Decarbonizing Health Care: Measuring the Carbon Footprint Impact of a National VA Telehealth Program.
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2025-04
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Health care systems are increasingly recognizing the environmental harms generated by medical care and are seeking to reduce their carbon footprints. They can accomplish measurable reductions in greenhouse gas emissions while maintaining high quality and even improving care by pursuing cobenefits - programs that simultaneously reduce environmental harm and benefit patients' health. The authors describe Advanced Comprehensive Diabetes Care (ACDC), an evidence-based telehealth program for diabetes patients in the U.S. Department of Veterans Affairs (VA) system that has concurrently improved patient care and reduced the VA's carbon footprint. Designed for patients with poor diabetes control, the program leverages existing clinical infrastructure to provide nurse-delivered telemonitoring, self-management support, and provider-aided medication management. ACDC has improved patient outcomes while reducing patient travel time, out-of-pocket costs, and greenhouse gas emissions. ACDC served 576 patients between 2017 and 2022. The authors estimate that the program has prevented over 200,000 miles of driving, saving around US$20,000 in gasoline costs for patients and 82 metric tons of carbon dioxide emission compared with equivalent in-person care. ACDC provides a template for improving health outcomes and patient as well as provider satisfaction while saving money and producing measurable reductions in carbon footprint.
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Weppner, William G, Amy S Jeffreys, Cynthia J Coffman, Hayden B Bosworth, David Edelman and Matthew J Crowley (2025). Decarbonizing Health Care: Measuring the Carbon Footprint Impact of a National VA Telehealth Program. NEJM catalyst innovations in care delivery, 6(5). 10.1056/cat.24.0149 Retrieved from https://hdl.handle.net/10161/33909.
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Scholars@Duke
Cynthia Jan Coffman
Hayden Barry Bosworth
Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities.
Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.
Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy
David Edward Edelman
My general interests are in the improve quality of care for chronic illness, using diabetes as a model. While I have performed research on screening for, diagnosis of, and clinical severity of unrecognized diabetes in patient care settings, my current line of work is in using health systems interventions to prevent cardiovascular disease, and to improve outcomes from comorbid diabetes and hypertension.
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