A Transparency Checklist for Carbon Footprint Calculations Applied within a Systematic Review of Virtual Care Interventions

Abstract

Increasing concerns about climate change imply that decisions on the digitization of healthcare should consider evidence about its carbon footprint (CF). This study aims to develop a transparency catalogue for reporting CF calculations, to compare results, and to assess the transparency (reporting quality) of the current evidence of virtual care (VC) intervention. We developed a checklist of transparency criteria based on the consolidation of three established standards/norms for CF calculation. We conducted a systematic review of primary studies written in English or German on the CF of VC interventions to check applicability. Based on our checklist, we extracted methodological information. We compared the results and calculated a transparency score. The checklist comprises 22 items in the aim, scope, data and analysis categories. Twenty-three studies out of 1466 records were included, mostly addressing telemedicine. The mean transparency score was 38% (minimum 14%, maximum 68%). On average, 148 kg carbon dioxide equivalents per patient were saved. Digitization may have co-benefits, improving care and reducing the healthcare CF. However, the evidence for this is weak, and CF reports are heterogeneous. Our transparency checklist may serve as a reference for developing a standard to assess the CF of virtual and other healthcare and public health services.

Health economic evaluation of preventive digital public health interventions using decision-analytic modelling: a systematized review

“…Recent methodological studies identify specific challenges for evaluating DiPH, such as the plurality of outcomes, including not only individual health benefits but also a broader societal perspective, for example by measuring the carbon footprint of digital health interventions [57]. Equity impacts may also be particularly important in this field.…”

Methods for Calculating the Carbon Footprint of Telemedicine: A Systematic Review

“…As an example, Masino et al solely included emissions of a computer screen contrary to Bartlett et al who considered LCA variables that are not related to telemedicine such as staff travel and overhead. Authors should consider using a systematic approach unless they have valid reasons not to do so for better precision of a streamlined LCA like suggested by Lange et al (55) Calculations also vary widely due to differences in e ciency of product manufacturing, internet speed, energy use, and transport emission rates. (17,20,45,46,56,57) Although solvable, these uncertainties increase the di culty of estimating and comparing LCAs.…”

Environmentally sustainable gastroenterology practice: Review of current state and future goals

“… Telemedicine : The carbon footprint savings related to telemedicine can range between 0.70 and 372 kg CO 2 e per consultation 32 . According to a recent study, approximately 148 kg of carbon dioxide equivalents were saved per patient due to telemedicine 30 . Some disadvantages of telemedicine include inability to perform a comprehensive physical examination to aid in diagnosis, technical difficulties, security breaches, and regulatory barriers 74 …”

“…32 According to a recent study, approximately 148 kg of carbon dioxide equivalents were saved per patient due to telemedicine. 30 Some disadvantages of telemedicine include inability to perform a comprehensive physical examination to aid in diagnosis, technical difficulties, security breaches, and regulatory barriers. 74 Paperless recordkeeping: Switching from paper-based recordkeeping to electronic medical records (EMR) can reduce the environmental impact of inpatient and outpatient practice in gastroenterology and other specialties.…”