Telemedicine: The Future of Healthcare

The terms telemedicine and telehealth are similar and both refer to healthcare delivery using technology, with the provider and the patient in different locations (Achenbach, 2020). Telehealth is considered the umbrella term that describes healthcare services that are provided from a distance, whereas telemedicine describes the specific clinical care. An easy way to understand the subtle differences in terminology is to think of telehealth as an unidentified hospital system, “Hospital Metro,” and telemedicine as any specific unit within that hospital. Telehealth includes clinical care, but it may also include dietary and case management. Telemedicine only includes your provider team and the treatment and care they prescribe and deliver.

Telemedicine uses technology to provide clinical care, specifically from a licensed healthcare professional using a telecommunication system. There are hundreds of commercially available platforms like VSee Clinic©, but Microsoft Teams has developed a version specifically for healthcare. Communication during a telemedicine visit may include (Khan & Khan, 2023):

1. Interactive real-time audio and/or video communications
2. The use of a web-based or cloud-based application
3. “Store and forward” technology (not including facsimile or email)

The services offered during a telemedicine visit are the same services provided in a face-to-face visit. The provider must determine if the visit need is appropriate for telemedicine, within the provider's scope of practice, and follows the regulatory guidelines of the state where the patient lives (Pandya et al., 2022).

The patient may live at home or in a skilled nursing facility. The telemedicine visit may take place at a smaller, rural hospital, a clinic, or another location. The location where the patient is during the visit is considered the “originating site,” and the provider's location is considered the “distance site” (Washington State Department of Health, n.d.). These terms are important for determining insurance reimbursement and jurisdiction for the scope of practice.

Telemedicine is a type of healthcare delivery that eliminates some barriers to access that have been identified over the years. Using innovative technology and telecommunication tools to connect a provider to a patient without the need to be in the same location extends the reach of healthcare to rural and remote locations. During the COVID-19 pandemic, telemedicine became a delivery method of choice for many patients and providers who otherwise could have faced serious health decline amid a healthcare crisis.

The usefulness of telemedicine goes far beyond the clinic appointment. Telehealth now extends to educational initiatives, health administration tasks, and public outreach. Patient consultations over an audiovisual platform are now combined with diagnostic evaluation and measurement tools without the need for physical attendance in a clinical setting, away from home or community. The constraints of time and accessibility have decreased significantly as telemedicine has grown to provide basic medical and specialty care from miles away.

The primary purpose of telemedicine is to enable communication between a healthcare provider and a patient, regardless of the miles between. That communication is necessary to paint the same picture that the initial assessment provides in a face-to-face visit. Early telemedicine began in the 20th century, when radio was used to relay medical treatment advice to sailors at sea (Achenbach, 2020). Fast forward to the late 20th century, with NASA’s use of telemedicine for monitoring animals and eventually astronauts during space missions (Simpson, 2020). This real-time treatment using advanced medicine enabled any patient to receive needed care, regardless of location. Both examples serve as early stories of successful telemedicine, which in the past 50 years has grown to include numerous technological advancements and improvements. Today, telemedicine can operate at a very advanced level through secure communication that protects patient privacy and advanced technology that creates lifelike remote consultations (Jeyanthi et al.,2014).

In the latter part of the 20^th century, academic institutions started testing video conferencing projects to link specialists with hospitals that lacked sufficient resources (Achenbach, 2020). The 21^st century's digital communication advancements have pushed telemedicine to the center of healthcare delivery. At the same time, existing technological limitations, regulatory constraints, and reimbursement issues keep it from being fully integrated into traditional medical practices (Pandya et al., 2022). The COVID-19 pandemic emphasized the critical demand for new healthcare approaches, firmly establishing telemedicine as a key component in global healthcare delivery (Khan & Khan, 2023). Telemedicine provided millions with safe and effective healthcare access when hospitals reached capacity and in-person visits presented health dangers.

