The ASSIST column

How green is health informatics?

John Leach makes the case for using teleconferencing technology to cut CO₂ emissions by reducing the need to travel

One of the benefits of technology is that it can transform the way we do business. This includes increasing access. Telemedicine and telecare are clear candidates to enable such transformation. We can already obtain advice from NHS Direct/NHS 24 in the UK, and there are some interesting and innovative applications of telemedicine and telecare. These enable people to stay in their own homes and they have the potential to reduce the number of journeys made to support these people. It is reasonable to ask if this has a positive impact for the environment in terms of a reduction in the emission of greenhouse gases.

There are probably thousands of small reductions in emissions that cumulatively could have a major impact. These benefits should be identified; they might influence the way we view the opportunities that technology offers us. However, we should also be aware of some of the consequences of replacing physical contact with tele-contact. If there is not continuing physical contact by family, friends and neighbours, the people being supported in their own homes could become socially isolated, which is the opposite of one of the goals of this type of care.

Another area that could benefit from transformation is conferencing. All too often it is the fortunate few who are able to attend when many more people in an organisation would benefit from listening to one or two sessions. This is even more pronounced with international conferences, which incur additional travel and hotel costs.

It may be necessary for a few people to travel to an international conference location but many people could attend a satellite session, or sessions, from their home country as, for a similar expenditure, conferences were run in multi-centres. In doing this they would save on travel time, travel costs, hotel accommodation and greenhouse gas emissions.

At each centre people could network and continue to discuss presentations informally as well as debating issues of concern that they were tackling in the workplace. The people attending these satellite conference sessions may have to shift their working day to that of the principal conference site but they would have to do that if they attended the main conference.

Using videoconferencing, questions could and should be taken from all of the sites on which the conference is being held. Those people who wished to be in “attendance” for only one or two sessions could do so from their workplace though perhaps discussion technology has yet to advance sufficiently to be practical. For some people it may be useful to follow the events at a later time; this would be particularly useful if the main conference is in a different time zone. I know of a practising informatics colleague in England who was able to lecture to and hold discussions with a group of students in Canada — something that the individual would not have done without this type of technology, given the pressures on his time.

The health informatics community is often seen as enabling transformational changes to be inflicted on other people, eg telemedicine and telecare — though some people will probably welcome these. Conferences are an opportunity to lead by example. The health informatics community in the UK should establish a location for a British conference centre for use by future international conferences with videoconferencing and other technology.

There is a debate about these arguments; on one hand the ASSIST National Council has endorsed this proposal. Conversely, many members of the BCS HIF Strategic Panel are not sufficiently convinced of this view. One of the reasons is that travel to international conferences is viewed as an implicit reward for devoting personal time to develop health informatics as a profession.

This is not restricted to health informatics; it is a view that is also prevalent in academia, where international travel is regarded as part of the compensation package in return for presenting papers at international conferences, and this is common to all disciplines. I have even become aware of people who study and advise on sustainable transport travelling around the world for such activities.

I attended a presentation by one woman who had planned a bicycle ride along the Rockies from south to north to draw people’s attention to the effect of global warming. I was banned by those around me from asking the obvious question. Fortunately, someone else asked it. We all learned that she was intending to fly from the UK to the start of her ride and fly back from the finish.

The travel bug is deeply ingrained in the human psyche. This might be dangerously ingrained amongst those who have the cerebral agility to engage in post hoc rationalisation. However, the vast bulk of the population will see this as self justification and what we need now is leadership by example.

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