Distance spanning solutions in health care and care are one example of digital services that aim to improve the availability of services for citizens and increase sustainability.
Environmental sustainability and the green transition are relatively new topics in discussions concerning the digitalisation of health care and care (Pereno & Eriksson, 2020), despite the many connections between climate change and healthcare and care challenges. It has been estimated that the healthcare sector is responsible for over 4 percent of greenhouse gas emissions globally (Andreae, 2022; see also Lenzen et al., 2020) and for up to 15 percent of emissions in industrialised countries (WHO, 2015). Digitalisation is seen as one way of reducing the negative environmental impacts of healthcare and care production (e.g. Fragão-Marques & Ozben, 2023), but concrete tools are needed to address the impacts of digitalisation in this field. This part introduces a novel methodology to assess the environmental, especially the climate impacts and social impacts of digital healthcare and care services. The results of a combined quantitative and qualitative assessment concerning the impacts of digital home care services in Finland are also presented.
The Nordic region aims to become the world’s most sustainable and integrated region by 2030. This ambitious Vision 2030 (Nordic Council of Ministers, 2020) comprises interlinked strategic priorities: a green Nordic region, a competitive Nordic region, and a socially sustainable Nordic region. Its implementation requires taking measures to promote a green transition in the Nordic countries and work towards achieving carbon neutrality, promoting green growth in the Nordic region based on knowledge, innovation, mobility and digital integration, and working towards social sustainability, such as contributing to good, equal and secure health and welfare for all, as well as involving everyone living in the Nordic region in digital development. In many ways, distance spanning solutions in Nordic health care and care are intertwined with this vision and each strategic priority and their interfaces. The Vision’s Objective no. 10, for example, focuses on involving people in the green transition and digital development, utilising the potential of this transition, and counteracting the widening gaps in society as a result of it. In particular, Objective 10 states that the green transition in health care and care involves taking advantage of digital solutions, offering healthcare and care services remotely, promoting innovation, and reducing their climate impact.
The United Nations (UN) Sustainable Development Goals (SDGs) also provide guidelines for the path towards achieving the sustainable digitalisation of healthcare and care services. As emphasised by Carson et al. (2021), SDGs are considered indivisible, and the pursuit of specific goals (e.g. improved access to healthcare and care services) needs to be undertaken while taking into account both the positive and negative spillover impacts on the other goals. Understanding that all SDGs interact as a system is essential to help guide the prioritisation of interventions, leverage synergies and avoid goal conflicts during implementation (Carson et al., 2021).
Limited research on environmental impacts
While the many positive expectations concerning the impacts of digital healthcare and care services are warranted, research is still limited, including research into and the development of usable and robust assessment methods for detecting environmental impacts, as well as other impacts (e.g. European Commission, 2019, mainly on evaluation). Digitalisation is not automatically positive from an environmental perspective, and new knowledge is needed to be able to make informed choices concerning digital healthcare and care services in the Nordic region (Carson et al., 2021). According to Andersen et al., 2021), it is unclear whether the increased use of electricity and rare materials due to digitalisation will be compensated for by efficiency gains and sustainable behaviours. In general, the sustainability of digital innovations depends on whether their integration is conducted in a way that supports their long-term stability (European Commission, 2019; Fragão-Marques & Ozben, 2023).
Healthcare and care services are a challenging field from the perspective of digitalisation. Such services are typically related to citizens’ fragile life situations. Diverse ethical issues, data protection and privacy are at stake here (Lerzynski, 2021). Despite the challenges, the enabling role of digitalisation is intriguing in Nordic healthcare and care services due to the broad scope and societal significance of these services, as well as the potential of digitalisation to reduce the need for human labour (e.g. Faggini et al., 2019) in the event of staff shortages. However, the different elements of sustainability require careful attention in any digitalisation project. The need for comprehensive impact assessments has been emphasised by both Nordic decision-makers and healthcare and care organisations and their personnel (Melkas et al., 2025).
This part introduces a novel methodology to assess the environmental, especially the climate impacts and social impacts of digital healthcare and care services. We also present the results of our quantitative and qualitative assessment concerning the impacts of digital home care services in Finland.
Our focus is on medicine robot services for home care clients (older people). The chapter shows how – and under what conditions – distance spanning solutions in health care and care can contribute to the green transition. We also give practical guidance for future impact assessments.