Sustainability issues and carbon emissions have become the focus of governments and companies in recent years. In particular, Taiwan's medical institutions generate a large amount of carbon emissions. Greenhouse gas emissions and the transportation of patients to hospitals have become significant sources of carbon emissions. The energy consumed during frequent medical visits, taking rides regardless of distance, and even going to the hospital for examinations increases tangibly and intangibly. This research aimed to investigate the impacts of telemedicine on hospital carbon emission reduction and the decisions for referral services. A simulation model is developed to test if the choice of different patients for medical treatment (telemedicine) can reduce transportation carbon emissions to the hospital. The patients who traveled to each hospital are grouped in clusters. Each cluster is set as a departure point, and the time required to reach each hospital from each departure point is calculated. A transportation time of 0 if telemedicine is used. In addition, this study also considers the proportion of patients who need to be referred to another hospital. In other words, if the patient's illness is classified as severe, he should have visited a healthcare center directly instead of multiple transportation. Therefore, the carbon emission due to less traveling time will also be calculated. The findings would provide decision-makers with the future of policymaking in reducing carbon emissions in healthcare organizations.