Entering the 21^st century, telemedicine became the star of healthcare delivery as fast-paced advancements rapidly changed the face of communication. Although traditional medical practices remained the standard of care, the COVID-19 outbreak quickly forced all healthcare stakeholders to get on board with telemedicine delivery. Before the COVID-19 pandemic, technology, legislation, and insurance barriers limited how telemedicine was used (Khan & Khan, 2023). When healthcare systems felt the strain of hospital overcrowding and the social panic for physical separation, telemedicine was quickly operationalized to solve the communication crisis. Luckily, telecommunication proved to be secure, and telemedicine was ushered in as an acceptable method of healthcare delivery during a time of emergency (Alenoghena et al., 2023). Much like other normal expectations, legislation and regulation were relaxed out of necessity during the years of the pandemic (Pandya et al., 2022). Where telemedicine was once considered an option, overnight it became the normal method of meeting your healthcare needs.

Telemedicine, much like telecommunications, was broadly adaptable and effective. In 2020, few people did not have a method of audio-visual communication in their pocket. Healthcare access quickly expanded across the pandemic and connected a critical lifeline from healthcare providers to remote populations across the nation and globe (Khan & Khan, 2023). Today, people value immediate access and communication, expecting responses within seconds, not hours or days. Our fast-paced society has seen telecommunications nimbly adapt to unforeseen circumstances, and telehealth appears to be a viable solution for persistent barriers to healthcare access (Khan & Khan, 2023). Telemedicine is far beyond a convenience to the busy commuter, but is now considered a better delivery method than an overcrowded clinic with excessive wait times. Telemedicine transformed from a concierge concept to a valuable resource that addressed critical deficits in healthcare delivery (George & George, 2023).

Critical deficits in healthcare delivery have been identified in both urban and rural areas, where vulnerable populations are at crisis-level shortages within healthcare (Achenbach, 2020). Those populations may consist of the very young or the very old, the impoverished, and the secluded communities who face significant challenges in accessing healthcare due to distance and scarcity of medical services (George & George, 2023). Telemedicine enables various health services, including preventive care, to be delivered with equal or improved effectiveness compared to traditional in-person services. Routine virtual check-ins and continuous progress monitoring are now easily accessible to patients who could never maintain consistent healthcare visits (Curtis et al., 2021).  Treatment that is essential for maintaining or restoring health in populations using services for chronic conditions has become almost completely virtual and user-friendly (George & George, 2023). Although grown from necessity, telemedicine now moves beyond being just an emergency solution to become a big step toward patient-centered care, where technology overcomes traditional location-based limitations.

Telemedicine requires high-quality audio and video capabilities, together with a user-friendly interface. For telemedicine to function as a viable alternative to face-to-face visits, data security for patients and providers, as well as convenience and accessibility, are basic expectations and benefits (Alenoghena et al., 2023). Other benefits of telehealth include:

• Asynchronous (not at the same time) communication enables patients to record clinical information and send it to a provider to review at their convenience.
• Healthcare providers can display test results or images through screen sharing during consultations or via a patient portal.
• Medical records benefit from integrated automatic documentation that operates without any manual intervention.
• A telehealth delivery model includes straightforward text-based options for consultations and scheduling appointments, along with follow-up communications.

Remote monitoring devices like Bluetooth blood pressure monitors, glucometers, and pulse oximeters are essential to track patient health data. Continuous data collection through remote monitoring is possible through wearable technology like Fitbit© and similar devices without needing in-person appointments (Kalasin & Surareungchai, 2023). These technology options enable the healthcare team to get immediate updates from monitors that connect through Bluetooth and Wi-Fi. Through continuous monitoring systems, providers can track health data trends, which enable them to prevent patient decline and detect when a medical intervention becomes necessary (Alenoghena et al., 2023).

Bluetooth Blood Pressure Cuff

Remote Glucose Monitoring Device

Patient medical histories, including diagnoses, medications, test results, immunizations, and healthcare team notes, are stored in Electronic Health Records (EHR) as complete digital records (Alenoghena et al., 2023). From simple to complex, a variety of EHR systems exist. Telemedicine consultations benefit from real-time access to updated EHRs, which maintain care continuity and support provider decision-making.

Telemedicine documentation can be more efficient while decreasing administrative workloads and reducing errors if integrated EHR systems are available for the telehealth capabilities (Kalasin & Surareungchai, 2023). Although use of a hospital-integrated EHR system provides the most comprehensive integration, it is allowable to use non-integrated commercially available technology if necessary (Alenoghena et al., 2023). Documentation tools that link directly to the EHR greatly enhance EHR functionality within telemedicine. Overall, the goal is to streamline the standardization of treatment procedures and eliminate opportunities for error. Any level of integration and elimination of double-tasking is a benefit.

