Teleconsultation for Preoperative Anesthesia Evaluation: Identifying Environmental Potentials by Life Cycle Assessment

Telemedicine Journal and e-Health, vol. 30, pp. e2050–e2058

Abstract

Introduction: Teleconsultations for preoperative evaluation in anesthesiology proved to be feasible during the COVID-19 pandemic. However, widespread implementation of teleconsultations has not yet occurred. Besides time savings and economic benefits, teleconsultations in anesthesia may have the potential to reduce CO 2 emissions. Methods: We conducted a life cycle assessment based on prospective surveys to assess the potential environmental benefits of preoperative anesthesia teleconsultations in comparison to the status-quo in-person consultations. Within 1 month, all patients presenting at the preoperative anesthesia clinic at RWTH Aachen University Hospital were asked about the distance traveled and mode of transportation to the hospital. The main outcome measure was the potential environmental benefit resulting from the implementation of teleconsultations. Results: In total, 821 out of 981 patients presenting at the anesthesia clinic participated in the survey. Most patients visited on an outpatient basis (62.9%) and traveled by car (81.7%). The median travel distance was 25 km [interquartile range 12–40]. If patients who came to the hospital solely for the anesthesia appointment had scheduled virtual appointments, the emissions of 3.03-ton CO 2 equivalents (CO 2 -eq) could be avoided in the first month after implementation. The environmental impact associated with the production of teleconsultation equipment is outweighed by the reduction in patient travel. If all outpatient appointments were performed virtually, these savings would triple. Within 10 years, more than 1,300 tons CO 2 -eq could be avoided. Conclusion: Teleconsultations can mitigate the environmental impact of in-person anesthesia consultations. Further research is essential to leverage teleconsultations for preoperative evaluation also across other medical specialties.

Authors 8

1. Linda Grüßer corresponding Aachen Department of Anesthesiology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany

2. Berfin Bayram Aachen Department Anthropogenic Material Cycles

   RWTH Aachen University

   Affiliation as printed

   Department Anthropogenic Material Cycles, RWTH Aachen University, Aachen, Germany

3. Sebastian Ziemann Aachen Department of Anesthesiology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany

4. Julia Wallqvist Aachen Department of Anesthesiology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany

5. Jan Wienhold Aachen Department of Anesthesiology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany

6. Rolf Rossaint Aachen Department of Anesthesiology

   Universitätsklinikum Aachen · St.-Johannes-Hospital Dortmund · RWTH Aachen University

   Affiliation as printed

   Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany

   Department of Anesthesia, Critical Care and Pain Medicine, St. Johannes Hospital Dortmund, Dortmund, Germany

7. Matthias Derwall Aachen Department of Anesthesiology

   Universitätsklinikum Aachen · St.-Johannes-Hospital Dortmund · RWTH Aachen University

   Affiliation as printed

   Department of Anesthesia, Critical Care and Pain Medicine, St. Johannes Hospital Dortmund, Dortmund, Germany

   Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany

8. Andreas Follmann Aachen Department of Anesthesiology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany