Telemedicine
Telemedicine uses information-communication technologies to provide clinical services between patients and health care providers or to share clinical information between providers. Telemedicine includes video conferencing or telephone-only visits, provided synchronously in real time, with patient-provider interaction, or asynchronously, where the patient and provider exchanges messages, text, images, or other materials1, 2. Telemedicine is sometimes called telehealth, but telehealth can be understood as broader than telemedicine and can refer to other health services and medical education or training provided remotely1.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased access to care
Improved access to reproductive health care
Reduced vehicle miles traveled
Reduced emissions
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Improved chronic disease management
What does the research say about effectiveness?
There is strong evidence that telemedicine increases access to care3, 4, 5, 6, 7, particularly among rural populations8, 9, 10 and other groups who experience challenges in access11, such as mobility1, 4. It also increases patients’ direct access to providers, services, and medication for women’s reproductive health care12, 13, 14, 15. Telemedicine also reduces carbon emissions by reducing vehicle miles traveled to appointments1, 16.
Telemedicine provides care equivalent to in person care for some health conditions1, 17, 18, 19, but more rigorous research is needed evaluating whether telemedicine improves health outcomes among individuals when used to treat acute conditions or more complex or chronic diseases, compared to solely in-person care1, 4, 18, especially as the focus of telemedicine services shifts to increasing patient convenience and reducing costs17.
Reproductive health care. Telemedicine can provide early access to medical abortion services13, 15 and appears comparable to in-clinic services in its safety, effectiveness, and acceptability to patients and providers12, 14, 15. A British study suggests a telemedicine/in-person hybrid model for providing remote medical abortions could lead to significantly shorter wait times from referral to treatment, increasing the number of abortions provided at 6 weeks or less gestation13. There is demand for self-managed abortion care, where medication is received through the mail and patients are supported via telemedicine20. A recent U.S.-based study suggests telemedicine appointments for abortion care increase timely access to such care21. However, in the U.S. legal and policy challenges to telemedicine-supported abortion care continue and are increasing20.
Telemedicine interventions for reproductive health can impact some pregnancy and birth-related health outcomes, including increasing perinatal smoking cessation and breastfeeding15, reducing postpartum depression22, and are a comparable alternative to in-person office visits to monitor patients for high-risk obstetric conditions15. However, it may not significantly improve maternal and fetal outcomes related to pregestational and gestational diabetes compared to usual care, although that may be because pregnant individuals are often already closely monitored for some conditions, limiting telemedicine’s effect23. Additionally, telemedicine interventions designed for adolescent sexual health may improve self-efficacy and condom use and increase screening and testing for sexually transmitted infections3.
Chronic disease. Telemedicine may improve chronic disease management in some cases, including reducing Hba1c in diabetic patients24 and modestly improving disease control in patients with multiple morbidities when interventions focus on a specific risk factor25. Post-hospital discharge medication-focused telehealth interventions can decrease hospital readmission rates, particularly as part of a multicomponent intervention, in older populations with chronic conditions, particularly heart failure26. Pharmacist-delivered telemedicine care, especially interventions delivered at predetermined times, may improve disease management, self-management, and treatment adherence for chronic diseases, as much as or more than in-person visits27. A variety of telemedicine interventions appear to modestly improve blood pressure in patients with cardiovascular disease and hypertension, particularly if the interventions last 6 months or longer; experts recommend telemedicine interventions include monitoring devices which report data automatically28. Asynchronous patient-physician messaging may decrease emergency department and hospital utilization among patients with multiple chronic conditions29. Conditions that have been shown to be sensitive to telemedicine include hypertension, diabetes19, 24, 30, 31, anticoagulation, hyperlipidemia, asthma, heart failure, HIV, chronic kidney disease, stroke, and COPD, as well as depression and posttraumatic stress disorder27, 32. Experts caution, however, that the type and intensity of interventions vary widely and more rigorous research is needed on whether telemedicine improves clinical outcomes for chronic diseases and overall health status among patients with multiple morbidities1, 24, 25.