Policy-makers need to understand organizational definitions and the logistics of providing telemedicine services to develop effective legislation. Policy development must be clear and flexible, while promoting innovation. Policies must also maintain patient safety and provide equitable access to care. Future legislation should address the transferability of professional licenses, along with improving access to insurance payment systems. Another policy focus could be the improvements needed to secure internet privacy regulations, as well as to improve internet access in remote areas. Policy-makers who partner with telemedicine and telehealth stakeholders in order to align regulations with existing organizational practices will be successful. The goal should be to support ongoing telehealth expansion while preserving the quality of care and maintaining practitioner accountability.

Compliance teams must partner with clinical leadership to deliver telemedicine services that adhere to all regulatory requirements. Maintaining compliance requires regular audits and risk assessments alongside training programs that protect both patients and providers (Ivanova et al., 2025). Organizations need to continuously monitor the changes in telemedicine regulations across the local, state, and federal levels.

A thorough understanding of the permitted services and any organizational policies specific to telemedicine enables any healthcare provider to deliver virtual care safely and effectively. Providers need to understand which clinical services are available for remote delivery, along with proper documentation requirements and approved telehealth technologies (George & George, 2023). Healthcare providers must keep updated with telehealth licensure regulations alongside patient consent protocols and clinical protocols. Remember, it is the provider’s responsibility to know their scope of practice and related laws and regulations (Pandya et al., 2022). Continuous professional development combined with collaborative communication between healthcare professionals and organizational leaders enables telemedicine care to meet patient needs and maintain professional standards (Ivanova et al., 2025).

Provider licensure stands as one of the most significant regulatory challenges in telemedicine. Healthcare providers in the United States require state licensure in the jurisdiction where their patients are present during telemedicine sessions. This requirement places providers under state medical board supervision while ensuring they follow state-specific practice guidelines, which may not be the state where they practice in-person medicine. Healthcare providers need to be aware of state-specific changes because telehealth licensure rules can quickly change due to legislative measures, executive orders, and state board policies.

Whether a single provider or organization providing telehealth services is a billion-dollar academic center or a local clinic, well-defined procedures must be in place to manage both legal and administrative aspects when treating patients who are located in different states. These protocols may include:

• Applying for Temporary or Emergency Licenses: Certain states provide rapid-licensing solutions for medical professionals during emergencies or for telehealth services with limited scope. Providers can rapidly grow their service offerings using these licenses because they eliminate the need to complete the entire licensure process.
• Establishing Telehealth Partnerships with Local Providers: Healthcare providers working together maintain consistent patient care and adherence to regional legal requirements. Healthcare partnerships can include shared care agreements, referral networks, and contractual relationships.
• Using Licensure Compacts (e.g., Interstate Medical Licensure Compact - IMLC): The IMLC compact simplifies the licensure process for physicians who qualify to obtain licenses across multiple member states. Multi-state telehealth practices face fewer administrative challenges, while patients in remote areas gain better access to healthcare services. Similar compact license privileges are in place, or are being introduced for most healthcare professions, including nursing, physical therapy, occupational therapy, and athletic training.

Credentialing and privileging are critical procedures to confirm healthcare providers' education level and professional background. These procedures confirm that clinicians have the necessary skills and permissions to administer particular healthcare services within their scope of practice at designated facilities or within insurance networks.

Healthcare facilities and insurance payers independently complete these verification processes, while telemedicine providers generally face the same criteria as traditional providers. Several institutions streamline their verification process by adhering to “credentialing by proxy guidelines” set by The Joint Commission and the Centers for Medicaid Services (CMS). Hospitals or clinics streamline their operations while staying compliant by accepting credentialing and privileging decisions from another accredited institution. Providers should connect with their state medical or nursing boards to learn about local credentialing regulations to keep their credentials current across all affiliated facilities and payers.

The rules for reimbursing telehealth services are complex and differ significantly based on the insurance provider. They also depend on the service type and geographic region. Providers need to stay diligent about the billing guidelines, documentation requirements, and visit standards from Medicare, Medicaid, and private insurance companies to receive appropriate compensation. Non-compliance with payer criteria results in claim denials and payment delays or triggers audits (Salmanizadeh et al., 2022). Medical coding and telehealth billing training must be ongoing for healthcare providers who deliver remote care services.

