Travel-Related Environmental Impact of Telemedicine in a Radiation Oncology Clinic

Abstract

Abstract Objective: The environmental impact of telemedicine within radiation oncology has not yet been established. This is particularly relevant as climate change is recognized as one of the largest threats to human health, including oncological outcomes. The health care sector significantly contributes to global carbon emissions, in part due to patient travel. We assessed the impact of telemedicine utilization on patient travel-related greenhouse gas (GHG) emissions for a large radiation oncology clinic located in a densely populated suburban setting. Materials and Methods: All in-person and telemedicine visits scheduled in a radiation oncology clinic over 7 consecutive days in June 2021 were retrospectively reviewed. Care visits with out-of-state patients were excluded. Travel distance between patients’ reported home address and the clinic address was estimated using Google Maps. Associated GHG emissions were calculated using a well-to-wheel model. Gas, hybrid, plug-in hybrid, and electric vehicle utilization were accounted for per statewide vehicle registration statistics. GHG emissions were converted into carbon dioxide equivalents (CO2e) using 100-year global warming potentials. Results: A total of 156 clinic visits were conducted over the time period; 115 via telemedicine (74%) and 41 in-person (26%). Patients traveling for in-person visits had a median round trip of 44 miles; of those seen via telemedicine, a median of 60 travel miles were saved. Use of telemedicine “saved” an estimated 13,828 travel miles in 1 week, translating into 719,056 miles saved annually. The forecasted annual savings of CO2e attributed to telemedicine visits is 339.8 metric tons, the equivalent emissions of 65.7 homes’ electricity use for 1 year. Conclusion: Integration of telemedicine within a radiation oncology clinic reduces the environmental impact of patient care. Advocacy efforts should support telemedicine where feasible and clinically appropriate to decrease carbon emissions associated with the practice of radiation oncology, as well as to establish and promote environmentally sustainable behaviors within the field.