How virtual epilepsy clinics could help save the planet

Did you know that seeing your doctor via a virtual clinic, rather than face-to-face, may be better for your health than you might have imagined? And, certainly better for the health of the planet.

The pandemic accelerated the pace of change in many areas, including the introduction of telemedicine for appointments with a doctor, neurologist or epilepsy specialist. And the enforced change provided researchers a rare window in which to carry out preliminary assessments of the potential benefits of telemedicine in reducing carbon emissions – a key contributor to global warming.

Epilepsy Climate Change

Before the pandemic, Epilepsy Climate Change - a group of researchers and scientists from around the world - had already raised concerns about the impact of climate change on people with epilepsy. 

People with severe epilepsy such as Dravet syndrome were seeing increased seizure activity during unusually hot summers. And a survey carried out by the charity showed that over 60 per cent of people with uncontrolled seizures believed that extreme temperatures either increased or worsened their seizures.

The NHS is committed to being a net zero emitter by 2040 and researchers from Epilepsy Climate Change, led by Professor Sanjay Sisodiya from Epilepsy Society, wanted to look at the potential contribution that reduced patient travel could make towards this target.

“The NHS target is ambitious and if we are to achieve net zero in the proposed timescale then we will need to make substantial changes to the way we deliver healthcare, one of which is patient travel,” said Professor Sisodiya. “Recognising the impact that climate change could have on people  with epilepsy adds to the urgency.”

Equivalent of five times round the equator

Over a six month period, from 16 March - 30 September 2020, over 1,200 people who would normally travel to the Chalfont Centre in Buckinghamshire for an appointment with their neurologist, were instead seen via a telemedicine clinic. This was at the height of the pandemic with lockdown or restrictions making face-to-face appointments impossible.

The changes to the delivery of healthcare appointments resulted in a saving of 224,000km of travel – the equivalent of driving a car five times around the equator. The likely emissions avoided were in the range of 35,000-40,000kg carbon dioxide equivalent. 

Remote appointments carry their own CO2 burden, but calculations carried out by the researchers showed that emissions arising directly from telemedicine were less than 200kg carbon dioxide equivalent (0.5 per cent of those for travel). 

Benefits and drawbacks

The researchers did not specifically look at the clinical impact of remote appointments, though one adverse reaction was recorded – the inability to review seizure and drug charts during a telephone conversation.

Other positive outcomes recorded anecdotally, included: family and carers being able to join the virtual consultation; reduced anxiety around traveling during the pandemic; ability to still keep an appointment even where a seizure may have made travel to clinic impossible.

The study was conducted on a short-term basis but the research team say it shows that telemedicine in epilepsy services appears safe and feasible, and could result in the reduction of greenhouse gas emissions.

However, they recognized that remote clinics may have proved easier for people who were already familiar with their clinician and therefore would be less concerned that important aspects of care may be missed.

Long-term benefits

Professor Sisodiya said: “As doctors, we have a responsibility to ensure that our practices do not negatively impact on those in our care. More research is needed, but the effects of climate change on people with severe epilepsy are already becoming apparent.

“If we can help to reduce greenhouse gas emissions through telemedicine then that has to be a huge benefit for our patients. This study was short-term and carried out during the pandemic when there were no other options. As we return to more normal services, we will need to review the long-term benefits of remote clinics for both patient and the planet, but this study has shown that we can adapt and change. We must of course make sure that it will be right for everyone.”

More information

You can read the full paper here Carbon emission savings and short-term healthcare impacts from telemedicine: an evaluation in epilepsy