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Virtual Medical Care
Topic Collection
April 29, 2026

Topic Collection: Virtual Medical Care

The continuing increase in the use and capabilities of virtual medical care (also referred to as telemedicine or telehealth, although care may be provided via telephone, web, or other means) has led many in the emergency medical community to plan or implement call centers and web- or telephone-based triage and treatment systems in anticipation of and during public health emergencies. Additionally, health systems are using virtual platforms to coordinate care and provide remote access to specialty care and assessment (e.g., trauma, stroke, and psychiatric) which can be leveraged during disasters to broaden access to specialty consultation (e.g., for patients with burn injuries or pediatric patients). These resources highlight strategies for implementing virtual medical care during a disaster, including lessons learned from recent events.  

This Collection was comprehensively refreshed in April 2026.

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category. Additional case studies and materials can be found in the following Topic Collections: Burns, Influenza Epidemic/ Pandemic, Natural Disasters, Coronaviruses (e.g., SARS, MERS, and COVID-19), and Utility Failures.

 

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Must Reads

CMS Office of Minority Health. (2023). Examining Rural Telehealth During the Public Health Emergency.
The authors compared Medicare enrollees’ fee-for-service telehealth use before (2018-2019) and during the pandemic (2020-2021) and found significant increases (particularly among younger, female patients). Behavioral health care was the most frequent service sought during the pandemic. The authors highlighted challenges facing rural enrollees (e.g., access to broadband, less telehealth use by males), and figures throughout the report compare use by patients living in large rural, small rural, and urban areas. They encourage provider awareness of changes in payment policies should the provision allowing the broad use of telecare expire.
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Healthcare Ready. (2019). Telehealth in Emergency Preparedness and Response.
This issue brief highlights how telehealth is being used in disaster preparedness and response and summarizes the challenges and potential solutions associated with this mechanism of healthcare delivery and regulatory resources.
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Interstate Medical Licensure Compact. (2026). Interstate Medical Licensure Compact.
This webpage provides information on the Interstate Medical Licensure Compact, an agreement between 29 states, the District of Columbia and the Territory of Guam, where physicians are licensed by 43 different Medical and Osteopathic Boards. Under this agreement licensed physicians can qualify to practice medicine across state lines within the Compact if they meet the agreed upon eligibility requirements.
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ProviderBridge. (2026). ProviderBridge.
Provider Bridge helps mobilize verified healthcare providers to communities where they are needed most. This resource is for verified clinicians willing to provide in-person care or telehealth services during medical emergencies and natural disasters.
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Sorenson, G. (2018). 3 Steps to Telemedicine Disaster Preparedness.
The author proposes three steps for telemedicine disaster preparedness: acknowledge telemedicine as a Standard of Care, establish tools and workflows before disaster strikes, and form partnerships between public and private organizations.
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Telehealth.HHS.gov. (2024). Best Practice Guide: Telehealth for Emergency Preparedness. Health Resources & Services Administration, U.S. Department of Health and Human Services..
Telehealth.HHS.gov is a resource for providers and patients for telehealth including best practice guides, tip sheets, licensure, policies, billing, and research. This resource highlights how telehealth is a crucial tool for providing health care during an emergency, such as a pandemic or natural disaster. This guide provides details on how providers can use telehealth to perform quick assessments, triage patients, and deliver patient care.
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The University of New Mexico School of Medicine. (2026). Project ECHO.
The Extension for Community Health Outcomes (known as Project ECHO) was created to help provide healthcare providers in rural and underserved areas information they need to treat conditions such as Hepatitis C, chronic pain, and behavioral health disorders. In the event of a disaster, one or more of ECHO's "hubs" could assist with virtual healthcare education and consultation/provider collaboration.
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Wilson, K., Johnson, R., Hatzimasoura, C., et al. (2024). A Randomized Controlled Trial Evaluating the Effects of Nurse-led Triage of 911 Calls. (Abstract only.) Nature Human Behavior. 8: 1276–1284.
This article discusses the successes and challenges experienced since connecting non-emergent 911 callers to triage nurses into Washington, DC’s 911 Call Center in 2018. A study of one year of data found that (non-disaster) ambulance dispatch and transport dropped by nearly 40% and 30% respectively. An older case study is available here: https://www.annemergmed.com/article/S0196-0644(18)31164-8/fulltext .
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Applications for Telemedicine

Esberk, T. and Das, K. (2023). Telemedicine for the Management of Pediatric Burn Patients Admitted to Emergency Services. (Abstract only.) Journal of Telemedicine and Telecare. 29(10):755-760.
A total of 210 pediatric burn patients were included in this cross-sectional study to investigate the role of telemedicine in the management and triage of pediatric burn injuries. Both the the inter-rater reliability value for "clinical decision" and level of concordance between the two assessments were very high, supporting the use of virtual consultations when burn care specialists can not visit patients in person.
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Park, C., Cho, Y., Harvey, J., et al. (2022). Telehealth and Burn Care: From Faxes to Augmented Reality. Bioengineering. 9(5).
The authors review the literature and summarize how telemedicine has been used in burn care. They also review the use of augmented reality in the triage and management of burn patients. They note varied outcomes and the need to continue monitoring the use of augmented reality which shows "promise in immersive, real-time triage."
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Parvizi, D., Giretzlehner , M., Dirnberger, J., et al. (2014). The Use of Telemedicine in Burn Care: Development of a Mobile System for TBSA Documentation and Remote Assessment. Annals of Burns and Fire Disasters. 27(2):94-100.
The authors describe a mobile application that uses digital images of patients' burns superimposed on a patient-specific 3D model. The application was found to more accurately estimate burn size than burn experts when tested at two separate international burn meetings and demonstrates the utility of remote specialty assessments for local provider burn care.
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Schmollinger, M., Gerstner, J., Stricker, E., et al. (2025). Evaluation of an App-Based Mobile Triage System for Mass Casualty Incidents: Within-Subjects Experimental Study. Journal of Medical Internet Research. 26:e65728.
In this study, 38 emergency medicine providers evaluated two triage sessions using either a paper-based tool or an app-based mobile system. Overall, the app-based mobile system out-performed the paper tool. Qualitative feedback also supported this finding, with participants noting that the dashboard “significantly simplified their work,” indicating digitalization may optimize processes in disaster medicine.
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Tambini, S., Conti, A., and Caviglia, M. (2025). Emergency Medical Services Perception of the Use of Wearables in Patient Management During Mass Casualty Incident Management.
This article (while focused on Italian emergency medical services [EMS]) discusses findings from a survey of EMS dispatch centers gather professionals’ perceptions on hypothetical wearable devices during mass casualty incidents and other disasters (e.g., patient identification, e-triage tags, vital sign monitoring). Experienced respondents rated the device positively for improving situational awareness and coordination, but respondents expressed concerns about the device’s interoperability with existing tools and potential rescue delays.
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Telehealth Broadband Project. (2025). Uncovering Rural America's Internet Reality.
The information on this website can help individuals and their healthcare providers set up reliable broadband, facilitating care via telemedicine.
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Telehealth.HHS.gov. (2024). Best Practice Guide: Telehealth for Rural Areas. Health Resources & Services Administration, U.S. Department of Health and Human Services.
Telehealth can help address the health care needs of the 1 in 5 Americans who live in rural areas. This best practice guide for health care providers can help them develop a workflow for rural patients, provides information on billing, and teaches people who live in rural areas how to access the internet and use telehealth services.
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Ward, M., Carter, K., Bhagianadh, D., et al. (2023). Comparison of Telehealth and In-Person Behavioral Health Services and Payment in a Large Rural Multisite Usual Care Study. (Abstract only.) Telemedicine and e-Health. 29(11).
The authors found that when behavioral healthcare was provided by telehealth, there was a small but statistically significant finding in the amount and complexity of work required by the provider compared to in-person appointments.
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* Xiong, W., Bair, A., and Sandrock, C. (2010). Implementing Telemedicine in Medical Emergency Response: Concept of Operation for a Regional Telemedicine Hub. Journal of Medical Systems. 36(3): 1651-1660.
The authors developed and measured a model application in order to quantitatively analyze the potential health benefits of telemedicine in disaster response. They found that the model can support disaster response activities and enhance surge capacity; enhance the speed and effectiveness of medical response; and improve resource and operations planning, as well as internal and external situational awareness.
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Call Centers and Triage Lines

