Healing at a Distance

Fall 2026
Healing at a Distance

From a pandemic necessity to a multibillion-dollar industry, telehealth is changing how, when and where Americans access care.

By Amy Martin

ix months. That’s how long I was going to have to wait for a contact lens exam at my eye care center.

An office scheduler had called me to explain that my optometrist had left the practice, and my appointment next week would have to be rescheduled for the next available appointment—26 weeks later.

I hung up frustrated. I’d worn the exact same contacts for nearly two decades. Surely there had to be some other option? I quickly googled 1-800 Contacts. I’d seen the company’s advertisements before, but I’d never used their services.

Right at the top of the homepage was a link for an online vision exam. “Renew your contact prescription at home,” it offered, and for only $20 (my eye care center charges $80). Sounded good to me.

I clicked the link, and after answering a few questions to confirm my eligibility, I was prompted to use my phone camera to take a picture of each eye. Thirty seconds later, I was standing in my kitchen, 10 feet away from my phone as instructed, recording myself as I covered my right eye. “E, J, K, M.” Then left, “Q, P, T, V.”

I told the website what brand of contacts I wear and what my prescription is, paid the $20 and hit submit.

Could it really be this easy?

Six minutes later, I got the email. “Amy, your prescription is on file.” The address on the prescription was in Utah, where 1-800 Contacts is headquartered. It was signed by an optometrist who, according to my Google search, is quite an accomplished practitioner and professor based in Tennessee.

My contacts arrived in the mail a few days later.

The COVID Catalyst

The term telemedicine, which combines the Greek prefix tele and the Latin word medicus to mean “healing at a distance,” was coined in the 1970s. But its earliest known examples date back much further. In 1874, a surgeon in South Australia used a telegram to provide wound-care instructions to a patient more than 1,200 miles away. In 1879, three years after Alexander Graham Bell invented the telephone, a letter published in The Lancet medical journal suggested the device “might be of considerable use to doctors to ease their practice,” citing an example of an anxious American mother who called a doctor late at night fearing her baby had croup. “Lift the child to the telephone and let me hear it cough,” the doctor commanded, according to the anonymous letter-writer. After hearing the baby, the doctor determined the child did not have croup, and “all anxiety quieted.”

The internet, smartphones and video calling greatly expanded remote care options in the late 20th and early 21st centuries. But even well into the 2010s, the American healthcare system was resistant to widespread implementation for a broad variety of reasons, explains Professor of Economics Mónika López-Anuarbe, who specializes in health economics.

“The U.S. was not using telehealth as much as other countries were,” she says. “And then, boom! COVID hit.”

In January of 2020, Colin Gallant ’12, who earned a master’s degree in public health from Boston University after studying philosophy at Conn, had just started working as a health center manager for Planned Parenthood League of Massachusetts. The center where he worked did not provide abortion care services at the time, so it was deemed non-essential and was shut down during the early stages of the pandemic just two months later.

“The big conversation was around continuing to provide services at a time when people felt unsafe leaving their homes,” Gallant explains. “My boss called me and he’s like, ‘Since you’re not busy, why don’t you start spinning up the telehealth program?’ They had been thinking about it, so it wasn’t totally from scratch, but we basically brought it from a high-level conceptual conversation among leadership to beginning to provide telehealth services within a week.”

Likewise, Chrissie Brewer ’09, a New York City-based board-certified psychiatric nurse practitioner who specializes in care for children and young adults, was seeing patients in both a private practice and through the New York Foundling, the oldest and largest non-profit child welfare agency in the city, when the pandemic hit.

I remember thinking, ‘Well, that’s just not ever going to happen.’ And then COVID happened, and overnight we were seeing patients virtually.

— Chrissie Brewer ’09, board-certified psychiatric nurse practitioner

“Telehealth was something that we had been talking about, but there were a lot of barriers. The regulating bodies wanted to require all sorts of things, like the patient and the provider would both have to be in places that would protect their privacy, and we were going to have to install a room that was soundproof. All of these barriers were going to make it difficult to do or almost pointless in a lot of ways,” she says.

“I remember thinking, ‘Well, that’s just never going to happen.’ And then COVID happened, and overnight we were seeing patients virtually.”

Making the transition was a bit overwhelming—“very much baptism by fire,” Brewer recalls—but necessary.

“We had to continue to provide services for people. And we had to continue to do medication management for people who were very vulnerable. We worked with a lot of patients with trauma at the New York Foundling, and these people needed to be seen. There was just no two ways about it,” she says.