Acute conditions. Telemedicine may be an appropriate alternative, or first step in triage, for low-risk acute conditions for which people commonly seek treatment at an in-person appointment, such as conjunctivitis, emergency contraception, urinary tract infection (UTI), upper respiratory tract infections (URI), and sore throat (pharyngitis)33; such e-visits do not appear to increase emergency department use, and may be cost effective due to their short length (often only two or three minutes)33. Evidence is mixed, with some studies suggesting telemedicine leads to similar or better care outcomes such as appropriate prescribing of antibiotics or ordering of medical imaging18 while other studies suggest patients may be more likely to receive inappropriate antibiotics or that clinicians may not order appropriate tests. Telemedicine may reduce physician-related medication errors among seriously ill or injured children in rural emergency departments34. Experts suggest telemedicine may be more likely to produce beneficial outcomes, such as appropriate prescribing and expected rates of follow-up care, when providers and patients have an established relationship, the patient’s medical record is available, and on-site testing and follow-up care are accessible1. More research is needed about difficult-to-assess conditions and among patients with communication barriers1.
Other specialties. Telerehabilitation services may improve motor function following total knee replacement35 and reduce short-term disability and symptoms for patients with multiple sclerosis36. Telerehabilitation also appears to produce similar outcomes to center-based cardiac rehabilitation for low to moderate risk coronary artery disease patients37. Teleglaucoma screening detects more cases of glaucoma than in-person screening in remote and underserved communities38, and, overall, telemedicine appears to increase access to care for speech, language, and hearing services5. Telemedicine is also used globally for routine dermatologic care, but more research is needed which compares tele-dermatology with in-person consultation; experts suggest it may be well-suited for initial evaluations and follow-up visits1.
Environmental benefits. Telemedicine has the potential to reduce the carbon footprint of the health care industry, primarily by reducing vehicle miles traveled (VMT) and greenhouse gas emissions from patients driving to appointments. Telemedicine does generate some carbon emissions and those amounts vary, for example, with the length of the appointment, type of teleconferencing platform used, energy used to support the virtual connection, and different broadband capacities. In general, telemedicine appointments that replace a car trip of a few kilometers or more reduce carbon emissions16, 39, 40, 41. Experts also suggest that telemedicine can reduce traffic, wear on medical facilities, and reduce staff and patients’ exposure to infectious disease1.
Challenges. Providers and patients may encounter challenges in using telemedicine, including inconsistent reimbursement policies, inadequate reimbursement amounts, restrictions on which technologies can be used, and from what settings, and privacy regulations that can increase costs to ensure exchanges are secure1. Patients who are traveling may be excluded from care due to states’ different medical licensing systems, and certain prescription, visit, and patient types may also be excluded1. Telemedicine can also be challenging to evaluate because telemedicine visits can be simple or intensive and complex. Providers may prefer in-patient visits for high-risk patients or those with complex conditions when there is no disincentive for using in-person visits1. More research is also needed on diagnostic accuracy and timing in telemedicine, as well as delayed diagnosis legal claims in telemedicine compared to standard care1. A multi-institution study suggests providers want to continue using telemedicine but describe common challenges in receiving high-quality training, determining which patients are well-served by telehealth, and obtaining adequate physical exams42.
Recommendations. Overall, experts recommend telemedicine alongside standard care, not as a replacement1, 4. More research is needed on the effects of telemedicine on patient-provider trust and rapport; the ability to pick up on less easily observed symptoms and non-verbal communication remotely; the unavailability of therapeutic touch; and patients’ treatment adherence1, 4. Experts suggest that video appointments may allow providers to check on a patient’s home environment, perform a partial physical exam, observe some non-verbal communication, and may enhance the patient-provider relationship compared to audio only appointments43. Recommended operational support for providers conducting telemedicine appointments can include intake, scheduling, translation, and technical support coordinated between the patient and additional staff, which experts note may be easier to implement with video appointments44. Experts suggest asynchronous messaging may be well-suited for hospitals’ busiest times, such as flu seasons or during disasters, but recommend measures to manage potential burden on outpatient clinicians handling a high message volume, which could contribute to fatigue or burnout over time if not addressed1.
