{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:42:06Z","timestamp":1777876926344,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Increasing carbon dioxide (CO\n                      <jats:sub>2<\/jats:sub>\n                      ) in the atmosphere contributes to Earth\u2019s warming, which has negative impacts on human health. The health care system is a major contributor to CO\n                      <jats:sub>2<\/jats:sub>\n                      emissions. Telehealth has the capacity to reduce health-care-related emissions by eliminating patient travel to in-person appointments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Data were obtained from Nebraska Medicine's (NM) electronic medical record. Parameters included patient zip code, provider location, calendar year of visit, and provider specialty. Euclidean distance from centroid zip code to clinic location was calculated. Environmental Protection Agency estimates were used to convert mileage to CO\n                      <jats:sub>2<\/jats:sub>\n                      saved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      During the period January 1, 2019, to January 31, 2022, the NM health care system completed 214,241 telemedicine visits for patients whose home zip code is within Nebraska, resulting in greater than 2,600 metric tons of CO\n                      <jats:sub>2<\/jats:sub>\n                      avoided. Telehealth appointments increased by more than 22,000% from 2019 to 2020. An average of 12.38 kg of CO\n                      <jats:sub>2<\/jats:sub>\n                      was avoided with each telehealth visit. Medical specialties that avoided the most CO\n                      <jats:sub>2<\/jats:sub>\n                      included family medicine, endocrinology, and infectious disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      This study demonstrates the capability of the NM health care system to rapidly adjust to an emergency pandemic by drastically increasing the use of telehealth, which also avoided thousands of tons of transportation-associated CO\n                      <jats:sub>2<\/jats:sub>\n                      emissions. Telehealth appointments increased during the height of the pandemic by more than 22,000%. Telehealth is an effective CO\n                      <jats:sub>2<\/jats:sub>\n                      emission-reducing strategy and a worthy avenue to further explore reduced health-care-related emissions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/tmj.2024.0531","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T06:12:46Z","timestamp":1738735966000},"page":"590-596","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Transportation-Associated Carbon Dioxide Emissions Avoided by Use of Telehealth Through COVID-19 Pandemic"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3934-9886","authenticated-orcid":false,"given":"Anna","family":"Barent","sequence":"first","affiliation":[{"name":"College of Medicine, University of Nebraska Medical Center College of Medicine, Omaha, Nebraska, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siddhi","family":"Munde","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"El","family":"Kerns","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiyue","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charity","family":"Swain","sequence":"additional","affiliation":[{"name":"Digital Care Applications, Nebraska Medicine, Omaha Nebraska, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Tranisi","sequence":"additional","affiliation":[{"name":"Market Intelligence Department, Nebraska Medicine, Omaha, Nebraska, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse E.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska, USA."},{"name":"School of Natural Resources, University of Nebraska-Lincoln, Lincoln, Nebraska, USA."},{"name":"Daugherty Water for Food Global Institute, University of Nebraska, Lincoln, Nebraska, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Fifth National Climate Assessment","author":"Jay AK","year":"2023","unstructured":"Jay AK, , Crimmins AR, , Avery CW, et al. 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