Estimated Travel-Related CO2 Emissions Avoided Through Virtual Care for Inflammatory Bowel Disease Patients in Remote Regions of Ontario, Canada

Background/Objectives: Inflammatory bowel disease (IBD) requires frequent specialist follow-up, yet patients in remote areas face significant geographic barriers to care. Healthcare delivery also contributes substantially to greenhouse gas (GHG) emissions, with patient travel a major source. The Promoting Access and Care through Centres of Excellence (PACE) virtual care program was designed to improve access for IBD patients in underserved regions of Ontario. This study estimated travel-related carbon dioxide (CO2) emissions potentially avoided. Methods: A retrospective cohort study was conducted using the PACE registry at the Mount Sinai Hospital IBD Centre between June 2016 and October 2024. Adults with Crohn’s disease, ulcerative colitis, or IBD-unclassified residing ≥100 km from the Centre and completing ≥1 virtual visit were included. Two-way travel distance avoided was calculated using Google Maps, adjusting for any travel to local facilities. Carbon emissions were estimated using a composite base-case factor of 260 g CO2/km with predefined sensitivity analyses covering alternative vehicle-mix and transport scenarios. Results: Among 389 IBD patients, 2222 virtual visits were completed. The mean (±SD) two-way distance avoided per visit was 843 ± 812 km, corresponding to 219 ± 211 kg CO2 per visit. The mean cumulative reduction per patient was 1252 ± 2245 kg CO2, totalling 487,104 kg (487 tonnes) over eight years. Conclusions: The PACE program was associated with substantial estimated reductions in travel-related CO2 emissions for IBD patients in remote Ontario, with results robust across vehicle mix and transport assumptions. Virtual care may offer a scalable pathway advancing both equitable access and healthcare-sector decarbonization.