Telehealth Nursing: Expanding Access to Care

Telehealth nursing has become an increasingly important part of healthcare delivery, expanding access to care for patients while creating new opportunities for nurses across a variety of specialties. From chronic disease management and remote patient monitoring to urgent care and behavioral health services, nurses are playing a central role in helping healthcare organizations deliver safe, effective, and patient-centered virtual care.

Although telehealth adoption accelerated during the COVID-19 pandemic, nurses have been using telehealth technologies for years to improve access, reduce barriers to care, and support patients in underserved communities. As healthcare continues to embrace digital technologies, telehealth nursing is expected to remain a growing area of practice requiring clinical expertise, communication skills, and technological competency.

“I have personally been practicing in telehealth for the past eight years,” says Mariea Snell, DNP, APRN, FNP-C, an associate professor of nursing and the director of the Doctor of Nursing Practice Programs at Maryville University. “I think the pandemic changed how people access care in large numbers, but it is not new. Many people with access issues due to physical disabilities or needs have used these systems. Others did not fully understand what it could do until put to the test.”

Georgia Reiner, MS, CPHRM, a Risk Analyst at the Nurses Service Organization (NSO), agrees that telehealth has been around for some time but notes that its utilization increased dramatically during and after the pandemic.

“Some nursing professionals, mainly advanced practice registered nurses (APRNs), including nurse practitioners (NPs), worked in telehealth before the beginning of the pandemic. However, there has been a dramatic increase in the utilization and availability of telehealth services due to policy changes implemented in response to the COVID pandemic,” says Reiner.

While telehealth utilization has stabilized since its pandemic-era peak, virtual care remains an important component of healthcare delivery. Healthcare organizations continue to use telehealth to improve access, support chronic disease management, expand specialty care services, and connect patients with providers regardless of geographic location.

Preparing Nurses for Telehealth Practice

If you’ve never worked in telehealth before, you may wonder whether additional training is required. The answer depends on a nurse’s role, educational preparation, employer requirements, and state regulations.

“All nurses can participate in telehealth,” says Snell. “They would provide the level of care that each are currently licensed to provide. In the case of a DNP/NP, they would treat patients the same way they would in an office setting.”

“Nurses and advanced practice registered nurses may receive training through their educational programs on the use of telehealth,” explains Robin Arends, DNP, CNP, FNP-BC, PMHNP-BC, CNE, FAAN, FAANP, APRN Program Director at South Dakota State University and nurse practitioner at Avel eCare. “If nurses do not receive this training in their educational preparation, they may receive it through their employment or workshops and educational programs.”

As telehealth becomes increasingly integrated into healthcare delivery, nursing programs are incorporating digital health, virtual communication, telehealth competencies, and healthcare technology training into curricula to prepare graduates for technology-enabled practice environments.

Arends notes that nurses should understand how to use telehealth equipment, assist patients with technology, communicate effectively through virtual platforms, and maintain professionalism on camera. They must also understand HIPAA requirements, information security, confidentiality, and state licensing regulations.

“Nurses should also be aware of licensing requirements as they need to be licensed in the state where the patient is located,” says Arends.

Reiner emphasizes the importance of verifying state practice requirements and preparing for potential technology failures or emergencies.

Before beginning telehealth practice, nurses should have contingency plans in place for:

• Technology failures or system outages
• Incomplete or interrupted transmissions
• Data security concerns
• Unauthorized access to information
• Natural disasters that may disrupt services

Challenges of Telehealth Nursing

While telehealth offers flexibility and convenience, virtual care presents unique challenges.

“The biggest challenge is that providing services via telehealth is so different from traditional, in-person care,” says Reiner. “When providing telehealth services, the nurse relies entirely on technology for the patient encounter.”

In addition to technical skills, telehealth nurses must develop strong communication and assessment abilities. Because physical examination opportunities may be limited, nurses often rely on observation, patient-reported information, clinical judgment, and remote monitoring technologies to support decision-making.

Healthcare organizations must also continuously evaluate telehealth programs to ensure quality and effectiveness. Important performance indicators may include:

• Patient complication and morbidity rates
• Compliance with provider performance criteria
• Diagnostic accuracy
• Adherence to clinical protocols
• Referral rates
• Patient satisfaction
• Cost per case
• Wait times for consultations and specialty services

Arends points out that maintaining licensure requirements across multiple states can also be challenging for nurses practicing virtually.

Documentation Remains Essential

Documentation requirements for telehealth encounters are no different than those for in-person care.

“Telehealth sessions should be as thoroughly documented as all other patient/client encounters,” says Reiner. “Just because some information may be automatically captured by software doesn’t negate the nurse’s professional responsibilities around documentation.”

Accurate documentation supports continuity of care, patient safety, quality measurement, regulatory compliance, and communication among healthcare team members.

Documentation should include all communications, clinical observations, orders, test results, patient education, and follow-up instructions according to organizational policies and professional standards.

Why Telehealth Nursing Continues to Grow

According to the experts interviewed, telehealth is likely to remain a permanent part of healthcare delivery.

“Nurses should consider getting into telehealth because this is the direction that healthcare is going in,” says Snell. “Incorporating technology in care will continue to develop and will never go back.”

Arends agrees.

“Nurses should consider working in telehealth because there are increasing opportunities in this area of healthcare. Patients saw the benefit of telehealth during COVID and want to continue to receive healthcare through this modality.”

Arends believes nurses will continue to be key contributors to telehealth’s growth.

“Nurses are the core of healthcare,” she says. “Many studies have shown that nurses utilizing telehealth for remote monitoring as well as real-time audio video telehealth formats have reduced complications and readmissions and increased access to care.”

Telehealth also enables nurses to better understand patients’ home environments, identify safety concerns, assess barriers to care, and support patients who might otherwise struggle to access healthcare services.

“The greatest reward of working in telehealth is helping the patient achieve the best health outcomes while minimizing barriers to accessing healthcare,” says Arends.

As healthcare delivery continues evolving, telehealth nursing offers opportunities to improve access, enhance patient engagement, and support care across diverse populations. Nurses will continue to play a critical role in ensuring virtual care remains safe, effective, and patient-centered while helping healthcare organizations adapt to an increasingly digital future.

This article was originally published in August 2024 and updated in June 2026 to reflect new information.