How could this strategy advance health equity? This strategy is rated potential to decrease disparities: supported by some evidence.
Telemedicine is a suggested strategy to decrease geographic disparities in access to health care between rural and urban areas1 by improving access for rural populations and in areas with medical provider shortages8, 10, 17. Telemedicine appears to improve access to care for populations experiencing transportation barriers17, such as among rural veterans8 and older adults9, including those with limited mobility outside the home4. Telemedicine-supported abortion care may increase access for women who live in states that prohibit or restrict abortion20. In general, more rigorous research is needed to understand persistent disparities in usage and acceptance, with interventions focused on ensuring telemedicine is available to those who desire to use it.
Telemedicine appears to be a viable option to treat rural veterans, including those with complex conditions, reducing the need for travel, improving health outcomes, and providing significant savings on transportation costs8. Experts suggest telemedicine can improve access for those experiencing barriers related to vehicle ownership, income, geographic isolation, and limited access to specialists8. Telemedicine increases access to telerehabilitation services in rural communities and can improve patient satisfaction with occupational, physical, and speech-language therapy services10. Telemedicine also appears promising for increasing access and continuity of care in rural areas among older adults with dementia, per studies in which patients accessed telemedicine centers55.
Prior to the public health emergency, telemedicine use for prenatal care was low56. A study of Medicaid patients who are pregnant which compared rural and urban uptake suggests that increased use by rural patients in this group was sustained following the public health emergency56. Experts caution that if states reduce Medicaid provider reimbursement in response to possible or actual federal budget cuts, this could affect telehealth access and usage, especially in rural areas where there are already fewer Medicaid-accepting providers56.
A recent U.S.-based study suggests telemedicine appointments for abortion care increase timely access to care21, especially for patients who live in rural areas, those who would have to drive over 100 miles to a providing facility, those experiencing food insecurity, and among patients younger than 2521. As access to abortion care is increasingly restricted, experts suggest telemedicine may reduce disparities in access to this care more than other health services21.
Two U.S.-based studies looking at the telemedicine expansion (2021-2022), suggest disparities in use may have decreased compared to the beginning of the COVID-19 pandemic, finding similar usage rates by age, race, ethnicity, income, urban/rural location57 and education58. Disparities persist in video-enabled compared with audio-only visits as well as health care online portal use59, even with significant increases in use in 2020 and 2021 when barriers were removed due to the COVID-19 pandemic1, 43. Video-enabled visits in particular appear to be used more by younger, higher income, urban, white adults – and less by those with lower incomes, adults with less than a high school degree, individuals who identify as Black, Latino/a, or Asian, and adults over age 6543. Video visits may be used more often by individuals who identify as transgender compared with other groups43.
Health insurance coverage and internet access and technology literacy are still well-recognized barriers to telemedicine use43. A Wisconsin-based study of the COVID-19 public health emergency finds telehealth expansion helped maintain access to primary care among Medicaid beneficiaries, especially among those with less education and lower incomes, though these groups were more likely to use audio-only11. Notably, usage in this study only increased among Hispanic and non-Hispanic Black individuals with high-speed internet, and there was greater completion of audio-only visits among Black, Hispanic or Latino, and Asian relative to white individuals11. Audio-only visits may be more likely among those older than 65 and those without health insurance58; those without insurance are least likely to use telemedicine overall43. More research is needed regarding what contributes to higher rates of audio-only visits, including how patients are triaged11, 60.