Key areas to consider include:

• Accurate Coding: Specific service codes are needed to bill telehealth services. As telehealth technology develops and introduces new services like remote patient monitoring and asynchronous visits, providers need to keep their coding knowledge current. Online courses are available for basic billing and annual refresher courses with updates.
• Proper Documentation: Providers need to maintain detailed records of telehealth encounters to facilitate reimbursement claims. They need to document necessary details such as patient consent, the visit's date and time, the type of communication technology or platform used, participant locations, and clinical findings. As services evolve, mandatory documentation is certain to change.
• “Parity” in Reimbursement: Insurers such as Medicare and Medicaid now offer the same or “on par/parity” reimbursement rates for telehealth visits as they do for in-person appointments. The same reimbursement rate for telehealth visits often requires compliance with conditions, including originating site requirements and practitioner type, while documenting patient consent (Ivanova et al., 2025).

The purpose of the Ryan Haight Online Pharmacy Consumer Protection Act (2008) is to control online prescriptions of controlled substances with the goal of preventing abuse and misuse. The law requires that prescribing controlled substances through the internet involve an initial face-to-face medical examination, which may be followed up with telehealth visits and occasional face-to-face follow-ups (Hoffman, 2020). Regulatory bodies are aware that telemedicine would function more effectively without this oversight. However, protection of patient safety standards is of utmost importance. Changes to current safety standards, like the Ryan Haight Act, may simplify telemedicine but endanger patients.

Not all visits are suitable for telemedicine. Healthcare providers and support staff must have strong clinical decision-making skills for identifying appropriate cases and redirecting inappropriate cases. Routine follow-ups, behavioral and mental health consultations, medication management, and lifestyle counseling are appropriate cases for telemedicine. Minor acute conditions, including skin problems and UTIs, along with colds, could also be considered for a telemedicine visit. However, not all visits are best suited for telemedicine due to various reasons, most related to the complexity of the chief complaint or the complexity of the patient. The provider is responsible for recognizing those limitations and providing appropriate care delivery.

Complex physical examinations or symptoms requiring hands-on evaluation are not appropriate for telemedicine. Procedures or the use of diagnostic tools requiring in-office equipment must be seen in person; however, after the initial evaluation, it may be completely appropriate and best served via telemedicine.

Before a telemedicine visit is scheduled, the provider, nurse, or office staff must coordinate access to devices and internet service. Communication with the patient should identify needs for language assistance or technical assistance from a family member or caregiver. For the novice telemedicine practitioner, it is important to distinguish between virtual-ready and in-person-required encounters.  Although clinical decision trees and triage tools are commercially available, it may be valuable to establish well-defined clinical-readiness and compliance-readiness procedures to train and practice provider-patient interaction prior to new telemedicine practice (Otto et al., 2023; Ufholz et al., 2022).

One clinical area well served by telemedicine is primary care. Primary care providers (PCPs) utilize virtual visits to perform various medical services for established patients. If those patients live in remote or underserved areas, telemedicine improves their access to essential healthcare. Telemedicine also provides essential access to healthcare services for both elderly patients and those who encounter mobility difficulties by removing obstacles like transportation needs and lengthy wait periods while enabling patients to remain engaged and maintain continuous care (Hoffman, 2020). These are some examples of telemedicine visits:

• Conduct routine consultations and wellness checks
• Monitor vital signs and symptoms
• Provide health education and preventive counseling
• Treat minor acute health issues, including colds, rashes, and infections
• Address medication refills and prescription needs

Patients with chronic conditions such as diabetes, hypertension, asthma, and heart disease need consistent monitoring and consistent healthcare to avoid complications (Ufholz et al., 2022). Another benefit of telemedicine includes chronic disease management and symptom review:

• Remote Patient Monitoring (RPM): Medical devices, including glucometers and blood pressure cuffs, together with other wearables, send assessment information to healthcare providers (Kalasin & Surareungchai, 2023).
• Virtual Care Plans and Coaching: Based on the data collected from RPMs, medical providers can offer customized care plans and coaching that may improve disease management.
• Improved Access to Support: Regular virtual check-ins scheduled by patients minimize the need for physical visits.
• Medication Management: Improves and helps patients avoid hospitalization due to medication lapse or symptom mismanagement. Because of the decreased burden of a telehealth visit, patient engagement improves through continuity and convenience.

