measures to reduce the risks of climate change in a multi-stressor environment. Hence, the authors can confirm that this does not alter their adherence to all PLOS ONE policies on sharing data and materials.

                Conceived and designed the experiments: ÅH. Performed the experiments: ÅH. Analyzed the data: ÅH KE LL MN. Wrote the paper: ÅH KE LL MN.


                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Pages: 10
                This work was partly undertaken within the Umeå Centre for Global Health Research, with support from FAS, the Swedish Council for Working Life and Social Research (grant no. 2006-1512). The work was also supported in part by funding from the Swedish International Development Cooperation Agency (SIDA). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Research Article
                Research and Analysis Methods
                Database and Informatics Methods
                Health Informatics
                Medicine and Health Sciences
                Health Care
                Environmental Health



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