Abstract
BACKGROUND: Telemedicine can promote access to specialized care and avoid travel to referral centers. OBJECTIVES: To present the environmental impacts and the positive results for the sustainability of the Brazilian public health system after the implementation of the TeleNordeste Project developed by hospital BP - A Beneficência Portuguesa de São Paulo. DESIGN AND SETTING: A retrospective cohort study was developed in three states in the Brazilian Northeast, Alagoas, Maranhão, and Piauí. METHODS: This study was conducted between August 2022 and December 2023. All patients participating in telemedicine care were selected for this type of care by Primary Health Care (PHC) doctors according to the need for clinical discussion. The variables analyzed were the total distance and time (round trip) saved by telemedicine care, the amount of carbon emissions not released into the environment, gasoline costs, resolution of care through teleconsultation, and evaluation of the Net Promoter Score. RESULTS: In total, 25,194 consultations were conducted via telemedicine, requiring in-person referral in 775 tele-interconsultations, representing a resolution rate of 96.92%. It saved approximately 10,737,287 miles (17,279,988.6 km) and 264,302 hours for patients and the municipal health department, and reduced carbon dioxide (CO2) emissions according to Environmental Protection Agency (EPA) parameters, estimated at 4,294,915 kg, saving US$ 1,660,068.89 (R$ 8,532,754.09) on gasoline. CONCLUSION: To our knowledge, in Brazil, this study is one of the first to present results on the impact of telemedicine on reducing carbon emissions in relation to the movement of patients to reference centers in healthcare networks and the resolution of care provided in health units in the context of the PROADI-SUS TeleNordeste Project developed by BP and promotes reflection on the potential benefits of telemedicine according to current evidence.