Another use of telemedicine is to connect patients to specialists, without the need for a long drive for a 45-minute initial visit. Through virtual platforms, patients can access multiple specialty consultations, receive diagnostic advice, and share images through real-time communication. Telemedicine consultations can connect patients to experts in fields like dermatology and cardiology. Although certain clinical scenarios demand an in-person visit or assessment, a telehealth appointment is often an efficient first step for a non-urgent patient.

Another service that benefits from a telemedicine delivery model is psychiatric services. Access to psychiatry is often limited due to availability, location, and the stigma associated with mental health. Telepsychiatry serves as an essential element of mental health care today by increasing access across both urban and rural areas (Curtis et al., 2021). Through secure video conferencing, patients can receive:

• Psychiatric evaluations and diagnoses
• Medication management and follow-ups
• Individual and group therapy sessions
• Crisis intervention and suicide prevention services

Patients can benefit from receiving treatments in their home environment through telepsychiatry since this private setting enables them to feel more comfortable and open during sessions. Telepsychiatry provides these vulnerable groups with an essential, reachable support system for mental health (Sharma & Devan, 2023).

Telerehabilitation is a form of telehealth that provides rehabilitative care of occupational therapy and physical therapy remotely (Nguyen et al., 2023). While much of occupational and physical therapy rehabilitation services have traditionally been more “hands-on” approaches, rehabilitation practitioners have used their clinical skills to alter their therapeutic approach when delivering a session via telehealth (Breeden et al., 2023).  Similar to other healthcare professions already discussed, the use of telehealth visits for rehabilitation purposes has been shown to improve continuity of care, decrease travel time, and increase convenience (Breeden et al., 2023). This can be especially beneficial in rehabilitation settings, where the patient may have multiple rehabilitation sessions a week for 4-8 weeks in succession. Travel to and from appointments can become a burden to patients and caregivers. Rehabilitation professionals have expressed that telehealth visits can promote improved caregiver involvement, greater visibility of the home set up, and improved knowledge about the patient’s ability to function in their home environment (Breeden et al., 2023). Common physical and occupational therapy services that are conducive to telerehabilitation include:

• Pediatric and school-based therapy
• Rehabilitation to improve activities of daily living
• Lower back pain
• Functional movement screenings
• Post-discharge checkups and safety screenings
• Home safety evaluations and mobility screenings
• Rehabilitation for immunocompromised patients

As with other medical professions, there are situations in which telehealth or telerehabilitation is not appropriate.  These may include situations in which manual-based care is necessary for quality outcomes, such as in the postoperative care in which range of motion is required to be performed, or frozen shoulder.

There has been much discussion about improved access to care for rural and remote patients. However, some additional obstacles for patients include residency in senior living facilities, sub-acute rehabilitation homes, substance abuse rehabilitation, correctional facilities, and schools. Telemedicine can connect patients who are limited by time and availability. Patients who are sole caregivers for elderly parents or who work hours that are not conducive to regular office hours.

It is well known that the availability of healthcare services in rural and underserved communities has historically been restricted, but telemedicine bridges the gaps between provider and patient, regardless of reason (Curtis et al., 2021). As mentioned earlier, patients who do not have the typical barriers to access may have chronic illnesses that respond best to ongoing observation. Telemedicine bridges that gap through RPMs and virtual check-ins, which reduce interruptions in care and enhance patient health outcomes.

Throughout the history of telemedicine, many consider the virtual delivery model to be substandard care. What has been identified since the growth of telemedicine is the opposite. Patients experience better care when the care is prompt and consistent. Telemedicine offers quick medical response, continuous monitoring and support when needed, and access when complications arise. Through real-time video consultations or consistent messaging across secure platforms, providers and patients are visible to one another. Telemedicine improves treatment decisions as it allows simultaneous access to patient history in an EHR and virtual collaboration with other providers (Jeyanthi et al., 2014). Through this coordinated care delivery, patients achieve improved health results, often without leaving their homes.

