Health care in rural areas: proposal of a new telemedicine program assisted from the reference health centers, for a sustainable digitization and its contribution to the carbon footprint reduction

Introduction: This paper studies and quantifies the environmental benefits of implementing a new telemedicine service for users of the public health system in a rural area of Alicante (Spain). The proposed telemedicine service is based on carrying out 20% of the follow-on consultations with a specialist virtually from the Reference Health Centres with the support of qualified staff. This way of providing medical care remotely will be a good transition to fully online medical services, especially for the elderly. The proposed model avoids the displacement of users to the Alcoy Hospital, reducing the distances to be travelled, which will be directly reflected in a reduction of the emission of pollutants (carbon footprint) generated by patients' vehicles. Methods: Data from the Alcoy Health Department were used for 2019, the last year of normal activity of the health centres before Covid-19. Using data from the Department's health management report and the emission factors of the vehicles, we calculated the distances, hours, litres of fuel saved, as well as the tonnes of CO2 equivalent, CO2, CH4 and N2O. Results: With the implementation of this type of telemedicine, journeys would be avoided, saving 447,279 km, 7,580 h and 38,019 L of fuel. The emission into the atmosphere of 79.26 metric tons of CO2, 74.5 kg of CH4 and 487.28 kg of N2O per year would be avoided. Conclusions: The implementation of this telemedicine service contributes to a high degree to: (a) increasing the environmental sustainability of the rural health sector thanks to the reduction of traffic emissions (saving 9% of pollutants compared to the current system), (b) decongesting the health system by reducing face-to-face visits to specialists, (c) increasing the quality of life of patients by avoiding road travel (d) promoting the digitalisation of the rural population.