A study of telemedicine visits from March 2020 through December 2022 suggests telemedicine appointments reduce no-shows for appointments compared with missed in-person appointments, particularly among historically marginalized and underserved populations, such as Native American, non-Hispanic Black, Medicaid-insured, and self-pay patients60. Experts suggest telemedicine availability may reduce the impacts of factors affecting appointment attendance, such as lack of transportation or child care, or work schedule conflicts60. Telehealth expansion alone will not close gaps in primary care utilization by race/ethnicity11.
What is the relevant historical background?
Early advocates for telemedicine pointed to its potential to improve access, quality, and affordability of care, reducing disparities between populations in health care receipt61. Telemedicine was initially used for acute conditions, such as strokes or traumatic injuries, to connect specialist providers with clinicians treating patients in emergency departments. Telemedicine programs have also historically focused on rural populations, as well as those in the military and individuals who are incarcerated4. Before March 2020 and the onset of the COVID-19 pandemic in the U.S., provider-patient telemedicine use was increasing but was a tiny proportion of overall care1, especially video-enabled visits4. Most patients in the U.S. who used telemedicine did so through large academic medical centers, the Veterans Administration (VA) health systems, or purchased access if their healthcare provider offered direct-to-consumer services. Barriers to internet access and use prevented patients in rural areas, those with lower household incomes, disabilities1, and older adults from accessing care via telemedicine4. Legal barriers and differing state rules, such as whether medication could be prescribed over the internet also restricted use4. For example, prior to the legal decision to reverse Roe v. Wade in 2022, 19 states had banned or restricted use of telehealth for medication abortion62.
In March 2020, to support access to care and financial solvency for health care systems, Congress adjusted telemedicine restrictions for Medicare, including removing some restrictions for reimbursement, geography, and platform, as well as including telephone-only visits, and addressing interstate barriers to practice and privacy related to states’ differing rules, with state and private health insurance payors following this example1. A study of private and Medicare health care claims estimates that telehealth claims increased from 0.1% in 2019 to 5% of overall claims, as of 20211.
Telemedicine-supported abortion care has also been affected by recent changes in state and federal law and regulation. Medication abortion in early pregnancy has been available since 2000, when mifeprestone was approved by the U.S. Food and Drug Administration (FDA) for this use. As of 2023, medication abortion comprised 63% of all clinician-provided abortions in the U.S., an increase from 53% in 2020 and 39% in 201754.
Equity Considerations
- How widely available and used is telemedicine in your community or state – between providers, as well as providers and patients?
- Who is choosing which types of telemedicine interventions to offer patients and how are those decisions being reached? Which health needs are the focus? Which patient groups?
- How are health care providers, as well as community members, engaged in efforts to expand telemedicine use? What local or state laws and regulations restrict its use?
- What barriers might people experience at the local or state level in accessing telemedicine (e.g., health insurance coverage, internet access)? To using telemedicine meaningfully (e.g., digital literacy)?
Implementation Examples
As of September 2025, all 50 states, Washington, D.C., and Puerto Rico provide Medicaid and Medicare reimbursement for live video telehealth services, while 46 states and Washington D.C.’s programs also provide reimbursement for audio-only telehealth; in both cases, what is reimbursed varies45. Similarly, 44 states and Washington, D.C. have telehealth private payer laws45. After the onset of the COVID-19 pandemic in March 2020, telemedicine visits increased among all patient types1. As of 2025, telehealth does not appear to increase health care utilization, and so cost, per the American Hospital Association46.
A number of telemedicine and telehealth programs exist in the United States47. The federal website Telehealth.HHS.gov has updates on state and federal policy and project examples from across the U.S.47. The National Rural Health Association (NRHA) advocates for telehealth to increase rural access to health care and tracks related legislation48. The University of Missouri hosts the National Center for Telehealth Research and Policy, C-TRaP, founded in 202549 and the Missouri Telehealth Network (MTN), aimed at enhancing access to care in rural and underserved areas of Missouri50. The Children’s National Medical Center in Washington, D.C. has a telemedicine program that serves community hospitals, suburban health centers, inner-city health clinics, national hospitals, and international partners51.