The adoption of telemedicine generates significant economic benefits for both healthcare institutions and their patients.

If healthcare is viewed as resources and demands on those resources, telemedicine offers a solution that redistributes those resources across distances. The resources for rural and remote areas are often scarce or non-existent (Curtis et al., 2021). Telemedicine can assist the primary care provider by filling in shortage gaps. By consulting patients from multiple locations, specialty telemedicine providers can extend their expertise and expand their patient base without having to change their physical location (Curtis et al., 2021). Telemedicine can also offer support to frontline workers, and remote assistance from advanced providers can broaden service delivery capacity very effectively.

Virtual care solutions designed with specific needs in mind can improve healthcare access for those who face challenges from disabilities, financial constraints, transportation, or language barriers. Telemedicine bridges healthcare gaps by providing medical services despite those challenges, and to marginalized and underserved communities. Consider the tribal areas of western North America, where hundreds of miles span between communities. Consider the overcrowded urban areas, where refugee groups and low socioeconomic status leave every clinic with an 8-hour wait time for the most urgent or non-urgent complaints. Telehealth programs designed to innovate healthcare delivery have reached tribal lands, along with low-income urban neighborhoods and communities of migrants. These virtual programs are able to provide culturally-aware healthcare services to diverse patients. Telemedicine extends healthcare services with language translators and accessible digital platforms to various populations, reducing well-known health disparities (Frishammar et al., 2023). Mobile health applications and telehealth platforms reach populations with low-bandwidth connectivity, whether that is across the globe or next door. (Curtis et al., 2021).

As previously mentioned, telemedicine helps reduce disparities in mental health care. Telepsychiatry services remove stigma and other obstacles while reducing waitlists to provide fair mental healthcare access. The gaps that remain are an ongoing issue in internet infrastructure, digital and healthcare literacy, and availability of communication devices (Frishammar et al., 2023).

Telemedicine isn't just for diagnosing and treating one patient; it is a valuable tool for improving healthcare across a community, big or small. All of its benefits, such as disease monitoring, early intervention, and health promotion, are good for communities. Using telehealth to manage many non-urgent healthcare needs during COVID-19 lessened the burden on our frontline staff across the country. Telehealth also helped lower the spread of COVID-19 by keeping people at home and provided needed mental health support and chronic disease management during lockdown.

Beyond COVID-19, telemedicine plays a vital role in public health by helping doctors monitor and prevent diseases and by educating people about health. Telemedicine spreads education about vaccinations, mental health, and substance abuse disorders (Curtis et al., 2021; Jordan et al., 2021). These real issues that plague our communities well past the COVID-19 pandemic can still benefit from telemedicine outreach. Telemedicine can reach large populations quickly and is useful during emergencies or other disasters (Gadzinski et al., 2020). Eliminating some of the financial burden that telemedicine does not have leaves time to focus on diagnosis and treatment. Public health officials can handle business without the delay and costs that exist with traditional face-to-face visits. In summary, telemedicine is now an essential part of healthcare delivery that has improved access to care and supports public health initiatives worldwide.

Each patient interacts differently with healthcare providers. Therefore, providers and staff must be aware that each patient encounter has different expectations (Ufholz et al., 2022). Patients should have the option to select their favorite communication methods, ranging from text messages to phone conversations or video chats. Younger patients often choose mobile app messaging and text updates as their preferred communication methods, while older patients may prefer telephone check-ins or scheduled video calls.

The ability to schedule flexible appointments, provide after-hours access, and utilize asynchronous communication systems such as store-and-forward messaging helps improve patient engagement through patient-centered care that accommodates their busy lives instead of forcing them to adjust to healthcare systems with rigid structures.

During the visit, it is important to view the virtual experience with expectations similar to those of an in-person visit. Start the visit by confirming that the patient is alone and ready to begin the visit. Telemedicine's convenience and satisfaction are undermined when patients experience extended wait times or unclear information about platform access or provider availability. “Telemedicine Readiness” plans can plan for these concerns before they occur to make seamless transitions between in-person and telehealth visits.

Professionalism, social warmth, and visual connection through the camera that would occur during an in-person visit encourage patients to participate in their telemedicine visit. Providers must stay focused and ask open, patient-centered questions to gather information, confirm patient understanding, and encourage patients to take part in their healthcare plan.

