Green Virtual Care Tool

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How to use this site

This tool shows you the questions that will need to be answered to implement and maintain a sustainable Virtual Care System. You probably won't be able to answer all the questions by yourself, so identify the people that have the knwodlege and skills on the different areas covered by this tool and ask them the questions. They might be people in other departments or even some of the suppliers used by your organisation.

Beside the questions you will sometimes see an icon. Clicking on them will provide extra information. Below is a brief explanation of what each icon means:

Why should you ask this questionWhy should you ask this question?


Extra information and resourcesRead more about this subject


ideas that you could trySuggest actions to be taken next

Procuring software or developing it in house

ideas that you could try If you are not able to answer this questions yourself, ask your potential suppliers the questions below (also in pdf here) and assess their answers, using the explanatory information provided against each question, before deciding to use them
Why should you ask this question Ask if your supplier adopts green software principles. These include, for example, maximizing the efficiency of the most regularly run sections of code, not over engineering the code for accuracy beyond what is required in that specific application, and minimizing the data the software is processing. The Green Software Foundation’s Ten Recommendations for Green Software Development provides more detail on these, as does this resource on reducing your data usage, one of the ten recommendations. Be aware that following these recommendations will not eliminate environmental impacts because of rebound effects, but it will reduce them.

Why should you ask this question In-built calculators mean that tools have been incorporated into the software you procure to allow you to calculate carbon emissions arising from the use of the software. Such tools might be:

Why should you ask this question AI has a high energy consumption. Virtual Care Systems are currently unlikely to offer AI enhanced solutions and may just comprise conventional telehealth and remote monitoring, but AI is increasingly being introduced into these systems, particularly to assist with remote monitoring. Check whether AI is incorporated into the Virtual Care System you are considering. If it is, ask your supplier the following questions:
  • How were carbon emissions minimized during the training of the AI? For example, were energy efficient (low power) configurations used during training and/or was shared data used in training to minimize big data set redundancy with all the unnecessary environmental impacts that implies?
  • Is the AI included in the Virtual Care System optimally tuned such that it uses as little energy as possible whilst preserving the necessary level of performance?

Why should you ask this question This is important to consider for long term sustainability of the service. A high level of interoperability between your software systems means there is a reduced likelihood of complex and energy intensive integration or replacement projects now and in the future. Interoperability in software is usually achieved through Application Programming Interfaces (APIs). Check what API standards the software adheres to and how that compares with API standards of any existing or planned software you may want the Virtual Care system to integrate with. For an introduction to API standards, this industry blog is useful. It outlines the different API standards in different sectors, including health. Interoperability standards in Health IT are still emerging – with FHIR one of the leaders.

Why should you ask this question The energy gains from new materials do not offset the impacts linked to their manufacturing. Given this, it is important that the software can operate on the oldest possible equipment, so no new equipment needs to be purchased to access the software.

Why should you ask this question If the software can work on existing devices, it saves the need to manufacture further digital devices, therefore reducing environmental impacts associated with mining, manufacture, and waste. However, if a user’s own device, typically their phone, is, for example, used to host monitoring tasks that form part of the Virtual Care system, then the user may have to pay for this themselves. This is because it may be difficult to separate out the element of their ongoing phone costs that are attributable to the virtual care service. Having users cover the costs themselves is an equity issue.

Why should you ask this question Make sure the service guarantees the provision of corrective updates throughout the expected lifespan of the software you are procuring. As well as prolonging the lifespan of the software, this reduces the risk of service-related equipment becoming obsolescent as the software running on it is no longer supported. Be aware that owing to the fast evolution of technology and the consequent expectations around it, it is possible for the lifespan of digital services to be over extended. So, for example, a virtual care system user interface, for the patient or healthcare professional, might appear increasingly clunky as it ages, and this might ultimately result in the patient or healthcare professional not using it. Clearly it would then not achieve its intended health benefits and yet still be running with the associated environmental impacts.