To access health care today, people need reliable high-speed internet2. The Telehealth Broadband Project was a HRSA-funded pilot program which studied how to improve rural broadband access, including for healthcare, with partnerships in Alaska, Michigan, Texas, and West Virginia52. The Veterans Administration (VA) health system recognizes not all veterans have access to high-speed internet or internet-connected devices and so established Digital Divide Consult in 2020, a consulting system to connect veterans with social workers to troubleshoot and connect them with discounts and devices53. The VA also loans remote health monitoring devices and maintains centers with health technology experts to support veterans, their families and caregivers, and VA staff in using VA telehealth tools and technology53. The VA’s Anywhere to Anywhere initiative, (ATLAS – Accessing Telehealth through Local Area Stations) connects veterans living far from the VA with a location set up for private telehealth so that home internet is not a barrier53.
U.S. regulations on abortion care are changing quickly, complicating telemedicine-supported care. The U.S. Food and Drug Administration (FDA) removed restrictions on dispensing medication for abortions in 2023, making it possible for individuals to obtain medication abortion pills from retail pharmacies except in states with a near-total ban on abortion. Other states limit prescribing power to physicians, despite guidance from the World Health Organization (WHO) and others which says it is safe for advanced practice clinicians, such as physician assistants, to provide medication abortion54.
Implementation Resources
‡ Resources with a focus on equity.
HRSA-HHS Telehealth‡ - Health Resources & Services Administration (HRSA). Telehealth.HHS.gov.
HRSA-Telehealth - Health Resources and Services Administration (HRSA), Office for the Advancement of Telehealth. Telehealth active programs.
CCHP-Telehealth policy maps - Center for Connected Health Policy (CCHP). (n.d.). Telehealth policy trend maps. Retrieved June 25, 2025.
CCHP-Telehealth Fall 2024‡ - Center for Connected Health Policy (CCHP). State Telehealth Laws and Reimbursement Policies Report, Fall 2024. November 2024.
RHIhub-Telehealth - Rural Health Information Hub (RHIhub). Telehealth use in rural healthcare.
ATA - American Telemedicine Association (ATA).
Footnotes
* Journal subscription may be required for access.
1 Shaver 2022 - Shaver J. The state of telehealth before and after the COVID-19 pandemic. Primary Care: Clinics in Office Practice. 2022;49(4):517-530.
2 HRSA-HHS Telehealth - Health Resources & Services Administration (HRSA). Telehealth.HHS.gov.
3 Saragih 2021 - Saragih ID, Imanuel Tonapa S, Porta CM, Lee BO. Effects of telehealth interventions for adolescent sexual health: A systematic review and meta-analysis of randomized controlled studies. Journal of Telemedicine and Telecare. 2021.
4 Dorsey 2016 - Dorsey ER, Topol EJ. State of telehealth. New England Journal of Medicine. 2016;375(2):154-161.
5 Molini-Avejonas 2015 - Molini-Avejonas DR, Rondon-Melo S, de La Higuera Amato CA, Samelli AG. A systematic review of the use of telehealth in speech, language and hearing sciences. Journal of Telemedicine and Telecare. 2015;21(7):367-376.
6 Penate 2012 - Peñate W. About the effectiveness of telehealth procedures in psychological treatments. International Journal of Clinical and Health Psychology. 2012;12(3):475-487.
7 Kehle 2011 - Kehle SM, Greer N, Rutks I, Wilt T. Interventions to improve veterans’ access to care: A systematic review of the literature. Journal of General Internal Medicine. 2011;26(Suppl 2):689-96.
8 Quayson 2024 - Quayson, B. P., Hough, J., Boateng, R., Boateng, I. D., Godavarthy, R., & Mattson, J. (2024). Telehealth for rural veterans in the United States: A systematic review of utilization, cost savings, and impact of COVID-19. Societies, 14(12), 264.