Adhikari, B.B., Koonin, L.M., Mugambi, M.L., et al. (2018). Estimating Weekly Call Volume to a National Nurse Telephone Triage Line in an Influenza Pandemic. (Abstract only.) Health Security. 16(5):334-340.
The authors developed a Call Volume Projection Tool to estimate national call volume to Flu on Call® during an influenza pandemic. They extrapolated data from the 2009 experience of the Minnesota FluLine (during the H1N1pandemic) and applied it to a 20% attack rate, and case hospitalization rates from the 1968 and 1957 pandemics, respectively, to provide an estimated national weekly call volume.
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* Bogdan, G., Scherger, D., Seroka, A., et al. (2007). Adapting Community Call Centers for Crisis Support: A Model for Home-Based Care and Monitoring. U.S. Department of Health and Human Services.
The authors explain the development, testing, and implementation of a model to enable community health call centers (e.g., poison control centers, nurse advice lines) to support home-management and shelter-in-place approaches in certain mass casualty or health emergency events. The report includes a matrix with possible call center capabilities aligned with National Planning Scenarios and other guidance that can be tailored by call centers.
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Boyle, T., Ludy, S., Meguerdichian, D., et al. (2023). Feasibility and Acceptability of a Model Disaster Teleconsultation System for Regional Disaster Health Response. Telemedicine Journal and e-Health. 4;29(4):625–632.
The authors studied the feasibility of a partnership between the Region 1 Regional Disaster Health Response System and the American Burn Association, who developed a model regional disaster teleconsultation system. Using simulated disasters, the authors found high acceptance for the model, but participating physicians expressed the need for more reliable technology and improved audiovisual quality.
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Koonin, L. and Hanfling, D. (2013). Broadening Access to Medical Care During a Severe Influenza Pandemic: The CDC Nurse Triage Line Project. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. 11(1):75-80.
The authors describe the Centers for Disease Control and Prevention's Nurse Triage Line Project and its goals of using a coordinated network of nurse triage telephone lines during a pandemic to assess the health status of callers, help callers determine the most appropriate site for care, disseminate information, provide clinical advice, and provide access to antiviral medications to those who need it.
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Potter, J., Watson Gans, D., Gardner, A., et al. (2023). Using Virtual Emergency Medicine Clinicians as a Health System Entry Point (Virtual First): Cross-Sectional Survey Study. Journal of Medical Internet Research-mHealth. 2(1):e8.
The authors sought to determine the effect of access to emergency medical clinicians through the “Virtual First” (VF) program on patients seeking acute care needs at urgent cares or emergency departments (ED). Of the patients who were seen via VF, almost half indicated they would have gone to urgent care had they not connected with clinicians virtually first. Nearly all patients ranked receiving care in the comfort of their home as the most favorable aspect of VF. The authors highlight the cost-saving benefit to the patients and the reduction of unnecessary ED visits as reasons to consider adopting virtual emergency medicine telehealth programs.
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Russi, C.S., Beuning, A.J., Powell, R.S. et al. (2018). The Impact on Emergency Department Visits With a Telemedicine Program Interfacing With a Nurse Triage Call Line. Annals of Emergency Medicine. 72(4): S116–S117.
The authors discuss a 3-week observational study they conducted to determine outcomes from a triage protocol that had an emergency medicine physician consult with a triage line nurse, or with a patient directly, when the triage line nurse determined from call line disposition algorithms that a patient should be seen in the Emergency Department (ED). They concluded that this model could safely mitigate some unnecessary ED usage.
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Schroeder, T. (2023). AI-Powered Automation in State and Local Call Centers Bolsters Disaster Resilience. Disaster Recovery Journal.
In this editorial, the author describes how artificial intelligence (AI) can support call centers during disasters by reducing workload, providing pre-recorded information, routing and sharing caller information with call-takers, assisting with management integration, and making the process more efficient. AI can also be used to collect and analyze data after a disaster, helping localities plan for and program call centers to respond to certain queries.
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Sharma, S., El-Alfi, V., and Greene, D. (2024). Maintaining and Improving Virtual Call Centers for Public Health: The CUNY Recovery Corps Experience. (Abstract only.) Journal of Public Health Management and Practice. 30(6):869-878.
The authors discuss how virtual call centers were developed and used during the pandemic. Lessons learned by the CUNY Recovery Corps can provide a blueprint for setting up navigation services, emergency response, and supporting health and social services that can be used during similar incidents.
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* Spaulding, A.B., Radi, D., Macleod H., et al. (2013). Satisfaction and Public Health Cost of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza. Plos One. 8(1):e50492.
The authors describe the successful use of a telephone nurse triage line (NTL) set up by the Minnesota Department of Health for evaluating individuals with influenza-like illness and tele-prescribing of anti-virals. The NTL diverted callers from acute care visits at low cost and had a high rate of satisfaction among callers.
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The University of New Mexico School of Medicine. (2026). Project ECHO.
The Extension for Community Health Outcomes (known as Project ECHO) was created to help provide healthcare providers in rural and underserved areas information they need to treat conditions such as Hepatitis C, chronic pain, and behavioral health disorders. In the event of a disaster, one or more of ECHO's "hubs" could assist with virtual healthcare education and consultation/provider collaboration.
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Wilson, K., Johnson, R., Hatzimasoura, C., et al. (2024). A Randomized Controlled Trial Evaluating the Effects of Nurse-led Triage of 911 Calls. (Abstract only.) Nature Human Behavior. 8: 1276–1284.
This article discusses the successes and challenges experienced since connecting non-emergent 911 callers to triage nurses into Washington, DC’s 911 Call Center in 2018. A study of one year of data found that (non-disaster) ambulance dispatch and transport dropped by nearly 40% and 30% respectively. An older case study is available here: https://www.annemergmed.com/article/S0196-0644(18)31164-8/fulltext .
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* Yeager, V. (2009). Emergency Response, Public Health and Poison Control: Logical Linkages for Successful Risk Communication and Improved Disaster and Mass Incident Response. Homeland Security Affairs. 5:Article 2.
The author proposes bringing together the expertise of emergency response organizations, public health agencies, and poison control centers to institute call centers and/or triage lines to disseminate information to the public during emergencies, and answer questions and concerns to keep concerned individuals from flooding local emergency rooms. Real-world examples of successful collaborations from Canada, Great Britain, and the U.S. are included.
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Education and Training

American Medical Association. (2025). The Telehealth Landscape Post-Public Health Emergency.
Speakers in this 25-minute podcast describe how the use of telehealth grew significantly during the pandemic and how it is being used now to support patients in different communities, improve outcomes, and improve access to quality health care across the country.
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Rheuban, K. and Jin, J. (2022). Telehealth Integration and Optimization. American Medical Association.
This CME-eligible virtual toolkit module reviews: how to select a telemedicine service model; steps to determine the technology and support needed while following all applicable privacy, state, and federal laws; and practice guidelines to initiate a telemedicine service model.
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General Guidance and Research