“Once you got thrown in the deep end, you just learned to figure it out. And then that opened up the floodgates, and everybody was like, ‘Hey, this is pretty great! I can attend this appointment from my bed!’ It just caught on like gangbusters.”

Meeting Patients Where They Are

Today, more than 140 million Americans use telehealth, and it’s an $80 billion industry in the U.S. with a 19% annual growth rate. Mental healthcare takes up the largest share, with 86% of psychiatrists providing telehealth services weekly. Other top categories include neurology, endocrinology, gastroenterology, family medicine and urology.

The states with the most usage—Arizona, Colorado, Delaware, Florida, Hawaii, Idaho, Indiana, New Hampshire, South Dakota and Utah—suggest that access to care in rural areas and “healthcare deserts” may be a key driver.

“It’s not necessarily New England or California or the stereotypical places we think of being pioneers that are leading the charge,” López-Anuarbe says.

It was the potential of telehealth to increase access that first interested Lena Mininberg ’17, a multilingual board-certified women’s health nurse practitioner and certified nurse midwife. She had been working at a federally qualified health center in Omaha, Nebraska, providing in-person care to primarily non-English-speaking patients, when she decided to join Planned Parenthood as a bilingual telehealth clinician in January of 2025.

“Planned Parenthood was really at the forefront of expanding access to telehealth and expanding the services of what telehealth could provide, because that’s kind of their whole ethos, right? Making sure that everyone has access to the care that they need,” she says.

During her tenure at Planned Parenthood—Mininberg recently began a new position as a community medical liaison for Syneos Health—she provided basic fertility care services, gender affirming care, birth control and STI testing, as well as treatment for UTIs, erectile dysfunction and other sexual health concerns. Many of her patients lived in rural areas, did not speak English, worked long hours at factories or on farms, and had little or no health insurance—all barriers to accessing traditional healthcare.

“A lot of people can’t take the time off of work to drive long distances to an appointment, or they don’t have childcare, so we were able to meet them where they were. They’d be sitting in the parking lot, or in the bathroom at work, and just fitting their healthcare in wherever they could,” Mininberg says.

And for some of her patients, remote care was the only option.

“I had a lot of patients in the Twin Cities area during the ICE raids, and telehealth was an incredible boon to people who were not feeling safe or comfortable leaving their homes,” she explains. “It was very sad that they couldn’t just go out and get care, but I was glad they were still able to access care in a way that made them feel safe and comfortable.”

Broad Appeal

While access provided the initial spark, telehealth continues to grow for another key reason: People like it.

“When we were first coming out of the pandemic, the general feeling was that patients weren’t going to continue to tolerate things like video appointments. That turned out not to be true at all,” says Gallant, who is now the associate vice president of innovation and transformation at North Shore Community Health in Massachusetts.

Studies show high satisfaction rates, even among older Americans, and two-thirds of providers have a favorable view of telehealth, as well, López-Anuarbe says.

“One of the questions, of course, was about quality, and if patients would experience a decrease in quality. And it obviously doesn’t work for everything, like emergencies or complex physical evaluations, but for mental healthcare, routine needs and chronic care, it can work very well.”

Brewer now sees her patients primarily through telehealth via The Midtown Practice for Psychotherapy and Psychiatry and Linden Health Family Psychiatry. “It’s been phenomenal,” she says. “I work from home most days, and I love it. And my patients love that they don’t have to make long trips to see me. It’s much easier for them to find a 30-minute window to connect with me from work or home or wherever they are.”

Brewer says she typically won’t take telehealth patients younger than 12—“It can be tough to get younger kids to open up, and the logistical challenges are greater, since they often don’t have their own private space at home,” she says—but it’s been an excellent option for teens and young adults. In addition to New York, she’s licensed in Connecticut, New Jersey and Pennsylvania, which has allowed her to continuing seeing patients once they leave for college, and take on new patients from other states looking for her particular specialty.

“I have patients I’ve never met in person before, and I’ve been treating them for years,” she says. “Effective treatment doesn’t have to be limited by geography.”

North Shore Community Health, where Gallant has worked since 2022, offers a wide variety of telehealth services for patients older than 18, including annual well visits, endocrinology consultations, contraception counseling and chronic disease management, as well as for cold and flu symptoms, sore throat without fever, rash, urinary tract infection, and non-urgent back, joint and abdominal pain.

Gallant says about 30% of the community center’s visits are now done through telehealth, and the program is continuously expanding.

“There’s a cost savings for us in terms of overhead. I don’t have to worry about the physical space when scheduling video visits, so we are able to offer more appointments. We can also use more per diem providers,” he says.