After the telehealth visit, provide a summary with explicit instructions regarding medications, laboratory tests, and subsequent appointments. This summary should be promptly sent via the preferred method of secure communication.

We have discussed the numerous benefits of telemedicine, such as increased access to healthcare and convenience for patients. However, several challenges exist that remain barriers to widespread implementation. Addressing barriers of technology, privacy, finance, and clinical practice is critical to further expanding the delivery and adoption of telemedicine (George & George, 2023). By investing in technical infrastructure and educating stakeholders, providers, and patients, telehealth can become a more accessible and reliable component of modern healthcare.

These barriers remain substantial, but they can be overcome. Healthcare organizations must collaborate with technology developers, policymakers, and insurers to create effective solutions. Through deliberate and inclusive planning, telemedicine has the potential to transition from a pandemic-driven stopgap measure to a bigger, integral component of modern healthcare.

Some thoughts related to ways to address barriers are below:

• Invest in digital infrastructure for underserved regions.
• Achieve uniform reimbursement and licensing systems throughout all states and for all payers.
• Create secure platforms designed for user convenience that maintain privacy as a top priority while ensuring accessibility.
• Educate medical providers and patients in the effective use of telehealth technology.
• Existing care pathways require integration to preserve continuity of patient care.

Medical care requires informed consent as both a legal and ethical foundation. Telemedicine consent needs to cover treatment authorization and patient understanding of virtual healthcare operations, as well as their risks and available non-remote care options. Different from in-person consent, it is important for the provider to understand what constitutes telemedicine-specific consent (Ivanova et al., 2025). Telemedicine consent typically includes an explanation of technology (video, phone, messaging platforms), including any potential or likely risks. These risks may include technical failure, data breaches, and diagnostic limitations. Telemedicine-specific consent should include what alternative care exists, such as in-person visits or referrals (Ivanova et al., 2025).. This consent should also include an assurance of privacy and HIPAA compliance, giving patients the authority to revoke their consent whenever they choose.

Consent regulations vary by state despite HIPAA establishing a federal privacy standard. Explicit telemedicine consent is mandatory in some states, but general treatment consent suffices in others. Patients should understand that telemedicine is an option and should have the choice to refuse it.

In addition to the process of consent, but also throughout the telehealth visit, the documentation process should demonstrate that the patient fully understands the information given and not just their agreement to it (Ivanova et al., 2025). Patients have the ethical right to autonomy and should be given the resources needed to make informed decisions. Patients require essential information about the unique differences between telemedicine services and traditional in-person medical care, and providers have the responsibility to provide that information in a transparent and authentic manner (Ivanova et al., 2025). Healthcare should remain accessible, with accommodations made for patients' language abilities and technological skills, along with their cognitive capacities.

• Use standardized telemedicine consent templates.
• Patients require updated consent confirmation whenever there are changes to telemedicine platforms or treatment methods.
• Maintain comprehensive records of all consent activities in the electronic health record system (EHR).

Telemedicine removes physical location limits but still faces legal obstacles. Licensing in medicine falls under state jurisdiction, and clinicians practicing outside their licensed state without proper authorization risk facing disciplinary measures or legal consequences. Challenges persist in telemedicine as the location of the patient, the “originating site,” and the provider's “distance site” may differ. Providers must obtain licensure within the state where their patients reside, according to most state regulations. Interstate licensing compacts, such as the Interstate Medical Licensure Compact, aid providers but are not comprehensive for every provider type and state. Temporary exceptions for interstate practice occurred during public health emergencies such as COVID-19, but are changing daily as the crisis has ended (Ivanova et al., 2025). Best practices include joining interstate licensure compacts where eligible, consultation with legal counsel, and development of compliance checklists specific to each state where services are provided.

Telemedicine cannot reach its full potential without strict adherence to ethical standards and legal protections. Patient consent must be transparent and inclusive. Providers need to show strong diligence to maintain proper licensure. Effective planning and thorough documentation serve as essential strategies to reduce medical liability. Best Practices include a review of malpractice insurance to confirm telemedicine coverage, define documentation requirements for telemedicine that equal or surpass traditional face-to-face patient care, and establish protocols to handle situations when technology fails or when there is uncertainty in medical diagnosis.