American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. (2017). Hospital Disaster Preparedness for Obstetricians and Facilities Providing Maternity Care. Obstetrics and Gynecology. 139(6): e291-2297.
This committee statement discusses the need for disaster preparedness and response considerations for hospitals that provide maternity care, including antepartum, intrapartum, postpartum, and neonatal care. The committee focuses on the need for developing strategies to stabilize and transport obstetric patients, manage patient surge, and virtual expert consults; use common terminology; create a related perinatal subcommittee assessing disaster needs; and establishing downtime, labor-in-place, and telemedicine procedures.
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* American Medical Association. (2022). Telehealth Implementation Playbook.
During a pandemic, healthcare facilities may need telehealth/medicine capabilities. Telehealth policies help to prevent potential exposure in the workplace, thus limiting the impact on the health of the healthcare workforce. This guide is a resource for administrators to initiate those capabilities.
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Association of State and Territorial Health Officers. (2026). Telehealth.
This webpage includes links to the Association's resources on telehealth (e.g., their e-learning center, results from a 2025 needs assessment, and a policy update).
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Atiyeh, B., Dibo, S.A., and Janom, H.H. (2014). Telemedicine and Burns: An Overview. Annals of Burns and Fire Disasters. 27(2):87-93.
The authors discuss the use of telemedicine to bring the specialized expertise of burn centers to more patients. They also describe its challenges, including technical difficulties, legal uncertainties, limited financial support, reimbursement issues, and the need for more evidence of its value and efficiency.
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Carr, M., Isakov, A., Lyon, M., and Ross, M. (2023). The Pivotal Role of Telehealth in Disaster Response. Southeastern Telehealth Resource Center.
The speakers emphasize the importance of integrating telehealth within comprehensive health care delivery systems. Examples of everyday applications of telehealth programs are provided, with an emphasis on using telehealth following a chemical, biological, radiological, nuclear, and/or explosives or other surge events.
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* Healthcare Ready. (2019). Telehealth in Emergency Preparedness and Response.
This issue brief highlights how telehealth is being used in disaster preparedness and response and summarizes the challenges and potential solutions associated with this mechanism of healthcare delivery and regulatory resources.
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Johnson, A. (2019). Telehealth: The Beginner’s Guide to Legal Pitfalls. Frost, Brown, Todd, LLC.
This article discusses key legal considerations for providers to consider in their provision of telehealth services. Specifically, it discusses: the Anti-Kickback Statute and Stark Law; the Corporate Practice of Medicine Doctrine; and scope of practice and licensure issues.
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Kaim, A. (2025). Changing the Paradigm of Field Hospitals: A Model for Integrating Telemedicine Into Disaster Medical Deployments.
Based on a literature review and subject matter expert input, the authors examined the role of telemedicine in sudden onset (e.g., natural disasters) and prolonged incidents (e.g., pandemics). Telemedicine was found to bolster medical care, helping with early trauma care during sudden incidents and maintaining routine during prolonged incidents, and the authors encourage incorporating telemedicine as a core element of field hospital planning.
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Lopez, A. (2014). Treatment of Ebola in the Digital Age. Arizona Telemedicine Program.
The author presents strategies for preventing Ebola disease transmission through the use of telemedicine. Specifically, she discusses a national Ebola hotline to triage at-risk cases; using Bluetooth digital monitoring for high-risk suspect cases without symptoms; video enabled ambulance transfers; and an electronic ICU set up that minimizes exposure of live caregivers. Similar strategies could be applied to the management of other emerging infectious disease outbreaks.
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National Consortium of Telehealth Resource Centers. (2026). Telehealth Resources.
This website includes resources, news, events, webinars, and success stories to assist healthcare facilities with developing telehealth programs.
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National Consortium of Telehealth Resource Centers. (2026). Telehealth Resources.
This website includes resources, news, events, webinars, and success stories to assist healthcare facilities with developing telehealth programs.
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Openshaw, L. (2025). Disaster Medicine Handbook: A Quick Reference: Telehealth.
In this chapter of the handbook, visitors can learn about the history and basics of telehealth and how it can be used to care for children in disasters (and related challenges). Links to related resources are also provided.
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Sorenson, G. (2018). 3 Steps to Telemedicine Disaster Preparedness.
The author proposes three steps for telemedicine disaster preparedness: acknowledge telemedicine as a Standard of Care, establish tools and workflows before disaster strikes, and form partnerships between public and private organizations.
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State of Florida, Telehealth Advisory Council. (2017). Expanding Florida’s Use and Accessibility of Telehealth.
Though written for the state of Florida, the analysis and recommendations related to the 6 topic areas for potential expansion of telemedicine services (defining telehealth; health insurance coverage; reimbursement for telehealth; health care practitioner licensure; patient/consumer protections; and technology) may be valuable to planners in other jurisdictions as they develop or expand their respective telemedicine programs in support of disaster response.
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Swink, K. and Miller, J. (2026). Tele-Critical Care: System Level Optimization: Transforming Outcomes with Improved Access. ICU Management and Practice. 26(1)
In this article, the authors provide an overview of tele-critical care (TCC) in the intensive care unit while acknowledging the positive effect it can also have on the emergency department and related units. They emphasize the need for established trust and clear roles in these scenarios and describe how TCC can help alleviate pressure and connect providers with specialists while patients are waiting to be admitted.
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Telehealth Centers of Excellence. (2026). Telehealth and Emergency Health.
The Telehealth Centers of Excellence develop telehealth resources for organizations, researchers, and providers, and staff. This includes resources focused on emergency health.
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Telehealth.HHS.gov. (2024). Best Practice Guide: Telehealth for Emergency Preparedness. Health Resources & Services Administration, U.S. Department of Health and Human Services..
Telehealth.HHS.gov is a resource for providers and patients for telehealth including best practice guides, tip sheets, licensure, policies, billing, and research. This resource highlights how telehealth is a crucial tool for providing health care during an emergency, such as a pandemic or natural disaster. This guide provides details on how providers can use telehealth to perform quick assessments, triage patients, and deliver patient care.
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Telligen and gpTRAC. (2014). Telehealth Start-Up and Resource Guide: Version 1.1.
This collaborative resource was created “to provide an overview and framework for implementing telehealth in critical access hospitals and rural areas.” It includes a listing of research related to telehealth and outcomes, and lessons learned and best practices from organizations that successfully implemented telehealth programs and contributed to this document.
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* U.S. Department of Health and Human Services. (2009). Pandemic and All-Hazards Preparedness Act (Public Law 109-417) Telehealth Report to Congress.
This report to Congress discusses telehealth and its potential uses during public health emergencies and disaster medical responses. Payment and reimbursement considerations, as well as pertinent legal issues, are included.
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VSee. (2025). What is Telemedicine?
This vendor-provided resource includes a comprehensive overview of telemedicine, including content that discusses benefits and shortcomings of telemedicine; applications for telemedicine; regulations and reimbursement considerations; and barriers to telemedicine and associated solutions.
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* Xiong, W., Bair, A., and Sandrock, C. (2010). Implementing Telemedicine in Medical Emergency Response: Concept of Operation for a Regional Telemedicine Hub. Journal of Medical Systems. 36(3): 1651-1660.
The authors developed and measured a model application in order to quantitatively analyze the potential health benefits of telemedicine in disaster response. They found that the model can support disaster response activities and enhance surge capacity; enhance the speed and effectiveness of medical response; and improve resource and operations planning, as well as internal and external situational awareness.
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Burroughs, J. (2018). Telehealth-Credentialing, Privileging and Quality Oversight.
This presentation, created for the Washington Association of Medical Staff Services, discusses The Joint Commission (TJC) and Centers for Medicare and Medicaid Services (CMS) standards with regard to credentialing and privileging telehealth providers, as well as common pitfalls and best practices related to credentialing and privileging for telehealth.
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Center for Connected Health Policy. (n.d.). Legislation & Regulation Tracking. (Accessed 4/13/2026.)
This interactive map provides information on telehealth legislation and regulation. Users can search by data type, state, and CCHP classification (e.g., reimbursement, licensing, networking adequacy).
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Centers for Medicare & Medicaid Services. (2021). ACO Next Generation Model Telehealth Waiver Frequently Asked Questions.
This document provides frequently asked questions and answers related to the Telehealth Expansion Waiver. The first section includes questions related to waiver policy, and the second section includes replies to questions about data submission requirements.
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Centers for Medicare & Medicaid Services. (2026). List of Telehealth Services.
Providers can reference this list of services payable under the Medicare Physician Fee Schedule when furnished via telehealth for coverage from 2021-present.
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Centers for Medicare & Medicaid Services. (2026). Telehealth.
This webpage includes links to responses to frequently asked questions and other resources related to telehealth (e.g., review criteria and remote patient monitoring).
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Centers for Medicare & Medicaid Services. (2026). Telehealth FAQ. U.S. Department of Health and Human Services.
CMS provides answers to commonly asked questions surrounding the use and coverage of telehealth services in this document.
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Gonzalez, G. (2018). Telemedicine Expands Care, Adds Exposures. Business Insurance.
This resource discusses the increased potential for medical malpractice risks, cyber risks, and challenges related to regulatory and legal exposures stemming from telemedicine use as technology has outpaced laws and regulations that govern healthcare practice.
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Interstate Medical Licensure Compact. (2026). Interstate Medical Licensure Compact.
This webpage provides information on the Interstate Medical Licensure Compact, an agreement between 29 states, the District of Columbia and the Territory of Guam, where physicians are licensed by 43 different Medical and Osteopathic Boards. Under this agreement licensed physicians can qualify to practice medicine across state lines within the Compact if they meet the agreed upon eligibility requirements.
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Psychology Interjurisdictional Compact. (2026). PSYPACT.
This website shares information on the interstate compact designed to facilitate the practice of telepsychology and the temporary in-person, face-to-face practice of psychology across state boundaries.
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Telehealth.HHS.gov. (2026). Telehealth Policy Updates. Health Resources & Services Administration, U.S. Department of Health and Human Services.
This webpage provides information on and links to federal legislation and physician fee schedules surrounding the telehealth policies (e.g., extending access to services and using telehealth to serve rural areas and provide behavioral health care).
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* U.S. Department of Health and Human Services. (2009). Pandemic and All-Hazards Preparedness Act (Public Law 109-417) Telehealth Report to Congress.
This report to Congress discusses telehealth and its potential uses during public health emergencies and disaster medical responses. Payment and reimbursement considerations, as well as pertinent legal issues, are included.
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U.S. Government Accountability Office. (2022). Telehealth in the Pandemic—How Has It Changed Health Care Delivery in Medicaid and Medicare?
Nearly half of the U.S. population is covered by Medicaid and/or Medicare. This resource provides an overview of how telehealth use changed since the pandemic (e.g., only Medicaid participants had access to telehealth before), presents the challenges faced by providers and residents in more rural areas, and lists issues with determining quality of care provided by telehealth, and suggests improvements in tracking how services are provided.
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Lessons Learned

