Environmental and social impacts of a televisit process: Combined qualitative and life cycle assessment

The healthcare sector is a significant contributor to global greenhouse gas emissions, largely due to resource-intensive care processes. Telemedicine represents an innovative solution for managing chronic patients, with the potential to reduce environmental impacts and improve healthcare accessibility. However, current literature lacks a standardized approach to comprehensively assess the environmental and social effects of such practices. The study aims to overcome current limitations evaluating the environmental and social impacts of televisits as an alternative to traditional in-person follow-up visits for chronic heart failure (HF) patients in a large Italian hospital. The Life Cycle Assessment (LCA) steps ensure an objective and standardized environmental evaluation. Data on social and human-related aspects for preliminary mapping of social impacts has been acquired by means structured interviews. Environmental LCA using the ReCiPe 2016 method quantifies the environmental impacts of one in-person or remote visit process for a one patient, including direct and indirect emissions from transportation, energy use, paper materials and telecommunications. Internal hospital stakeholders were involved in defining aspects of interest for initial mapping of social impacts. Results demonstrate that televisits significantly reduce environmental impacts, particularly in relation to patient transportation. On the social side, stakeholders reported benefits in terms of patient's experience, care continuity, and improvement of clinical workflows. The study emphasizes the necessity of establishing continuous impact monitoring systems to ensure long-term sustainability and efficiency. By demonstrating the environmental benefits and social acceptability of televisits, this research contributes to the development of evidence-based strategies that can enhance both patient care and sustainability in the healthcare sector. • Environmental and social assessment are combined for a comprehensive evaluation of telemedicine's sustainability. • ReCiPe Midpoints and Endpoints are used to estimate environmental impacts of televisit and in-person visit processes. • Telemedicine reduces environmental impacts, by decreasing patient transportation, the primary source of emissions. • Social dimensions reveal improvements in patient experience and continuity of care, for chronic disease management. • A reproducible results is presented to support the effective and sustainable implementation of telemedicine solutions.