But the growing trend is in asynchronous care, or care where the patient isn’t having a face-to-face interaction with a provider.

“That would include giving yourself an eye exam to be reviewed later, or it can look like an e-consult, where someone fills out a questionnaire on a patient portal and a provider or a specialist will look at it and make some sort of recommendation,” Gallant says. “That’s significantly less expensive for the health center than if the patient were to come into the office and see that specialist. It can be less expensive for the patient, too, depending on insurance and billing.”

It’s super convenient for patients, and also a lot cheaper, because they’re not paying for the provider’s time in a face-to-face visit.

— Lena Mininberg ’17, board-certified women’s health nurse practitioner and certified nurse midwife

Gallant is also working on a remote monitoring program for patients with high blood pressure. Over the course of one to two months, a patient takes and reports their own blood pressure, which is then tracked remotely by a nurse who follows up with instructions based on the trends, he explains.

“The total cost of monitoring a patient’s blood pressure this way can be less expensive than even a single visit, and often more impactful because the patient is getting regular access to the provider and the responsive care they need. So it reduces costs and the patient is getting a better outcome.”

At Planned Parenthood, Mininberg processed asynchronous patient requests via the organization’s PPDirect app.

“People download the app on their phones, and they make basic requests for things like birth control or treatment for herpes if they have a previous diagnosis. They fill out and submit a health questionnaire, and then the provider has access to their medical records. If it’s something pretty simple and straightforward, you just go ahead and fill the prescription and then it would get mailed out to them directly,” she explains.

“It’s super convenient for patients, and also a lot cheaper, because they’re not paying for the provider’s time in a face-to-face visit. Patients could use insurance in certain states, but for the most part, it was out of pocket for around $30.”

Challenges Beyond the Screen

Even as telehealth continues to grow, many of the barriers that prevented widespread adoption before the pandemic remain. Insurance reimbursement can be complicated, and while Medicare and Medicaid have extended COVID-era reimbursement policies, they haven’t yet been made permanent.

For providers, state-by-state licensing is a huge obstacle. States can have vastly different requirements and processes, and applying is both time-consuming and expensive.

“I wish it were easier. I have four licenses, but I want more. I want Rhode Island. I want Vermont. I want Maryland,” Brewer says. Without them, she can’t continue care for patients who attend college in those states, for example, and she has to cancel sessions for current patients who travel to other states for work or vacation.

“They come on and are like, ‘Hi from Florida!’ And I have to tell them, ‘I’m sorry, I can’t actually treat you if you are in Florida—we need to reschedule.’”

Brenda Coutinho ’86 is a Massachusetts-based board-certified OB-GYN with more than 30 years of experience in traditional in-person practice, including labor and delivery, gynecological surgery, obstetric care and menopause management. After decades in the field and with her children now grown, she is considering transitioning her career to providing remote menopause management care—a highly sought-after specialty—through telehealth. But to do that fulltime requires multiple state licenses.

America now makes up about half of the global telehealth market.

— Mónika López-Anuarbe, Professor of Economics

“Most of the major telehealth companies want you to have at least 10,” Coutinho explains. “I started with Florida and did that one on my own and it is a painful, painful process. Once you do one or two, you’re like, ‘I can’t possibly do this myself.’”

Coutinho eventually turned to a company that assists providers with the application process, and she’s now licensed in nine states with a 10th pending. But it’s been an expensive endeavor.

“I’ve invested more than $15,000 already and I’m really only at the beginning of my journey,” she says.

She also has some ethical concerns about direct-pay companies that may push providers to offer patients medications or supplements that might not be necessary.

“Supplements can go a long way, and there are a lot of things we should be taking, especially as we get older. But when you have a membership with one of these companies and it’s $68 a month, the company isn’t going to make a profit unless you are paying for prescriptions,” says. “There are very good, ethical companies, but there are others that just get my spidey senses up.”

López-Anuarbe shares those concerns, particularly with the “massification” of healthcare into a volume-driven corporate industry.

“You end up with these rich people who know nothing about healthcare buying all of these companies, through private equity acquisitions and similar alternatives. And so it might not be your provider driving the decisions,” she says.

“At the same time, because many of these companies cut out insurance completely in favor of self-pay models, there is some healthy competition in terms of pricing, and consumers have greater access to services and medications that insurance won’t cover.”

Even with its challenges, experts agree that telehealth will only continue to grow, and the U.S. is now leading the charge.

“America now makes up about half of the global telehealth market,” López-Anuarbe says. “We were late to the party, but now we are generating the money.”