Abualenain, J. (2024). Use of Technology in Disaster Medicine. Eurasian Journal of Emergency Medicine. 23(3): 155-158.
Based on a literature review of articles published between 2000-2023, the author examines how telemedicine, mobile health, and point-of-care ultrasound have been used in disaster scenarios. Telemedicine was found to boost communication, remote diagnostics, and coordination. Mobile health applications helped with patient tracking, triage, and resource allocation. Having point-of-care ultrasound allowed providers to make rapid diagnoses using portable, non-invasive tools. Challenges identified in the review included interoperability, unreliable communication networks, lack of training/support, and legal and ethical considerations.
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BlueCross and BlueShield of Texas. (2018). What BCBSTX Learned From Hurricane Harvey Insurance Claims.
BlueCross BlueShield of Texas reviewed member claims for the 6 months post-Harvey and compared them to the same time period the previous year and found that “many people turned to technology in the form of telemedicine for the first time.” There was a rise in mental and physical health conditions such as post-traumatic stress disorder (PTSD), as well as infectious and parasitic diseases post-Harvey. The claims data also showed an increase in substance abuse, pneumonia and Chronic Obstructive Pulmonary Disease (COPD).
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Boyle, T. P., Boggs, K., Gao, J., et al. (2023). Hospital-Level Implementation Barriers, Facilitators, and Willingness to Use New Regional Disaster Teleconsultation System: Cross-Sectional Survey Study. JMIR Public Health and Surveillance. 9(e44164).
The authors surveyed 164 hospitals and freestanding emergency departments in New England to understand their teleconsultation and telecommunication systems and capabilities. Other than rural facilities, most reported receiving routine non-disaster telehealth services and having adequate internet/cellular services. More than 80% reported being somewhat or very likely to use a regional disaster teleconsultation system, supporting the Region’s telehealth project to provide temporary access to clinical experts in a disaster.
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Brouillette, M. (2024). In a Postpandemic Era, Is Telehealth Still a Vital Tool? Annals of Emergency Medicine. 83(3): pA11-A14.
The author reviewed the literature and described how telemedicine has been used in more urban areas to reduce emergency department crowding and patient wait times, while increasing patient satisfaction since the pandemic. In rural areas it has been used to bolster services offered by smaller area hospitals, where providers can use cameras to examine patient wounds, IVs, and EKG monitors. The authors note that telehealth use remains popular and emphasize its utility specifically for emergency medicine.
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Cimons, M. (2018). When There's a Hurricane Between You and The Hospital, Telemedicine Could Save The Day.
This article discusses key findings from the 2018 Usher-Pines, et al. paper, which analyzed the experiences of Doctor on Demand in the weeks following Hurricanes Harvey and Irma in 2017. Study data showed that use of the service peaked three to six days after the hurricanes made landfall, with patients seeking treatment for “chronic conditions, advice, counseling and refills, and back and joint concerns, including injuries.” Notably, referral rates for in-person care were in line with those seen in telemedicine during non-emergency times.
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Cohen, J. (2019). Telemedicine for Disaster Relief: MDLive's Dr. Deborah Mulligan on Responding to Hurricane Harvey. (Free registration required.) Becker’s Hospital Review.
This resource is a transcript from an interview discussing the use of a specific telemedicine system to provide medical care after Hurricane Harvey. It includes a good characterization of the types of nonemergency medical needs a community may have after a disaster, as well as the role telemedicine can play in response.
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Der-Martirosian, C., Chu, C., Griffin, A., and Dobalian, A. (2018). Telehealth at the US Department of Veterans Affairs after Hurricane Sandy. Journal of Telemedicine and Telecare. 25(5):310-317.
This paper identifies the types of Veterans Affairs telehealth services used following Hurricane Sandy (2012) during the 7 months the Manhattan Veterans Affairs Medical Center, and examines the patient characteristics of those users. The most commonly used telehealth services included those for primary care, triage, mental health, home health, and ancillary services.
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Friedman, R., Carpenter, D., Shaver, J., et al. (2022). Telemedicine Familiarity and Post-Disaster Utilization of Emergency and Hospital Services for Ambulatory Care Sensitive Conditions. (Abstract only.) American Journal of Preventive Medicine. 63(1):e1-e9.
The authors compared telemedicine use before and after the 2017 Tubbs wildfire in California to determine if knowledge of the virtual option affected hospital use. They noted a year-long decrease in emergency department and inpatient use for patients with asthma, diabetes, hypertension, heart failure, and coronary artery disease for those who were familiar with telemedicine prior to the incident.
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Glatter, R., Platt, S., and Pagan, N. (2018). How Telemedicine Can Improve Our Disaster Response.
The presenters in this 17-minute video discuss New York Presbyterian Hospital’s experience leveraging its telemedicine program to bring specialty consultation to Puerto Rico after Hurricane Maria in 2017. They discuss the lessons learned from their experience, which include allowing for time to obtain necessary regulatory approvals, and having the needed equipment and connectivity to successfully establish a telemedicine program to support a disaster-stricken area.
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Grielsamer, A. (2018). VHA’s Telehealth Emergency Medicine Uses Holiday to Test Systems, Prepare for Emergency Responses. U.S. Department of Veterans Affairs, VAntage Point.
The VA’s Telehealth Emergency Medicine team exercised its signal strength capabilities during the July 4th, 2018 holiday on the National Mall to demonstrate how VA technologies could be used during an emergency. This exercise could serve as a reference for other entities when developing testing plans for their respective telemedicine systems.
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Grover, J., Smith, B., Williams, J., et al. (2020). Novel Use of Telemedicine by Hurricane Evacuation Shelters. (Abstract only.) Prehospital Emergency Care. 24(6):804-812.
Many residents were housed in state evacuation shelters after Hurricane Florence struck North Carolina in 2018 and the authors sought to understand the in-person and telehealth emergency care services used by evacuees in two counties. Of the 93 telemedicine encounters, the average patient age was 49, close to 70% were female, and nearly half used the service to refill medication. Over 40% said they would have gone to an emergency department had telemedicine not been provided. The authors encourage similar research and the use of telemedicine in disaster shelters to alleviate pressure on emergency services and hospitals.
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* Healthcare Ready. (2019). Telehealth in Emergency Preparedness and Response.
This issue brief highlights how telehealth is being used in disaster preparedness and response and summarizes the challenges and potential solutions associated with this mechanism of healthcare delivery and regulatory resources.
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Hofmeyer, J., Leider, J., Satorius, J., et al. (2016). Implementation of Telemedicine Consultation to Assess Unplanned Transfers in Rural Long-Term Care Facilities, 2012–2015: A Pilot Study. (Abstract only.) The Journal of Post-Acute and Long-Term Care Medicine. 17(11): 1006–1010.
The authors describe the development of a telemedicine approach to assess residents from rural long-term care facilities for potential (costly) transfer to hospitals. The pilot test was promising, as it reduced stress levels and costs associated with transfers.
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Houlihan, B., Ethier, E., Veerakone, R., et al. (2024). Trauma-Informed Leadership in Quality Improvement: What We Learned From Practicing in a Pandemic. Pediatrics. 153 (Supplement 1):e2023063424G.
During the pandemic, the authors note that clinics serving children and youth with special/medically complex health care needs were particularly negatively affected and found themselves having to pivot to telehealth and other options to provide real-time care. The article describes the nature of the trauma associated with the pandemic and how trauma-informed care was found to improve patient outcomes and boost clinician and staff wellness and retention.
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Kim, T.J., Arrieta, M.I., Eastburn S.L., et al. (2013). Post-disaster Gulf Coast Recovery Using Telehealth. Telemedicine Journal and E-Health. 19(3):200-10.
The authors, whose work focuses on telemedicine to meet post-disaster mental health needs, conducted semi structured interviews with both regional key informants and national organizations with Gulf Coast recovery interests and determined seven factors for telehealth success: funding, regulatory, workflow, attitudes, personnel, technology, and evaluation. Included in this resource is also a discussion of prior research conducted on the use of telemental health services.
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Kim, Y., Groombridge, C., Romero, L., et al. (2020). Decision Support Capabilities of Telemedicine in Emergency Prehospital Care: Systematic Review. Journal of Medical Internet Research. 22(12):e18959.
The authors reviewed relevant literature to assess whether pre-hospital patient diagnoses made via telemedicine aligned with those made in hospital. While difficult to generalize and replicate scientifically, findings indicate that telemedicine can be useful in challenging environments (e.g., disasters) and enables access to remote experts to support medical decision on scene or in prolonged field care. They also note, however, that the impact of human and technology factors on patient care is poorly understood and documented.
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Litvak, M., Miller, K., Boyle, T., et al. (2022). Telemedicine Use in Disasters: A Scoping Review. (Abstract only.) Disaster Medicine and Public Health Preparedness. 16(2):791–800.
The authors conducted this review to understand the use and common challenges associated with disaster telemedicine in order. They identified themes and developed recommendations for implementing telemedicine and overcoming barriers for regional disaster health responses in the United States.
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Lokmic-Tomkins, Z., Bhandari, D., Bain, C., et al. (2023). Lessons Learned from Natural Disasters around Digital Health Technologies and Delivering Quality Healthcare. International Journal of Environmental Research and Public Health. 20(5):4542.
In the context of climate change and increases in weather-related disasters, electronic health records (EHRs) are an important component of a resilient health care system when reaching underserved or remote areas. The authors cover lessons learned globally in EHR (e.g., use cloud-based systems to facilitate continuity of operations), telehealth and telemedicine, electronic prescribing and referrals, mobile health, artificial intelligence and machine learning in health care, the internet of things for health (e.g., monitoring devices) and robotics.
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Meehan, T. (2018). Applying Telehealth to Natural Disasters. Health Recovery Solution.
This article discusses telehealth use during past emergencies and disasters, including blizzard and loss of power by Massachusetts General Hospital in 2014 (wound imaging for follow-up of post-operative patients and general maintenance of appointments for patients with chronic illness), and Hurricane Ike in 2008 (wound imaging and video messaging for bites from bees, fire ants, or mosquitoes, wounds or rashes, and skin infections from contaminated floodwaters). It also reviews how telehealth can help with chronic disease monitoring and prescription refills following mass evacuations, and how it could support 911 triage and ambulance deployment.
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Mohr, N., Young T., Harland, K., et al. (2019). Emergency Department Telemedicine Shortens Rural Time-To-Provider and Emergency Department Transfer Times. (Abstract only.) Telemedicine Journal and E-Health. 24(8):582-593.
The authors reviewed incidents where 2,857 of 127,928 qualifying emergency department (ED) encounters consulted telemedicine. They found that telemedicine decreases ED door-to-provider time and length of stay, and they emphasize the need for future research on the impact of telemedicine in rural areas.
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Murren-Boezem, J., Solo-Josephson, P., and Zettler-Greeley, C. (2020). A Pediatric Telemedicine Response to a Natural Disaster. Telemedicine Journal and e-Health. 26(6):720-724.
Telemedicine was offered to families of pediatric patients before and after Category 4 Hurricane Irma struck in Florida. The authors reviewed 262 telemedicine visits over eight days to determine related use and patterns. Most visits took place either the day before or after the storm, with the most frequent complaints being upper respiratory, skin-related, fevers, or gastrointestinal. The authors note high satisfaction from both patients and providers and suggest more research on the use of telemedicine during and after disasters.
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O’Connor, L., Dunkel, L., Weitz, A., et al. (2026). Digitally Delivered, Systemically Challenged: A Qualitative Study of Health System Readiness for Digital Care. PLOS Digital Health. 5(1): e0001193.
The authors conducted a series of interviews with senior leaders from diverse U.S. health systems to better understand their feelings about digital health technology (DHT). While overall promising (particularly when using DHT in rural areas)), participants noted challenges integrating DHT with existing workflows and electronic health records, data privacy and cybersecurity, and reimbursement not keeping up with innovation.
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Piza, F., Steinman, M., Baldisserotto, S., et al. (2014). Is There a Role for Telemedicine in Disaster Medicine? Critical Care. 18(6): 646.
The authors describe the successful use of a telemedicine videoconferencing system to treat burn patients following a 2013 nightclub fire in Brazil.
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Ramachandran, A., Northcraft, H., Steers, W., et al. (2025). Telehealth Utilization for Primary Care Delivery During Hurricanes Michael (2018) and Ian (2022) in the Veterans Health Administration. (Abstract only.) Telemedicine Journal and E-Health.31(7):866-874.
Veteran's Health Administration facilities provided telehealth services after two hurricanes four years apart. The authors reviewed primary care after each and found increases in telehealth visits, particularly in severely affected areas. They note that while virtual care increased and was critical for primary care delivery and to maintain patient care, it lagged in rural areas, “exacerbating disparities in care delivery.”
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Region V for Kids. (2023). Rural and Critical Access Hospital Telehealth Survey.
This survey of rural and Critical Access Hospitals assessed regional telehealth capabilities, including nonchildren’s, community hospitals. Findings indicated that overall, during the pandemic, telehealth was used as a tool of sustainment for normal operations.
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Region V for Kids. (2023). Telehealth Survey, Pt. 3: Advanced Understanding of Children’s Hospitals’ Disaster Telehealth Capability (July 2023).
This 17-question survey of children’s hospitals examined regional telehealth capabilities, current programs, practices, and capacities. This survey revealed one key lesson: telehealth is principally organized and used as an instrument of routine clinical operations: telehealth for disaster operations is an accessory function. Access findings from the 2022 survey here: https://static1.squarespace.com/static/67c0d6dba09682269ccf5285/t/685ab94358df0878ffcc92fc/1750776133279/2022_Telehealth_Environmental_Scan_Report.pdf and the 2020 survey here: https://static1.squarespace.com/static/67c0d6dba09682269ccf5285/t/685ab78337925e3351bec34f/1750775684424/Sharing_Knowledge_-_A_telehealth_survey_report_cpXcqC5.pdf
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Reichert, C. (2018). How the University of Virginia Delivered Telehealth to Ebola-Stricken Africa. ZDNet.
This article describes how the University of Virginia used telehealth to support communication with patients in isolation, as well as to allow health care professionals in PPE to visually consult with physicians back in the United States without having to doff their PPE.
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Siwicki, B. (2018). Telehealth Success Story: 97% of Harris County TB Patients Took Their Meds During Hurricane Harvey. Healthcare IT News.
During Hurricane Harvey and its aftermath in 2017, Harris County, Texas public health staff reached out to tuberculosis (TB) patients via mobile phone, landline or text messages to patients via its telemedicine application (app) to support medication compliance. Patients were given a month’s worth of medication prior to the storm, and asked to upload videos of themselves taking their medication through the app.
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* Spaulding, A.B., Radi, D., Macleod H., et al. (2013). Satisfaction and Public Health Cost of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza. Plos One. 8(1):e50492.
The authors describe the successful use of a telephone nurse triage line (NTL) set up by the Minnesota Department of Health for evaluating individuals with influenza-like illness and tele-prescribing of anti-virals. The NTL diverted callers from acute care visits at low cost and had a high rate of satisfaction among callers.
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Spitzer, J. (2017). Telemedicine Interest Surges During Hurricane Irma. Becker’s Hospital Review.
The author discusses patient demand for telehealth services from 2 Florida hospitals during Hurricane Irma in 2017. One saw a 554% increase in installation of its telemedicine application, and the other had more than 2,700 patients sign up over a 3-day period.
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Tintinalli, J. (2018). From the Front Lines of Hurricane Florence. Emergency Physicians Monthly.
The second story in this article discusses how telemedicine was implemented in shelters following hurricane Florence in 2018 to provide care, order prescriptions, and minimize transport to emergency departments (EDs). Emergency Medical Services (EMS) Branch Directors were assigned to each shelter, all of which had iPads to connect with the telemedicine application used by a local hospital ED, with power and internet service provided through generators and portable WiFi units.
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Uscher-Pines, L., Fischer, S.H., Tong, I., et al. (2018). Virtual First Responders: The Role of Direct-to-Consumer Telemedicine in Caring for People Impacted by Natural Disasters. Journal of General Internal Medicine. 33(8): 1242-1244.
The authors analyzed administrative data from Doctor on Demand in the 30 days following Hurricanes Harvey and Irma (August–September 2017) to characterize post-disaster telemedicine use. Use peaked on days 4-6 after landfall and 63% of the patients were first-time users.
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Van Oeveren, L., Donner, J., Fantegrossi, A., et al. (2017). Telemedicine-Assisted Intubation in Rural Emergency Departments: A National Emergency Airway Registry Study. (Abstract only.) Telemedicine Journal and E-Health. 23(4):290-297.
The authors reviewed data on 206 patients who had an intubation attempt while on a video telemedicine link from May 1, 2014 to April 30, 2015. The success rate (96%) matched those of large-center studies.
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Weigel, P., Merchant, K., Wittrock, A. et al. (2019). Paediatric Tele-emergency Care: A Study of Two Delivery Models. (Abstract only.) Journal of Telemedicine and Telecare.
The authors examined two types of tele-emergency department (ED) pediatric programs (specialized and general) to determine how "tele-ED models have implications for evaluative measures."
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Wray, C., Myers, U., Slightam, C., et al. (2024). Research Priorities to Expand Virtual Care Access for Patients in the Veterans Affairs Health Care System. Journal of General Internal Medicine. 39(Suppl 1):14–20.
This article highlights consensus recommendations from the Access Workgroup of the 2022 Veterans Affairs Virtual Care State-of-the-Art Conference. While considered a national leader in telehealth, the workgroup noted gaps in ensuring fair, high-quality virtual care access, particularly for rural Veterans, older adults, and those with socioeconomic or digital challenges. The authors list six priorities for additional research, including optimizing Veterans’ access to virtual care, creating standardized virtual care metrics, customizing technology to address access challenges, and identify strategies to boost patient and clinician adoption of virtual care.
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* Yeager, V. (2009). Emergency Response, Public Health and Poison Control: Logical Linkages for Successful Risk Communication and Improved Disaster and Mass Incident Response. Homeland Security Affairs. 5:Article 2.
The author proposes bringing together the expertise of emergency response organizations, public health agencies, and poison control centers to institute call centers and/or triage lines to disseminate information to the public during emergencies, and answer questions and concerns to keep concerned individuals from flooding local emergency rooms. Real-world examples of successful collaborations from Canada, Great Britain, and the U.S. are included.
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Lessons Learned: COVID-19

