# Examining the Carbon Footprint of Orthopaedic Outpatient Care and Comparing the Emissions From In-Person Versus Virtual Models of Care: A Systematic Review

## TL;DR

This paper reviews how virtual care in orthopaedics reduces carbon emissions compared to in-person visits, mainly by cutting down patient travel.

## Contribution

The study systematically compares emissions from virtual and in-person orthopaedic care, highlighting travel reduction as a key factor.

## Key findings

- Virtual care reduces carbon emissions by a median of 11.8 kgCO₂e per patient interaction.
- Patient travel is the primary source of emission reduction in virtual care models.
- Low certainty of evidence calls for better measurement of travel and associated emissions.

## Abstract

Healthcare systems are responsible for a significant proportion of global greenhouse gas emissions. Trauma and orthopaedics has an exceptionally high emission profile in comparison to other specialities. This systematic review synthesises the available literature regarding the impact of virtual care/telemedicine on the carbon footprint of outpatient orthopaedics. Nine studies, encompassing over 500,000 patients, were included following a search across major databases. Virtual care has consistently been shown to have a smaller carbon footprint than traditional in-person appointments, primarily by reducing patient travel, resulting in a median reduction of 11.8 kgCO₂e per patient interaction. Secondary benefits, such as patient cost savings and improved accessibility, were also observed. However, the certainty of evidence was low due to the risk of bias across the studies; future research should aim to directly measure patient travel and other associated emissions.