Subscribe to RSS
DOI: 10.1055/a-2447-0069
Economic and Environmental Pollutant Impact of Maternal–Fetal Telemedicine
Funding None.
Abstract
Objective
The global issue of greenhouse gas emissions has significant implications for the environment and human health. Telemedicine provides a valuable tool for delivering health care while reducing gas emissions by limiting the need for patient travel. However, the environmental effects of telemedicine in high-risk pregnancy populations remain unassessed. The aim of this study was to estimate the economic and environmental impact of an outpatient teleMFM program.
Study Design
This retrospective cohort study examined all visits at three teleMFM clinics more than 90 miles away from the nearest in-person MFM office between October 1, 2021, and May 1, 2022. Travel distances and times were calculated for each appointment between the patient's home, telemedicine clinic, and nearest in-person clinics, using zip code data and Google Maps web-based map calculator tools. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if in-person using inflation-adjusted Internal Revenue Service annual standard mileage reimbursement rate ($0.58 per mile), and the U.S. Environmental Protection Agency Office of Transportation and Air Quality's average annual emissions and fuel consumption for gasoline-fueled passenger vehicles.
Results
During the study period, a total number of 2,712 appointments were scheduled, of which 2,454 were kept (cancellations removed) and analyzed. Visiting a teleMFM clinic resulted in 204 miles, 200 minutes, and $118.32 saved per patient visit compared with visiting the nearest in-person clinic. Over a 7-month period, a total of 96.6 metric tons of emissions were saved.
Conclusion
This study demonstrates the positive economic and environmental impact of teleMFM utilization in communities remote from in-person care. Given the contribution of greenhouse gas emissions to climate change, such findings may provide strategies for our specialty to make informed policy, advocacy, and business decisions.
Key Points
-
Telemedicine is a growing and accessible healthcare option; however, current research on this topic primarily focuses on clinical outcomes and patient satisfaction, overlooking the its environmental impacts.
-
Visiting a teleMFM clinic resulted in 204 miles, 200 minutes and 118.32 dollars saved per patient during their pregnancy compared to visiting the nearest in-person clinic. Over the study period a total of 94.6 metric tons of emissions were saved.
-
We demonstrate that the widespread deployment of teleMFM programs can not only address the current MFM supply-demand mismatch, but also save families valuable windshield time (travel time and cost) while having a positive impact on the environment.
Note
The findings of the paper were presented at the 43rd Annual Pregnancy Meeting of the Society for Maternal-Fetal Medicine in San Francisco, CA, held from February 6–11, 2023.
Publication History
Received: 23 September 2024
Accepted: 20 October 2024
Accepted Manuscript online:
23 October 2024
Article published online:
25 November 2024
© 2024. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Zhang AL, Balmes JR, Lutzker L. et al. Traffic-related air pollution, biomarkers of metabolic dysfunction, oxidative stress, and CC16 in children. J Expo Sci Environ Epidemiol 2022; 32 (04) 530-537
- 2 ACOG Executive Board. Addressing Climate Change. ACOG Position Statements. 2016 . Accessed March 2024 at: https://www.acog.org/clinical-information/policy-and-position-statements/position-statements/2021/addressing-climate-change
- 3 Bekkar B, Pacheco S, Basu R, DeNicola N. Association of air pollution and heat exposure with preterm birth, low birth weight, and stillbirth in the US: a systematic review. JAMA Netw Open 2020; 3 (06) e208243
- 4 Kumari U, Sharma RK, Keshari JR, Sinha A. Environmental exposure: effect on maternal morbidity and mortality and neonatal health. Cureus 2023; 15 (05) e38548
- 5 Pichler P-P, Jaccard IS, Weisz U, Weisz H. International comparison of health care footprints. Environ Res Lett 2019; 14: 064004
- 6 Morcillo Serra C, Aroca Tanarro A, Cummings CM, Jimenez Fuertes A, Tomás Martínez JF. Impact on the reduction of CO2 emissions due to the use of telemedicine. Sci Rep 2022; 12 (01) 12507
- 7 Leighton C, Conroy M, Bilderback A, Kalocay W, Henderson JK, Simhan HN. Implementation and impact of a maternal-fetal medicine telemedicine program. Am J Perinatol 2019; 36 (07) 751-758
- 8 Holmner A, Ebi KL, Lazuardi L, Nilsson M. Carbon footprint of telemedicine solutions–unexplored opportunity for reducing carbon emissions in the health sector. PLoS One 2014; 9 (09) e105040
- 9 Masino C, Rubinstein E, Lem L, Purdy B, Rossos PG. The impact of telemedicine on greenhouse gas emissions at an academic health science center in Canada. Telemed J E Health 2010; 16 (09) 973-976
- 10 Internal Revenue Service. IRS issues standard mileage rates for 2022. Published December 17, 2021. Accessed November 10, 2022 at: https://www.irs.gov/newsroom/irs-issues-standard-mileage-rates-for-2022
- 11 United States Environmental Protection Agency. Average Annual Emissions and Fuel Consumption for Gasoline-Fueled Passenger Cars and Light Trucks. Accessed October 28, 2024 at: https://nepis.epa.gov/Exe/ZyPURL.cgi?Dockey=P100EVXP.txt
- 12 Purohit A, Smith J, Hibble A. Does telemedicine reduce the carbon footprint of healthcare? A systematic review. Future Healthc J 2021; 8 (01) e85-e91
- 13 Dullet NW, Geraghty EM, Kaufman T. et al. Impact of a university-based outpatient telemedicine program on time savings, travel costs, and environmental pollutants. Value Health 2017; 20 (04) 542-546
- 14 Paquette S, Lin JC. Outpatient telemedicine program in vascular surgery reduces patient travel time, cost, and environmental pollutant emissions. Ann Vasc Surg 2019; 59: 167-172
- 15 Gillenwater JA, Rep MA, Troy AB, Power ML, Vigh RS, Mackeen AD. Patient perception of telemedicine in maternal-fetal medicine. Telemed J E Health 2024; 30 (01) 198-203