Remote health care appointments in the United States prevented carbon dioxide emissions equivalent to that of 130,000 gasoline-powered cars in 2023, according to a new study. The study is the first large-scale effort to look at the impact of the shift towards telemedicine, which accelerated during the COVID-19 pandemic, on carbon emissions.
“The health care sector contributes significantly to the global carbon footprint,” says study coauthor A. Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design. The health care system is responsible for about 9% of greenhouse gas emissions in the United States, and transportation is responsible for 29%.
Telemedicine could mean less driving to and from appointments and thus reduced greenhouse gas emissions associated with health care. The effect could be especially pronounced for people in rural areas who may need to travel long distances for doctor visits.
“Our findings suggest that the environmental impact of medical care delivery can be reduced when lower-carbon options, such as telemedicine, are substituted for other services that produce more emissions (such as in-person medical visits),” Fendrick says.
In the new study, Fendrick and his colleagues mined an insurance claims database of de-identified medical information covering 19% of insured adults in the U.S. for details about telemedicine visits from April through June 2023.
They combined this with U.S. government data on the average distance people drive for medical care and the average carbon dioxide emissions from gasoline-powered cars to determine the carbon emissions prevented by avoided travel due to telemedicine visits. The analysis took into account that not all telemedicine visits substitute for an in-person medical visit, and that telehealth visits themselves also produce carbon emissions due to internet use.
An average of almost 1.5 million telehealth visits were recorded in the insurance claims database per month, of which almost 66,000 were people in rural areas. Between 741,000 and 1.35 million of the 1.5 million visits substituted for in-person visits, the researchers report in The American Journal of Managed Care.
Depending on what percentage of telehealth visits truly substitute for in-person appointments, as well as what percentage of people travel to their appointments in electric vehicles or via public transport, telemedicine visits in the claims database averted between 4 million and roughly 8.9 million kilograms (kg) of carbon dioxide emissions each month.
If extrapolated to the entire U.S. population, this would result in a savings of 21.4 million to 47.6 million kg of carbon emissions each month, equivalent to taking 61,000 to 130,000 gasoline-powered vehicles off the road.
The fact that telemedicine reduced health care carbon emissions was not surprising, but “we were astonished by the magnitude of the impact,” Fendrick says.
Policymakers should consider the carbon-cutting potential of telemedicine when deciding how to regulate and in what circumstances to permit telehealth, the researchers argue. Climate impact could also become a factor for clinicians and patients to consider. “We are hopeful that research such as ours that quantifies emissions resulting from various options will be used to assist in the clinical decision-making process and ultimately reduce the climate impact of medical care delivery,” says Fendrick.
Source: Delarmente B. et al. “Impact of telemedicine use on outpatient-related CO2 emissions: estimate from a national cohort.” The American Journal of Managed Care 2025.
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