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Virtual care associated with significant environmental and patient cost savings


A new study by researchers at ICES, Lawson Health Research Institute and Western University finds that virtual care during the COVID-19 pandemic led to a significant reduction in carbon dioxide emissions and patient travel-related expenses, such as gasoline, parking or public transit costs.

Prior to the pandemic, less than two per cent of patient visits with physicians took place virtually. The beginning of the pandemic (April-June 2020) triggered a rapid transition to virtual visits, which soared to 70 to 80 per cent, and then stabilized at 50 to 60 per cent of all physician visits.

This cross-sectional study published in JAMA Network Open used healthcare administrative data from Ontario, Canada to identify all patients with at least one virtual care visit between March 2020 and December 2021.

“Virtual care has become an important part of the healthcare system in Ontario, and in addition to improved patient convenience, it results in significant environmental and financial benefits for patients” says lead author Dr. Blayne Welk, associate professor of surgery at Western's Schulich School of Medicine & Dentistry, urologist at St. Joseph’s Healthcare London, associate scientist at Lawson, and adjunct scientist at ICES Western. “The financial and environmental benefits of virtual care will likely continue beyond the pandemic and are particularly relevant for some patients who were frequent recipients of virtual care.”

Findings show that for more than 10 million patients with at least one appointment during the study period (63 million visits in total), virtual care was associated with estimated savings of:

  • 3.2 billion kilometres of patient travel;
  • 545 to 658 million kilograms of carbon dioxide (CO2) emissions; and
  • $569 to $733 million (Canadian [US $465-$599 million]) in expenses for gasoline, parking, or public transit.

The avoidance of carbon dioxide emissions during the pandemic due to virtual visits represented approximately 0.2 per cent of the total annual carbon dioxide emissions (150 megatons) from Ontario.

The number of virtual care visits was greater for those aged 65 and older, individuals with multiple health conditions, and those living in urban areas. Due to distance travelled, virtual care may offer more potential environmental benefits and patient cost savings for rural residents. Other factors, such as decreased time off work (given that some virtual visits can be done during the day with little interruption to work) may have had additional benefits for some working adults and parents of young children.

“Virtual visits should not replace all in-person visits, but they are an important option that can enhance the care that physicians provide for patients” says Dr. Alexandra Zorzi, a paediatric oncologist at Children’s Hospital at London Health Sciences Centre and associate scientist at Lawson. “Our findings suggest that physicians should continue to offer virtual care appointments when appropriate, especially for patients living in more remote areas and those that have barriers to accessing in-person healthcare.”

The study, “Association of virtual care expansion with environmental sustainability and reduced patient costs during the COVID-19 pandemic in Ontario, Canada” was published in JAMA Network Open.

Author block: Welk B, McArthur E, Zorzi AP.

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario

Lawson Health Research Institute
is one of Canada’s top hospital-based research institutes, tackling the most pressing challenges in healthcare. As the research institute of London Health Sciences Centre and St. Joseph’s Healthcare London, our innovation happens where care is delivered. Lawson research teams are at the leading-edge of science with the goal of improving health and the delivery of care for patients. Working in partnership with Western University, our researchers are encouraged to pursue their curiosity, collaborate often and share their discoveries widely. Research conducted through Lawson makes a difference in the lives of patients, families and communities around the world. To learn more, visit www.lawsonresearch.ca.


Western University delivers an academic experience second to none. Since 1878, The Western Experience has combined academic excellence with life-long opportunities for intellectual, social and cultural growth in order to better serve our communities. Our research excellence expands knowledge and drives discovery with real-world application. Western attracts individuals with a broad worldview, seeking to study, influence and lead in the international community.


Misty Pratt
Senior Communications Officer, ICES
[email protected]


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