9 Rush 2022 - Rush, K. L., Singh, S., Seaton, C. L., Burton, L., Li, E., Jones, C., ... & Janke, R. (2022). Telehealth use for enhancing the health of rural older adults: A systematic mixed studies review. The Gerontologist, 62(10), e564-e577.
10 Harkey 2020 - Harkey, L. C., Jung, S. M., Newton, E. R., & Patterson, A. (2020). Patient satisfaction with telehealth in rural settings: a systematic review. International Journal of Telerehabilitation, 12(2), 53.
11 Tilhou 2024a - Tilhou, A. S., Jain, A., & DeLeire, T. (2024). Telehealth expansion, internet speed, and primary care access before and during COVID-19. JAMA Network Open, 7(1):e2347686.
12 Cochrane-Cleeve 2025 - Cleeve A., Lavelanet A., Gemzell-Danielsson K., Endler, M. (2025). The use of telemedicine services for medical abortion (Review). Cochrane Database of Systematic Reviews, 6:CD013764.
13 Aiken 2021 - Aiken ARA, Lohr PA, Lord J, Ghosh N, Starling J. Effectiveness, safety and acceptability of no-test medical abortion (termination of pregnancy) provided via telemedicine: A national cohort study. BJOG: An International Journal of Obstetrics and Gynaecology. 2021;128(9):1464-1474.
14 Endler 2019 - Endler M, Lavelanet A, Cleeve A, et al. Telemedicine for medical abortion: A systematic review. BJOG: An International Journal of Obstetrics & Gynaecology. 2019;126(9):1094-1102.
15 DeNicola 2020 - DeNicola N, Grossman D, Marko K, et al. Telehealth interventions to improve obstetric and gynecologic health outcomes. Obstetrics & Gynecology. 2020;135(2):371-382.
16 Purohit 2021 - Purohit, A., Smith, J., & Hibble, A. (2021). Does telemedicine reduce the carbon footprint of healthcare? A systematic review. Future Healthcare Journal, 8(1), e85.
17 Shigekawa 2018 - Shigekawa E, Fix M, Corbett G, Roby DH, Coffman J. The current state of telehealth evidence: A rapid review. Health Affairs. 2018;37(12):1975-1982.
18 Bashshur 2016 - Bashshur RL, Howell JD, Krupinski EA, et al. The empirical foundations of telemedicine interventions in primary care. Telemedicine and e-Health. 2016;22(5):342-375.
19 Cochrane-Flodgren 2015 - Flodgren G, Rachas A, Farmer AJ, Inzitari M, Shepperd S. Interactive telemedicine: Effects on professional practice and health care outcomes (Review). Cochrane Database of Systematic Reviews. 2015;(9):CD002098.
20 Skuster 2022 - Skuster P, Moseson H. The growing importance of self-managed and telemedicine abortion in the United States: Medically safe, but legal risk remains. American Journal of Public Health. 2022;112(8):1100-1103.
21 Koenig 2023 - Koenig, L. R., Raymond, E. G., Gold, M., ... & Updahyay, U. (2023). Mailing abortion pills does not delay care: A cohort study comparing mailed to in-person dispensing of abortion medications in the United States. Contraception. 121:109962.
22 Hanach 2021 - Hanach N, de Vries N, Radwan H, Bissani N. The effectiveness of telemedicine interventions, delivered exclusively during the postnatal period, on postpartum depression in mothers without history or existing mental disorders: A systematic review and meta-analysis. Midwifery. 2021;94:102906.
23 Laursen 2022 - Laursen SH, Boel L, Udsen FW, et al. Effectiveness of telemedicine in managing diabetes in pregnancy: A systematic review and meta-analysis. Journal of Diabetes Science and Technology. 2022;17(5):1364-1375.
24 Timpel 2020 - Timpel P, Oswald S, Schwarz PEH, Harst L. Mapping the evidence on the effectiveness of telemedicine interventions in diabetes, dyslipidemia, and hypertension: An umbrella review of systematic reviews and meta-analyses. Journal of Medical Internet Research. 2020;22(3):e16791.
