Donald Neil, Irukulla Shashi
West Herts Teaching Hospitals NHS Trust, Watford, United Kingdom.
Ashford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, United Kingdom.
Telemed J E Health. 2022 Apr 20. doi: 10.1089/tmj.2022.0047.
Introduction:Telemedicine is a rapidly expanding service in the digitization of health care systems. Recently emphasis has been placed on the decarbonization of health care systems with National and World Health Organization initiatives aimed at carbon neutrality toward the mid-21st century. This study investigates greenhouse gas emissions related to telemedicine, its potential role in achieving carbon neutrality and its role in determining policy. We further investigate patient benefits related to telemedicine.
Methods:A systematic review was conducted of the PubMed, Medline, EMBASE, EMCARE, CINAHL, and HMIC databases. Eligibility of studies was determined by predefined criteria.
Results:{'sub': ['2', '2'], '#text': 'A total of 31 studies were identified totaling over 57,000 patients. Carbon savings ranged from 0.69\u2009kg COe (carbon dioxide equivalent) to 893\u2009kg COe per encounter. Distances saved also ranged from 6.1 to 3,386\u2009km. Further analysis of 18 included studies was conducted for cost savings that ranged from €1.73 in fuel costs to over U.S. $900 in travel related expenses. Similarly, 15 included studies were analyzed for time savings, which ranged from 38\u2009min to 24\u2009h.'}
Conclusions:There are substantial carbon savings to be made with telemedicine systems. Furthermore, there are substantial benefits to patients in terms of both time savings and cost savings. Rural and isolated communities or patients needing tertiary or quaternary care may be a particular cohort that might benefit disproportionally from telemedicine and is an area where the largest per capita emission savings can potentially be made.
远程医疗是医疗保健系统数字化中一项迅速发展的服务。最近,随着国家和世界卫生组织旨在实现21世纪中叶碳中和的倡议,医疗保健系统的脱碳受到了重视。本研究调查了与远程医疗相关的温室气体排放、其在实现碳中和中的潜在作用及其在政策制定中的作用。我们还进一步研究了与远程医疗相关的患者受益情况。
对PubMed、Medline、EMBASE、EMCARE、CINAHL和HMIC数据库进行了系统综述。研究的纳入标准由预先确定的标准决定。
共识别出31项研究,涉及超过57000名患者。每次诊疗的碳减排量从0.69千克二氧化碳当量到893千克二氧化碳当量不等。节省的距离也从6.1公里到3386公里不等。对18项纳入研究进行了进一步分析,以评估成本节省情况,节省的燃料成本从1.73欧元到超过900美元的旅行相关费用不等。同样,对15项纳入研究进行了时间节省情况分析,节省的时间从38分钟到24小时不等。
远程医疗系统可大幅节省碳排放。此外,在节省时间和成本方面,患者也能获得巨大益处。农村和偏远社区或需要三级或四级护理的患者可能是特别受益于远程医疗的群体,也是人均减排量可能最大的领域。