ASPR TRACIE. (2020). Telehealth in Alternate Care Sites: Ensuring Patient Care and Staff Safety in Massachusetts.
The use of telehealth increased exponentially in response to COVID-19, when many hospitals scrambled to add tablets to their inventory, facilitating patient communication with both loved ones and healthcare providers. Dr. Paul Biddinger, Medical Director for Emergency Preparedness at Mass General Brigham and Director of the Center for Disaster Medicine (Massachusetts General Hospital), Juan Estrada, Senior Director for Telehealth Consults at Massachusetts General Hospital and Dr. Lee Schwamm, Vice President of Virtual Care at Mass General Brigham shared how staff adjusted to this new method of healthcare delivery and how lessons learned were incorporated in near real time.
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ASPR TRACIE. (2021). Poison Center Roles During the Pandemic.
Julie Weber, RPh, CSPI, President, American Association of Poison Control Centers and Director of the Missouri Poison Center in SSM Health Cardinal Glennon Children's Hospital highlighted the role of poison centers in public health and response, how staff are integrated into disaster response, and data related to calls received during the COVID-19 pandemic.
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ASPR TRACIE. (2021). The Virtual Hospital at Home-Denver Health's Experience Treating COVID-19 Patients Remotely.
Denver Health is a Level 1 Trauma Center and Urban Safety Net hospital with 550 beds and nine federally qualified community health centers located throughout the city. Before the pandemic, the hospital had 227 adult medical surgery/critical care beds, 47 were intensive care unit (ICU)-level beds, and 12 were intermediate care beds. They ran near or at capacity and often experienced adult emergency department boarding. Patrick Ryan, MD, MPH, and Connie Savor Price, MD (from Denver Health and the University of Colorado School of Medicine) shared their experiences creating the "Virtual Hospital at Home" model to manage the significant surge in patients in the fall of 2020.
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Boyle, T., Mehra, A., Smith, N., et al. (2024). The First Statewide Implementation of a Regional Disaster Teleconsultation System to Expand Critical Care Surge Capacity: A Case Study in Vermont. Telemedicine and e-Health. 30(5):1495–1498.
In this case study, the authors describe a partnership between the Region 1 Disaster Health Response System, the State of Vermont, and the National Emergency Tele-Critical Care Network to provide telehealth services during a COVID-19 surge with mean time to service implementation of 27 days. These findings emphasize the need for integrated teleconsultation systems into state and local emergency management plans to improve start up times.
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CMS Office of Minority Health. (2023). Examining Rural Telehealth During the Public Health Emergency.
The authors compared Medicare enrollees’ fee-for-service telehealth use before (2018-2019) and during the pandemic (2020-2021) and found significant increases (particularly among younger, female patients). Behavioral health care was the most frequent service sought during the pandemic. The authors highlighted challenges facing rural enrollees (e.g., access to broadband, less telehealth use by males), and figures throughout the report compare use by patients living in large rural, small rural, and urban areas. They encourage provider awareness of changes in payment policies should the provision allowing the broad use of telecare expire.
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Getachew, E., Adebeta, T., Muzazu, S. G. Y., et al. (2023). Digital Health in the Era of COVID-19: Reshaping the Next Generation of Healthcare. Frontiers in Public Health. 11(942703).
The pandemic called for digital health interventions (DHI) to both track the spread of disease and to facilitate patient care and tracking. The authors discuss how DHI was used to aid the health sector through prevention, early diagnosis, treatment adherence, medication safety, care coordination, documentation, data management, outbreak tracking, pandemic surveillance, and highlight limitations for future use.
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Marcus, B., Newton, C., Rafton, S., et al. (2022). Regional Pediatric Disaster Network Guides Statewide Telehealth Initiation during COVID-19 Pandemic. (Abstract only.) American Journal of Disaster Medicine. 17(2):163-169.
Before the pandemic, many pediatric clinics in Washington were not able to institute telehealth. The authors share how they worked with their regional pediatric disaster network to conduct a needs assessment to provide direct telehealth support to Washington clinics and a coalition of statewide advocacy groups during the pandemic.
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Pamplin, J., Quinn, M., and Little, J. (2025). Experience of The National Emergency Tele-Critical Care Network. Telemedicine and e-Health.31(5)
The authors share their experience providing more than 1,800 days of coverage to 60 hospitals in 17 states and territories through a free, ad hoc consultation service created for clinicians rapidly communicate with experts during the pandemic. The authors discuss their experiences delivering support and provide recommendations to guide future development and integration of telemedicine programs into the National Disaster Medical System and for integrating telemedicine into rural health during disasters and public health emergencies.
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Uschnig, C., Recker, F., Blaivas, M., et al. (2022). Tele-ultrasound in the Era of COVID-19: A Practical Guide. Ultrasound in Medicine and Biology. 48(6):965-974.
Tele-ultrasound (TUS) was used during the pandemic to help diagnose pneumonia for certain patient populations such as pregnant women, children, and non-mobile patients. The authors provide an overview of current and potential use of TUS, providing a table that lists strengths and weaknesses and discussing how TUS has been used in trauma medicine and can be used in future emergencies to improve triage and reach residents in more rural areas where it may be difficult to obtain high-quality imaging.
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VanderWerf, M., Bernard, J., Barta, D., et al. (2022). Pandemic Telemedicine Technology Response Plan and Technology Assessment Phase 2: Pandemic Action Plan Key Issues and Technology Solutions for Health Care Delivery Organizations in a Pandemic. Telemedicine and e-Health. 28(4):443–456.
During the pandemic, the National Telemedicine Technology Assessment Resource Center (TTAC) was asked to develop a Pandemic Response Action Plan that would allow health care providers to use telemedicine and related technologies to address critical issues. This article describes how the Pandemic Response Action Plan was developed based on 11 identified pandemic-specific needs improving capabilities and resilience of organizations for future pandemics.
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Zachrison, K., Cash, R., Boggs, K., et al. (2024). Emergency Department and Health Care System Factors Associated with Telehealth Innovation During the COVID-19 Pandemic. (Abstract only.) Telemedicine Journal and e-Health. 30(2):527-535.
The authors compared data before and during the pandemic to examine how the use of telehealth in emergency departments (ED) changed. ED use of telehealth increased significantly more than predicted, particularly where telehealth structure existed. Pre-existing capabilities were also positively related to innovation.
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Plans, Tools, and Templates

