The global rapid embrace of telehealth has transformed accessibility and effectiveness in healthcare but has consequent implications for the environment. Digital consultations allow for decreased emissions from patient travel, but the infrastructure that supports it: Information and Communications Technology (ICT) including data centers, cloud networks and medical devices, has a significant impact on energy usage. This paper provides a Green Telehealth Framework (GTF) which seeks to allow technological efficiency, operational sustainability and policy cohesion to help enable low carbon digital health ecosystems. The GTF is constructed from studies in sustainability and digital transformation across a number of disciplines and addresses the environmental severity of telehealth through methods including optimizing design, improving renewable energy ICT and promoting sustainable policy instruments. Real world case study applications from the United Kingdom, Australia and the United Arab Emirates demonstrate its practical viability and cost benefit. The comparative study undertaken shows that there may be an energy usage reduction of up to 30% and significant long-term cost savings. Finally, certain recommendations are provided to help telehealth include sustainability as a measurable dimension of the quality of telehealth which promotes the vision of climate-resilient digital health systems.
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