eHealth and Telemedicine Applications in Climate Change Mitigation: A Comprehensive Analysis for the Health Information Exchange, Care Collaboration, and Patient Engagement domains

Summary

Healthcare systems account for approximately 4.4 to 4.6% of global greenhouse gas emissions. This represents a critical contradiction, as the very sector dedicated to protecting human health is contributing to environmental degradation, which in turn threatens health. Digital health technologies have the potential to provide a solution, as they enable ways to maintain optimal healthcare while protecting the environment.

The goal was to investigate how digital health technologies contribute to environmental sustainability through three primary mechanisms: Health Information Exchange systems, Care Collaboration, and Patient Engagement. This analysis evaluates empirical evidence for CO2 emissions reduction and considers the European Health Data Space initiative, as well as applications and experiences from different geographic regions.

We conducted a comprehensive literature review focusing on peer-reviewed studies from 2012 to 2025 that quantified the environmental impacts of implementing digital health. The selection criteria prioritized studies with transparent methodological approaches and measurable environmental outcomes. Regional case studies were included to understand different implementation strategies and their environmental consequences.

The analysis of large-scale systematic reviews covering more than 68 million digital health consultations shows significant benefits for the environment. CO2 savings per virtual consultation range from 0.70 to 372 kg CO2 equivalent, with differences primarily attributable to geographical factors, transport structures, and healthcare models. Avoiding unnecessary duplicate tests and reducing waste for paper and medications also make significant contributions. At the same time, the energy consumption of the technological infrastructure accounts for less than 1% of the emissions avoided through reduced travel.

Digital health technologies show considerable potential for reducing the environmental footprint of healthcare while maintaining or even improving clinical outcomes. To support this, it is necessary to establish standardized measurement tools, create policy frameworks, apply standardized interoperability approaches, and carefully consider equal treatment in implementation.