Administration for Strategic Preparedness and Response. (2026). The ASPR Telemedicine Program. U.S. Department of Health and Human Services.
ASPR can rapidly deploy personnel virtually during disasters and public health emergencies with the following capabilities: cadre of medical specialists, language interpretation, access to secure Health Information Exchange, electronic medical record integration, electronic or e-prescribing, and data analytics dashboards.
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* American Medical Association. (2022). Telehealth Implementation Playbook.
During a pandemic, healthcare facilities may need telehealth/medicine capabilities. Telehealth policies help to prevent potential exposure in the workplace, thus limiting the impact on the health of the healthcare workforce. This guide is a resource for administrators to initiate those capabilities.
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Baker, C. (n.d.). Digital Health Tools in Disaster Preparedness, Mitigation, and Recovery: An Environmental Scan. (Accessed 4/16/2026.) California Telehealth Resource Center.
Health care providers can use the information on this page to learn more about digital health tool modalities (e.g., asynchronous, remote monitoring, telehealth, artificial intelligence), and how to incorporate technology into disaster phases. Case studies and trends are also highlighted.
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* Bogdan, G., Scherger, D., Seroka, A., et al. (2007). Adapting Community Call Centers for Crisis Support: A Model for Home-Based Care and Monitoring. U.S. Department of Health and Human Services.
The authors explain the development, testing, and implementation of a model to enable community health call centers (e.g., poison control centers, nurse advice lines) to support home-management and shelter-in-place approaches in certain mass casualty or health emergency events. The report includes a matrix with possible call center capabilities aligned with National Planning Scenarios and other guidance that can be tailored by call centers.
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Centers for Disease Control and Prevention. (2023). Assist in Medical Office Telephone Evaluation of Patients with Possible Influenza for Health Care Settings. U.S. Department of Health and Human Services.
Medical staff can use this flowchart to help triage calls and identify high-risk patients for consideration of initiation of antiviral treatment prior to an office visit.
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Mid-Atlantic Telehealth Resource Center. (2022). FQHC Telehealth Best Practices: Lessons Learned from the Pandemic – Telehealth after the Public Health Emergency – Where Should We Go From Here?
This webinar features speakers from Federally Qualified Health Centers discussing how they plan to incorporate lessons learned during the pandemic to telehealth to optimize their existing infrastructure including use in quality improvement, enhancing staff and patient experiences, and financial efficiency. The link at the bottom of the page allows readers to access a sample telehealth workflow document and a decision tree to help decide whether/how to schedule telehealth appointments.
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ProviderBridge. (2026). ProviderBridge.
Provider Bridge helps mobilize verified healthcare providers to communities where they are needed most. This resource is for verified clinicians willing to provide in-person care or telehealth services during medical emergencies and natural disasters.
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Using Artificial Intelligence in Virtual Disaster Medical Care

