Teleophthalmology at a primary and tertiary eye care network from India: environmental and economic impact.

OBJECTIVE: To evaluate the environmental and economic impact of teleophthalmological services provided by a primary (rural) and tertiary (urban) eyecare network in India. METHODS: This prospective study utilised a random sampling method, and administered an environmental and economic impact assessment questionnaire. The study included 324 (primary: 173; tertiary: 151) patients who received teleconsultations from July to September 2022. The primary network (rural) used a colour-coded triage system (Green: eye conditions managed by teleconsult alone; yellow: semi-urgent referral within 1 week to a month, red: urgent referral within a day to a week). The tertiary network (urban) included new and follow-up patients. The environmental impact was assessed by estimating the potential CO2 emissions saved by avoiding travel for various transport modes. Economic impact measured by the potential cost savings from direct (travel) and indirect (food and wages lost) expenses spent by yellow and red referrals (primary) and the first-visit expenses of follow-up (tertiary) patients. RESULTS: The primary rural network saved 2.89 kg CO2/person and 80 km/person. The tertiary urban network saved 176.6 kg CO2/person and 1666 km/person. The potential cost savings on travel expenses were INR 19,970 (USD 250) for the primary (average: INR 370 (USD 4.6) per patient) and INR 758,870 (USD 9486) for the tertiary network (average: INR 8339 (USD 104) per patient). Indirect cost savings (food and wages) were of INR 29,100 (USD 364) for the primary and INR 347,800 (USD 4347) for the tertiary network. CONCLUSION: Teleophthalmology offers substantial environmental and economic benefits in rural and urban eyecare systems.

The environmental impacts of telemedicine in place of face-to-face patient care: a systematic review.

Background: Health services have considerable environmental impacts through the production of greenhouse gases and air pollutants. Changes to service provision are needed to mitigate these impacts. Telemedicine may be one tool to achieve this through reductions in travel. Methods: A systematic literature review was conducted using four databases. The search was limited to original studies in English. Studies were critically appraised using a cross sectional and economic modelling tool. Results were extracted for environmental impacts of the telemedicine service. The reporting of this review is line with PRISMA guidelines. Results: Out of 2,916 search results, 14 met full inclusion criteria. All 14 studies found an environmental benefit of telemedicine versus face-to-face consultations through reduced greenhouse gas emissions from travel. Three studies found there to be fewer greenhouse gas emissions through telemedicine consultations after accounting for greenhouse gas emissions from the use of telemedicine equipment.