A Transparency Checklist for Carbon Footprint Calculations Applied within a Systematic Review of Virtual Care Interventions

Int J Environ Res Public Health. 2022 Jun 18;19(12):7474. doi: 10.3390/ijerph19127474.

Abstract

Increasing concerns about climate change imply that decisions on the digitization of healthcare should consider evidence about its carbon footprint (CF). This study aims to develop a transparency catalogue for reporting CF calculations, to compare results, and to assess the transparency (reporting quality) of the current evidence of virtual care (VC) intervention. We developed a checklist of transparency criteria based on the consolidation of three established standards/norms for CF calculation. We conducted a systematic review of primary studies written in English or German on the CF of VC interventions to check applicability. Based on our checklist, we extracted methodological information. We compared the results and calculated a transparency score. The checklist comprises 22 items in the aim, scope, data and analysis categories. Twenty-three studies out of 1466 records were included, mostly addressing telemedicine. The mean transparency score was 38% (minimum 14%, maximum 68%). On average, 148 kg carbon dioxide equivalents per patient were saved. Digitization may have co-benefits, improving care and reducing the healthcare CF. However, the evidence for this is weak, and CF reports are heterogeneous. Our transparency checklist may serve as a reference for developing a standard to assess the CF of virtual and other healthcare and public health services.

Keywords: carbon dioxide equivalents; carbon footprint; digital health; digital public health; e-health; greenhouse gas; systematic review; telehealth; telemedicine; virtual care.

Publication types

  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carbon Footprint*
  • Checklist
  • Humans
  • Telemedicine*

Grants and funding

Public funding by Leibniz ScienceCampus Bremen Digital Public Health (lsc-diph.de), which is jointly funded by the Leibniz Association (W4/2018), the Federal State of Bremen and the Leibniz Institute for Prevention Research and Epidemiology–BIPS for Oliver Lange’s inputs to the research project. The public funding bodies had no role in the study design or in the collection, analysis and interpretation of data. The writing of the report and the decision to submit the article for publication were the responsibilities of the authors. The researchers were independent of the funders, and all the authors had full access to all of the data (including statistical reports and tables). They take full responsibility for the integrity of the data and the accuracy of the data analysis.