Hassan, A., He, S., Peng, B., et. (2026). Building a Tactical Medical Chatbot for Conflict and Low-Resource Settings: A Low-Code Platform Approach. Healthcare. 14(1): 100780.
During disasters, access to healthcare can be challenging for many due to damaged infrastructure, unreliable connectivity, and disruptions in healthcare delivery. The authors developed and conducted preliminary evaluation of a Tactical Medical (TacMed) Chatbot and reviewed its use by frontline responders deployed internationally over 90 days. It was most likely to be accessed for hemorrhage control, during moments of high trauma or field emergencies. The authors plan to refine the Chatbot in several ways: ensure it is more accessible in areas with limited connectivity, bolster interpretation features, and better tailor information to the user.
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Rakhilin, N., Morris, H.D., Pham, D., et al. (2025). Opportunities for Artificial Intelligence in Operational Medicine: Lessons from the United States Military. Bioengineering. 12(5):519.
The authors evaluate how artificial intelligence (AI) has been used by the U.S. military in a variety of ways (e.g., non-invasive medical imaging, caring for veterans’ mental health) in disaster environments and conflict areas. They discuss the current state of AI and its potential uses in operational medicine as developed for the military and encourage medical schools to evaluate adopting AI into curriculums and provide a roadmap for getting started.
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Snoswell, C., Snoswell, A., Kelly, J., et al. (2025). Artificial Intelligence: Augmenting Telehealth with Large Language Models. (Abstract only.) Journal of Telemedicine and Telecare. 31(1):150-154.
The authors briefly describe how the integration of large language models, such as ChatGPT, integrated into search engines will change the way patients and healthcare providers access and receive medical information and encourage clinicians to remain current on LLMs related capabilities and limitations.
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Trump, B., Galaitsi, S., Cegan, J., and Linkov, I. (2025). How Will AI Shape the Future of Pandemic Response? Early Clues From Data Analytics. Risk Analysis. 45(12):4544-4556.
The COVID-19 pandemic revealed numerous critical gaps in healthcare which, the authors hypothesize, can be anticipated and potentially addressed by artificial intelligence (AI). They explore how AI could be used to address data acquisition and aggregation gaps, synthesis gaps, and values-based decision support tools, followed by explaining how AI can be used to address pandemic analytics and response gaps (e.g., public health surveillance, understanding real-time flow of resource needs, and creating clear and ethical triage protocols).
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Umlauf, L., Remley, M., Colombo, C., and Pamplin, J. (2025). Artificial Intelligence Decision Support Systems in Resource-Limited Environments to Save Lives and Reduce Moral Injury.
Future military conflicts involving large-scale combat operations may lead to casualty rates (and patient surge) rivaling those of World War II. The authors describe the effects of patient surge attributed to pandemics, MCIs, and natural disasters in resource-limited environments and encourage health care planners to evaluate how Artificial Intelligence Decision Support Systems can be used to help anticipate scale during future public health emergencies.
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Yan, T. and Tian, J. (2025). The Application of Artificial Intelligence in Addressing Biothreats. (Abstract only.) Disaster Medicine and Public Health Preparedness. 19:e184.
A comprehensive overview of utilizing artificial intelligence (AI) to address biothreats highlights how engaging in experiential learning, obtaining high-quality data, and refining algorithms can help healthcare use AI to mitigate bioterrorism.
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Agencies and Organizations

