Kaiser Permanente Study Measures the Impact of Telehealth on the Environment

New research from a trio of healthcare’s heavy hitters indicates telehealth is also good for the environment.

In what’s being billed as the first large-scale study in the US, researchers from Kaiser Permanente, Brigham and Women’s Hospital and Harvard Medical School are reporting that connected health platforms dramatically reduce greenhouse gas emissions, making those services as healthy for the environment as they are for patients.

The study, published online in The Journal of Climate Change and Health, attributes most of the results to the adoption of telehealth during the coronavirus pandemic, when in-person visits dropped sharply and both providers and payers limited their travel time. But the researchers noted that any telehealth service offers an opportunity to reduce stress on the environment.

“The rapid and widespread adoption of telehealth during the COVID-19 pandemic has had significant environmental health benefits, primarily through reduction in transportation-associated emissions,” the study concluded. “If the US healthcare system were to maintain or expand upon current levels of telehealth utilization, additional reductions in GHG emissions would potentially be achieved through impacts on practice design. Ambulatory visit carbon intensity would be an effective way to measure these changes.”

The researchers focused on Kaiser Permanente Northwest serving some 600,000 people in Oregon and southwest Washington. Working with colleagues from BID and Harvard, they tracked transportation-related greenhouse gas (GHG) emissions for outpatient visits – including primary care, specialty care and mental healthcare - from 2015 to 2020. In all, they charted 15.6 million outpatient visits, a 15.9 percent overall and an average increase of 3.2 percent per year.

That all changed with COVID-19, which saw in-person outpatient visits drop 46.2 percent in 2020, while telehealth visits – which had been growing 39.3 percent each year – surged 108,5 percent.

The researchers pointed out that the reduction in GHG emissions isn’t tied to a decline in healthcare visits, since those visits were still happening online. And they said changes in fuel efficiency or transportation mode share would have a minimal effect.

Likewise, the reduction in GHG emissions caused by a shift to telehealth outweighs any increase in emissions associated with the use of telemedicine equipment, either by patients at home or providers at hospitals and medical offices. And the study may even by underestimating GHG emission reductions, as it didn’t account for providers working from home during the pandemic.

As part of the study, the research team developed a new metric that will help future projects measure an outpatient facility’s environmental footprint.

While touted as the largest study of its kind, it isn’t the first to take into account the environmental benefits of telehealth.  Earlier this year, CommonSpirit Health, a Chicago-based network encompassing some 700 care sites and 142 hospitals in 21 states, issued an Earth Day press release estimating that its connected health platform had reduced announce GHG emissions in a year to equal 250,000 trees planted and more than 3,000 cars removed from roadways.

 And in 2017, the American Telemedicine Association launched a task force, organized by then-president Peter Yellowlees, to study how telemedicine might be affecting climate change and global warming. The effort was spurred by a study from the University of California at Davis – where Yellowlees is a professor of clinical psychiatry – that found that its telehealth program saved patients and clinicians 5 million miles of travel over 18 years, amounting to about nine years in travel time and $3 million in costs, and helped UC Davis reduce nearly 2,000 metric tons of carbon dioxide, 50 metric tons of carbon monoxide, 3.7 metric tons of nitrogen oxides and 5.5 metric tons of volatile organic compounds.

“Telemedicine and health information technology help save time, energy, raw materials (such as paper and plastic), and fuel, thereby lowering the carbon footprint of the health industry,” Yellowlees wrote in a 2010 paper titled Telemedicine Can Make Healthcare Greener. “By implementing green practices, for instance, by engaging in carbon credit programs, the health industry could benefit financially as well as reduce its negative impact on the health of our planet.”