Environmental eHealth : A critical compenent of eHealth readiness assessment by Richard Scott, CEO & Principal Consultant for NT Consulting, Editor - Journal ISfTeH, Canada

1. 1
ENVIRONMENTAL e-HEALTH
- A CRITICAL COMPONENT of e-HEALTH
READINESS ASSESSMENT -
Dr. Richard E. Scott 1,2 and Dr. Maurice Mars 2
1 NT Consulting – Global e-Health Inc., Calgary, Alberta, Canada; Departments of
Family Medicine and Community Health Sciences, University of Calgary, Calgary,
Alberta, Canada
2 Telehealth Department, University of KwaZulu-Natal, Durban, South Africa

2. e-Health and
Environmental e-Health
- What Exactly Are They ? -

3. e-Health
- Perspective -
Definition
• “The use of Information and
Communication Technologies
(ICT) for health”
• http://www.who.int/topics/ehealth/en/
Reality
• “There is no aspect of health
or healthcare that has not
been, is not being, or will not
be impacted by e-Health”

4. Global Health / OneHealth
e-Health
Telehealth Health Informatics
[Telemedicine]
[Telepaediatrics]
[Decision Support
Systems]
[Electronic Records]
[Teleradiology]
[Home Telehealth
/ Telecare]
[EHRs]
[PHRs]
[EPRs]
[Tele-Social Work;
Tele-Pastoral care]
[Surveillance
Systems]
[Websites;
RPM; ‘Apps’]
e-Learning
(TEL / TEEL /
TEET)
e-Commerce
[EMRs]
Global e-Health
[SMART Cards]
[Telerehabilitation /
Teleoccupational Therapy]
[m-Health]
[Surveillance; GPS
location]
[Blended Learning]
[Distributed Learning]
[Reimbursement]
[Billing / Fee for Service]
[Teledermatology]
© Dr. Richard E. Scott; 2004, 2006, 2009, 2012, 2015; 2016 ; www.ntcehc.ca
University
Health
Centres
Education
Clinical Care
Research
[Remote Personal
Monitoring]

5. Environmental e-Health
- Perspective -
Environmental e-Health is:
•“The study of the impact of
e-health on the
environment (harms and
benefits) and means of
mitigation (harms) or
enhancement (benefits) of
these impacts.” Mt. Kilimanjaro has been the
subject of many scientific
studies because of its shrinking
glaciers

6. Environmental Impact Of
e-Health
- The (Brief) Low-Down -

7. Environmental e-Health
- Environmental e-Health Impact Model -
e
W
A
S
T
E
Upstream Issues
Materials, Manufacturing,
Packaging, Distribution
Mid Strm
Use
(Energy / Water)
Downstream Issues
e-Waste / WEEE
(Recycling / Reuse)
R
E
S
O
U
R
C
E
D
E
P
L
E
T
I
O
N
ENERGY / GHGs
Holistic ‘Cradle to Grave’ or Life Cycle Analysis (LCA)
Understand the types of environmental impact of e-Health
Water Air Ground
Natural (Global) Environment
Opportunities for Change in Practice, Process, and Policy

8. Environmental e-Health
Readiness
- What’s Out There ? -

9. e-Health Readiness
- Technology is not Enough !! -
“The degree to which users, health-
care institutions, and the health-care
system itself, are prepared to
participate and succeed with e-health
implementation.” Jennett et al. (2005)

10. Environmental e-Health Readiness
- Technology is not Enough !! -
“The degree to which users,
health-care institutions, and the
health-care system itself, are
aware of, and able to ameliorate,
environmental impact of e-health
implementations.” Scott and Mars. (2016)

11. Environmental e-Health Readiness
- Literature Search -
Papers Identified in e-
Databases
(PubMed + Google
Scholar) - 269
Papers After Duplicates
removed and Preliminary
Screen - 28
Papers Excluded: Non-
English; duplicates; ‘disaster’
related; no model or
framework - 241
e-Health Readiness
Models / Frameworks.
(e-Health OR eHealth OR Telemedicine OR Telehealth) AND (Readiness OR Preparedness)

12. •Models or frameworks noting the
environmental impact of e-health.
NONE
•Papers using the term ‘environment’
FOUR
•BUT - only in reference to the e-health
‘setting’
Environmental e-Health Readiness
- Findings -

13. So What ?
- Importance -

14. Significance ?
- What WE Contribute -
• Twitter – a tweet ‘emits’
about 0.02g CO2
(50m/day = 1 tonne of
CO2
• Google – a search
query ‘emits’ 0.2g CO2
(= 3L water)
• e-Mail – each email
‘emits’ 0.25g CO2

15. Significance ?
- The Ever Increasing Volume of Activity -
Medium Per
SECOND
Per DAY Per YEAR
Tweets [1st] 10,520 15,148,800 5,529,312,000
Instagram Photos 2,963 4,266,720 1,557,352,800
Tumblr Posts 2,356 3,392,640 1,238,313,600
Skype calls 1,927 2,774,880 1,012,831,200
Google searches [2nd] 51,449 74,086,560 27,041,594,400
YouTube videos 111,132 160,030,080 58,410,979,200
e-Mails (mostly
spam!)
2,441,657 3,515,986,080 1,283,334,919,200
Internet traffic [3rd –
users]
30,949 GB 44,566,560 GB 16,266,794,400 GB

16. Sustainable e-Health
- Not Just Now – But the FUTURE !! -
A sustainable e-Health solution is:
”One that uses ICT resources to meet the
health needs of the present without
compromising the ability of future
generations to meet their own health
needs”.
Scott RE, 2009.
After: Bruntland Commission

17. Summary and Conclusions
- What We Need To Do -

18. • Be aware of:
• The existence of ‘Environmental e-Health’ as an issue
• The growing depth and breadth of global application
• Developed vs developing country realities
• Identify only:
• ‘Technologically appropriate’, ’culturally sensitive’, ‘locally
relevant’, and ‘environmentally sustainable’ e-health
solutions of overall value as determined by LCA
• Require:
• Meaningful EeIA from conception to termination (LCA)
• Influence / change:
• Policy, Process, and Practice to encompass EeH
Environmental e-Health
- Summary Thoughts ~ As Proponents WE must ….. -
Endorse – Enable - Enforce

19. Environmental e-Health Readiness
- Conclusion -
A setting (Country, Community, Institution, Individual) must:
• Recognise the environmental impact of e-health
• Have - in place - training, process, policy, enforcement
• Perform Environmental e-Health Impact Assessments
(EeIA) including LCA
• Ensure reduction of negative upstream, midstream, and
downstream environmental impacts
ONLY THEN is the setting truly ‘READY’ for implementation
of e-Health

20. Comments – Questions !?
- Environmental e-Health and Readiness Assessment -
Richard Scott: NTC.eHealthConsulting@gmail.com
Maurice Mars: mars@ukzn.ac.za