Prospectively evaluating the environmental impacts of digital health applications: a case study and recommendations

To leverage the evaluation of the environmental impact of the Direct AP-HP/Lorah e-referral service offered in Paris (France) hospitals to create recommendations for evaluating the impact of digital health services.

We review the tools and methods currently available to measure the carbon footprint and electricity consumption of digital services in the context of Life Cycle Assessment (LCA) for a comprehensive evaluation. We use the recent deployment of a telemedicine communication service at a major French hospital as a case study to understand the practical implications of conducting an impact study. Three-deployment scenarii are considered: current usage, double usage and maximum capacity.

The bulk of the carbon footprint of the Direct AP-HP/Lorah service is due to servers vs network and user terminals in all scenarios considered. Computing hardware production impacts was instrumental in the overall impact assessment, as embodied impact represent 45% of Carbon footprint and the most of Metallic resource depletion. Recommendations for further studies notably include adequate anticipation of service usage and data collection.

The environmental impact of the new telemedicine service could be assessed in sufficient level of details to provide decision makers with an adequate comparison of the service with alternative email communication.

The recommendations derived from this use case should facilitate adequate impact data collection for future studies.