UVA Team Maps Path to Lowering Carbon Emissions in Outpatient Care

Researchers uncovered hidden emissions sources so massive they rival an entire fleet of cars. Their findings may change the future of patient visits forever.

A study published in Frontiers in Health Services reveals that a large, modern outpatient orthopedic center in the United States generated an estimated 11,049 metric tons of CO₂ equivalent in a single fiscal year. The total units of carbon dioxide emitted through all emissions at the center corresponds roughly to the annual emissions of 2,500 U.S. automobiles, or the carbon removal capacity of over 11,000 acres of mature forest.

The study, led by researchers at the University of Virginia in partnership with Rho Impact, shows that 81% of the clinic’s emissions stemmed from indirect (also called “Scope 3”) sources. Most notable of these indirect emissions were patient travel (52% of all Scope 3 emissions) and purchased goods & services (20% of all Scope 3 missions). While some may assume most healthcare emissions come from direct energy use or on-site fuel combustion, that is clearly not the case.

The research team included Anna Jett (UVA Environmental Institute Decarbonization Corps intern and Sustainability Fellow with the Office for Sustainability), Dr. Matthew Meyer (UVA School of Medicine and the Medical Director of Sustainability, UVA Health), Lisa Colosi-Peterson (UVA School of Engineering), Esther Bobbin and Seth Sheldon (Rho Impact), and Venkat Kothandaraman (Northwestern University).

The researchers assessed the freestanding Orthopedic Center associated with UVA in Charlottesville, VA. Here, emissions broke down as: 2% Scope 1 (direct on-site emissions), 17% Scope 2 (purchased energy), and 81% Scope 3 (supply-chain and value-chain emissions).

Scope 3 emissions included:

Patient transportation to/from the clinic (which accounted for 52% of Scope 3 and around 42% of the clinic’s total emissions). The median round-trip travel distance for patients was 63 miles.
Purchased goods and services (20% of Scope 3).
Employee commuting (12% of Scope 3).

Anna Jett (UVA Environmental Institute Decarbonization Corps intern and Sustainability Fellow with the Office for Sustainability) co-authored a paper which provides a blueprint for outpatient facilities to assess their complete carbon footprint.

“As our findings demonstrate, there’s value in expanding greenhouse gas inventories to include more Scope 3 emission sources. It allows us to better consider the impacts of how staff, patients, and products arrive at our clinics and what happens when they leave them,” said Anna Jett.

“This research underscores that true climate action in outpatient care means rethinking the entire ecosystem—from what we purchase, to how patients get to us, to how we deliver care,” said Dr. Matthew Meyer. “Telemedicine and other innovative models give us powerful tools to reduce emissions without compromising care.”

Some recommendations the scientists make based on their findings include rethinking telemedicine and virtual care. As patient travel was the largest single emission category, shifting eligible visits to remote options offers a substantial mitigation opportunity. But the researchers also note that telemedicine and virtual care offer other substantial benefits, too, such as saving patients who travel from far distances and reducing the other air pollutants from combustion.

When it comes to employee commuting, outpatient clinics should offer interventions like electric-vehicle charging stations, incentives for low-carbon commuting, and consider transport options for workers.

Finally, the team recommends that health systems partner with vendors to reduce upstream emissions and waste.

As healthcare seeks to align with broader efforts to eliminate environmental contamination, this study provides a valuable blueprint for outpatient facilities to assess their complete carbon footprint, including the often-overlooked travel and supply-chain emissions. By addressing these areas, health systems can move toward more sustainable care delivery without compromising patient outcomes.