Administration for Strategic Preparedness and Response. The Disaster Telemedicine Program. U.S. Department of Health and Human Services.
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American Hospital Association. Telehealth.
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American Medical Association. Telehealth Resource Center: Guides & Reports.
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American Telemedicine Association.
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Arizona Telemedicine Program.
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Center for Connected Health Policy, Current State Laws & Reimbursement Policies.
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Center for Telehealth and e-Health Law.
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mHealth Intelligence.
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Telehealth and Emergency Health.
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The Center of Excellence for Telehealth and Aging.
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The National Consortium of Telehealth Resource Centers.
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The National Telehealth Policy Resource Center.
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The National Telehealth Technology Assessment Resource Center.
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U.S. Department of Health and Human Services. Telehealth.HHS.gov.
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U.S. Department of Health and Human Services, Health Resources and Services Administration. Office for the Advancement of Telehealth.
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UNM Center for Telehealth.
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VA Telehealth Services.
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Workgroup for Electronic Data Interchange (WEDI).
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This ASPR TRACIE Topic Collection was comprehensively refreshed and reviewed in April 2026 by the following subject matter experts (listed alphabetically): Tehnaz P. Boyle, MD, PhD, Telehealth Group Lead, Region 1 Disaster Health Response System; John Hick, MD, Hennepin Healthcare; Katherine Mandeville, MD MSc, Associate Clinical Professor, Department of Pediatrics UCSD, Disaster Director, Rady Children's Hospital Division of Emergency Medicine; CDR Dina Passman, USPHS, National Emergency Tele-Critical Care Network Program Manager; Kelly Rhone, MD, FACEP, Chief Medical Officer, Avel eCare; Staff from the U.S. Department of Health and Human Services, Health Resources and Services Administration Office for the Advancement of Telehealth; and Alanda White, DNP, MSN, APRN, FNP-C, PMHNP-BC, FADLN, San Antonio Northwest Health Care Center.

It was comprehensively refreshed and reviewed in December 2019 by John Hick, MD, HHS ASPR and Hennepin County Medical Center; Matt McQuisten, MBA, NRP, eEmergency Account Executive, Avera eCARE; Kelly Rhone, MD, FACEP, Medical Director of Outreach and Innovation, Avera eCARE; and Mary Russell, EdD MSN, Healthcare Emergency Response Coalition, Palm Beach County Florida.

It was comprehensively reviewed in March 2016 by Dale C. Alverson, MD Professor Emeritus and Medical Director, University of New Mexico Center for Telehealth Chairman, New Mexico Telehealth Alliance, CMIO, New Mexico Health Information Exchange Chairman, American Telemedicine Association Interstate Telehealth Discussion Group; Timothy E. Davis, MD, MPH, Branch Chief, NDMS Operational Medicine, HHS ASPR; and John Hick, MD, HHS ASPR and Hennepin County Medical Center.

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