Investigators who analyzed more than 3 million ambulatory telehealth encounters in a statewide university health system during the COVID-19 pandemic reported that these online interactions had a positive impact on patient travel distance, time, and costs. Telehealth use also reduced the number of motor vehicle-related injuries and fatalities and decreased greenhouse gas emissions.

“These significant advantages of telehealth should be considered when planning future health services,” the authors concluded in a paper published in Telemedicine and e-Health.

A team led by Sristi Sharma, MD, MPH, a preventive medicine physician at the University of California, Davis, calculated that telehealth use eliminated approximately 53.7 million miles of travel, 1.8 million hours of travel time, and $33.5 million in travel costs. These savings translated into an average savings of 17.4 miles, 35.3 minutes, and $11.02 per telehealth encounter. Telehealth use avoided 42.4 crash-related injuries and 0.7 fatalities.

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Further, telehealth use eliminated 21,465.8 metric tons of carbon dioxide, 14.1 metric tons of total hydrocarbons, 212.3 metric tons of exhaust carbon monoxide, and 9.3 metric tons of exhaust nitrogen oxide emissions.

“This study has confirmed and will contribute to evidence for continuing telehealth ambulatory services as a cost-effective, safe, and environmentally friendly mode of care even after the pandemic is over,” Dr Sharma and colleagues concluded.

The current study is the first large-scale investigation into the round-trip distance, time, and cost-saving, and greenhouse gas emissions prevented from telehealth use during the pandemic, Dr Sharma said in an interview. She and her colleagues looked at data from the University of California at Davis, San Francisco, Los Angeles, Irvine, and San Diego health systems.

The researchers calculated the round-trip distance, travel time, travel costs, injuries and fatalities avoided, and greenhouse gas emissions that patients would have generated had they gone for in-person ambulatory services instead of telehealth services. The statewide university system serves close to 40 million people. Between January 2020 and December 2021, the health systems’ clinics had about 16.8 million outpatient visits. Approximately 18% of these visits were telehealth visits.

The study showed that telehealth can be a safe, efficient and cost-effective method to address climate change. The team said it hopes that health care facilities can build on the momentum created by the COVID-19 safety measures and widely adopt telehealth, even after the pandemic is over.

“Climate change is now a major threat to human health, and urgent steps are needed to address contributors to this global disaster. The health care industry is one of the largest contributors to climate change,” Dr Sharma said.

She also observed, “Research studies and national reports have indicated that the health care industry is responsible for nearly 10% of total national emissions. These emissions are a result of health care-related transportation, energy consumption and climate-unfriendly supply chain practices.”

The researchers hope these findings will lead to telehealth becoming a major modality of access to health care services by private and public sector health care providers beyond the pandemic. “In our study, apart from the environmental impact, we have also demonstrated how telehealth can be cost-effective for patients while decreasing the number of travel-related injuries and deaths,” Dr Sharma said.

Many studies have demonstrated a significant number of patients like having a telehealth option for their visits. In fact, Dr Sharma’s team recently showed that patient experiences are comparable between in-person care and care provided via telehealth.

“In addition to patient preferences, telehealth has been an effective mode of patient care delivery for healthcare providers as well,” she said. “Significant investments are being made to improve the technology that will be used for accessing telehealth services. These would collectively improve health care access for patients, and in turn improve outcomes.”


Sharma S, Yellowlees PM, Gotthardt CJ, Luce MS. Environmental impact of ambulatory telehealth use by a statewide university health system during COVID-19. Telemed J E Health. Published online December 23, 2022. doi:10.1089/tmj.2022.0396