25 Kraef 2020 - Kraef C, van der Meirschen M, Free C. Digital telemedicine interventions for patients with multimorbidity: A systematic review and meta-analysis. BMJ Open. 2020;10:e036904.
26 Emadi 2025 - Emadi, F., Dabliz, R., Moles, R., Carter, S., Chen, J., Grover, C., ... & Penm, J. (2025). Medication-focused telehealth interventions to reduce the hospital readmission rate: a systematic review. Journal of Pharmaceutical Policy and Practice, 18(1).
27 Niznik 2018 - Niznik JD, He H, Kane-Gill SL. Impact of clinical pharmacist services delivered via telemedicine in the outpatient or ambulatory care setting: A systematic review. Research in Social and Administrative Pharmacy. 2018;14(8):707-717.
28 Gao 2020 - Gao W, Lv X, Xu X, et al. Telemedicine interventions to reduce blood pressure in a chronic disease population: A meta-analysis. Journal of Telemedicine and Telecare. 2020;28(9):621-631.
29 Reed 2019 - Reed ME, Huang J, Brand RJ, et al. Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS ONE. 2019;14(6):e0217636.
30 Huang 2015 - Huang Z, Tao H, Meng Q, Jing L. Effects of telecare intervention on glycemic control in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. European Journal of Endocrinology. 2015;172(3):R93-R101.
31 Greenwood 2014 - Greenwood DA, Young HM, Quinn CC. Telehealth remote monitoring systematic review: Structured self-monitoring of blood glucose and impact on A1C. Journal of Diabetes Science and Technology. 2014;8(2):378-389.
32 Wootton 2012 - Wootton R. Twenty years of telemedicine in chronic disease management - An evidence synthesis. Journal of Telemedicine and Telecare. 2012;18(4):211-20.
33 Reed 2021a - Reed M, Huang J, Graetz I, et al. Treatment and follow-up care associated with patient-scheduled primary care telemedicine and in-person visits in a large integrated health system. JAMA Network Open. 2021;4(11):e2132793.
34 Dharmar 2013 - Dharmar M, Kuppermann N, Romano PS, et al. Telemedicine consultations and medication errors in rural emergency departments. Pediatrics. 2013;132(6):1090-1097.
35 Agostini 2015 - Agostini M, Moja L, Banzi R, et al. Telerehabilitation and recovery of motor function: A systematic review and meta-analysis. Journal of Telemedicine and Telecare. 2015;21(4):202-213.
36 Cochrane-Khan 2015 - Khan F, Amatya B, Kesselring J, Galea M. Telerehabilitation for persons with multiple sclerosis (Review). Cochrane Database of Systematic Reviews. 2015;(4):CD010508.
37 Huang 2015a - Huang K, Liu W, He D, et al. Telehealth interventions versus center-based cardiac rehabilitation of coronary artery disease: A systematic review and meta-analysis. European Journal of Preventive Cardiology. 2015;22(8):959-971.
38 Thomas 2014b - Thomas SM, Jeyaraman M, Hodge WG, et al. The effectiveness of teleglaucoma versus in-patient examination for glaucoma screening: A systematic review and meta-analysis. PLOS ONE. 2014;9(12):e113779.
39 Delarmente 2025 - Delarmente, B., Romanov, A., Cui, M., ... & Mafi, J. N. (2025). Impact of telemedicine use on outpatient-related CO2 emissions: Estimate from a national cohort. The American Journal of Managed Care, 31(9), 447-451.
40 Dacones 2021 - Dacones I, Cave C, Furie GL, Ogden CA, Slutzman JE. Patient transport greenhouse gas emissions from outpatient care at an integrated health care system in the Northwestern United States, 2015–2020. The Journal of Climate Change and Health. 2021;3.
41 Holmner 2014 - Holmner Å, Ebi KL, Lazuardi L, Nilsson M. Carbon footprint of telemedicine solutions - Unexplored opportunity for reducing carbon emissions in the health sector. PLoS ONE. 2014;9(9).
