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Figure 1.

Methods summary.

The study is based on the method used by Ong et al. that builds on existing LCA data for end-point devices used in videoconferencing and emission estimates for Internet traffic [17]. Completeness of the LCA data varies between devices, but includes energy costs and/or carbon emissions generated during manufacturing (M), distribution (D), operation (O) and end-of-life stages (E). Emissions data for MDE are provided in, or has been converted to, energy equivalents (kWh/unit) and is called embodied energy. Data for the videoconferencing solution (monitors, camera and video codecs) were modified to better fit our technological set-up. To obtain the hourly carbon cost of telerehabilitation in kgCO2e, we divided the embodied energy with estimates of the life length and use rates of all equipment, and applied a conversion factor of 0.6 kg CO2e/kWh [17], [20]. See also Equation 1.

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Figure 1 Expand

Table 1.

Life cycle and operating costs of end point devices.

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Table 1 Expand

Table 2.

Estimates of the Internet opex and embodied energy.

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Table 2 Expand

Figure 2.

Summary of results.

Net emissions for the two scenarios. Hand and plastic surgery section (a), and speech therapy unit (b). Information on the technological set-up used for individual appointments was only available in the hand and plastic surgery section (actual). Therefore, we applied the upper and lower bound scenarios in the speech therapy clinic.

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Figure 2 Expand

Table 3.

Accumulated life cycle carbon costs of telemedicine versus face-to-face meetings.

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Table 3 Expand

Figure 3.

Sensitivity analyses.

The analyses are based on the lower bound emissions scenario that emits 1.85 kgCO2e during a one hour meeting. All other factors were kept constant while changing the bandwidth (a), meeting duration (b) or use rates (c), respectively.

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Figure 3 Expand