The sustainability impacts of a web-based outpatient booking application.

Background: Climate change is a critical global issue, impacting ecosystems, economies and communities worldwide. The shift from paper-based to digital systems is becoming increasingly prevalent across industries, with downstream positive impacts on sustainability. In 2020, Austin Health, a public tertiary hospital in Victoria, Australia, adopted a web-based outpatient booking application, which succeeded the prior paper-based system. The application served as an integrated platform for administrative staff to access various Austin Information Technology platforms and replaced previous mail-based outpatient appointment notifications with Short Message Service-based notifications. This study aimed to assess the environmental impact and organisation-wide economic cost of a web-based outpatient booking application compared to the prior paper-based system across the same time period.

Methods: A retrospective environmental and economic assessment was conducted for both the web-based booking application and the paper-based system. The evaluation covered 36,925 outpatient diagnostic imaging studies - including CT, MRI, ultrasound and mammography - performed at Austin Health from 1st July 2023 until 30th June 2024. The environmental impact was assessed by calculating the expected carbon dioxide equivalent (CO₂e) emissions produced by each system. The economic cost analysis was conducted from the perspective of the hospital and included the direct costs of labour and materials/consumables.

Results: CO₂e emissions were significantly reduced using the web-based outpatient booking application compared to the prior paper-based system (38.5 tonnes compared to 0.002 tonnes), predominantly attributable to the elimination of postage-related fuel emissions (27.7 tonnes). The estimated net operating cost savings across the year was at least AUD 175,000 (in 2024 Australian Dollars, adjusted for inflation). This was primarily due to labour savings from the elimination of workflow inefficiencies (at least 2342 h saved) amounting to at least AUD 85,272 in salary, followed by savings from eliminated pathology tests (AUD 57,422) and postage costs (AUD 55,193).

Conclusion: The adoption of the web-based outpatient booking application led to a substantial reduction in carbon emissions and operating costs, alongside enhanced operational efficiency and productivity. These benefits are anticipated to be enduring, especially in the face of an ever-increasing demand for medical imaging services.