42 deMayo 2022 - deMayo, R., Huang, Y., Lin, E. J. D., Lee, J. A., Heggland, A., Im, J., ... & Chandawarkar, A. (2022). Associations of telehealth care delivery with pediatric health care provider wellbeing. Applied Clinical Informatics, 13(01), 230-241.
43 US DHHS-Karimi 2022 - Karimi M, Lee EC, Couture SJ, et al. National survey trends in telehealth use in 2021: Disparities in utilization and audio vs. video services. Washington, D.C.: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services (U.S. DHHS); 2022.
44 Patt 2024 - Patt, D., & O'Neill, C. (2024). Telemedicine and burnout—how enhancing operational support can improve digital health tools. The Cancer Journal, 30(1), 31-33.
45 CCHP-Telehealth policy maps - Center for Connected Health Policy (CCHP). (n.d.). Telehealth policy trend maps. Retrieved June 25, 2025.
46 AHA-Telehealth 2025 - American Hospital Association (AHA). (2025, April).Fact sheet: Telehealth. Retrieved April 14, 2026.
47 HRSA-Telehealth - Health Resources and Services Administration (HRSA), Office for the Advancement of Telehealth. Telehealth active programs.
48 NRHA Telehealth Broadband - National Rural Health Association (NRHA). (n.d.). NRHA rural telehealth and broadband. Retrieved April 14, 2026.
49 MU-CTRAP - University of Missouri (UM) School of Medicine. (n.d.). Center for Telehealth Research and Policy (C-TRAP). Retrieved April 14, 2026.
50 MU-MTN - University of Missouri (UM) School of Medicine. (n.d.). Missouri Telehealth Network. Retrieved April 14, 2026.
51 CNHS-Telehealth - Children’s National Health System (CNHS). Telehealth.
52 Telehealth Broadband Project - Telehealth Broadband Project. (n.d.). Overview: Understanding and improving rural broadband. Retrieved April 14, 2026.
53 Cruise 2025 - Cruise, C. (2025). Overview of telehealth in the Department of Veterans Affairs. American Journal of Audiology, 34(4), 781-784.
54 Guttmacher-Medication abortion 2025 - Guttmacher Institute. State Laws and Policies: Medication abortion. New York: Guttmacher Institute; April 23, 2025.
55 Sekhon 2021 - Sekhon, H., Sekhon, K., Launay, C., Afililo, M., Innocente, N., Vahia, I., ... & Beauchet, O. (2021). Telemedicine and the rural dementia population: A systematic review. Maturitas, 143, 105-114.
56 Bodas 2026 - Bodas, M., Park, Y. H., Luo, Q., & Vichare, A. (2026). Uneven access: How rurality and state policies shaped telehealth provision to Medicaid enrollees, 2020-2021. Telemedicine and e-Health, 32(4), 425-430.
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58 Chang 2024 - Chang, E., Penfold, R. B., Berkman, N. D. (2024). Patient characteristics and telemedicine use in the U.S., 2022. JAMA Network Open, 7(3), e243354.
59 Sheon 2026 - Sheon, A., & Khoon, E. C. (2026). Digital inclusion pathways to health equity. Health Affairs Health Policy Brief.
60 Ojinnaka 2024 - Ojinnaka, C. O., Johnstun, L., Dunnigan, A., Nordstrom, L., & Yuh, S. (2024). Telemedicine reduces missed appointments but disparities persist. American Journal of Preventive Medicine, 67(1), 90-96.
61 Bashshur 1995 - Bashshur, R. L. (1995). On the definition and evaluation of telemedicine. Telemedicine Journal, 1(1), 19-30.
62 KFF-Anderson 2021 - Anderson E, Salganicoff A, Sobel L. State restrictions on telehealth abortion. KFF; 2021.
Related What Works for Health Strategies
To see all strategies:
countyhealthrankings.org/whatworks