Environmental Impact of Medical Record-Based and Provider-to-Provider Telemedicine in the Catalan Health System

Background: Healthcare systems are responsible for a substantial share of global greenhouse gas emissions, partly due to patient and professional travel. Telemedicine-based interconsultations may reduce this environmental burden. Objective: To quantify avoided travel distances and associated reductions in CO₂ and N₂O emissions referable to interconsultations in the Catalan public healthcare system. Methods: A repeated cross-sectional study with stratified analysis was conducted including 1.48 million interconsultations from 2019, 2023-2025. Driving distances between origin and destination centers were estimated and converted into avoided emissions using standardized emission factors. Results: Non-presential, telemedicine-based interconsultations avoided 29.65 million km of travel, preventing 5.04 million kg of CO2, 0.14 million kg of N2O emissions and 0.24 million kg of CH4. Non-capital regions showed higher per-capita savings, while metropolitan areas accumulated higher absolute reductions. Conclusions: Interconsultations substantially reduce travel-related emissions and represent a scalable strategy to improve environmental sustainability in healthcare systems.