11 Proven Telehealth Solutions
Improving Access to Emergency Care

This is the second article in a multi-part series spotlighting proven telehealth-enabled solutions that address the goals outlined in CMS’s Rural Health Transformation Program. Each installment will focus on a different area of care — continuing here with emergency care — and demonstrate how telehealth is already improving access, outcomes, and sustainability in rural communities.

Over the past 15+ years, we’ve seen firsthand how telehealth can stabilize rural emergency departments (EDs), reduce unnecessary transfers, and keep care local.

When facilities are short on specialists, nurses, or even on-site physicians, telehealth has served as a lifeline. With the call for shovel-ready solutions in the new CMS Rural Health Transformation Program (RHTP), these long-proven solutions are no longer just “innovative”; they’re essential.

The RHTP’s $50B, five-year mandate — focused on sustaining rural hospitals, reducing avoidable Medicaid costs, and improving access across the care continuum — explicitly includes emergency care. And in most rural regions, emergency access isn’t just fragile; it’s fragmented.

The Problem: Rural Emergency Care Under Strain

Rural emergency departments face serious structural and staffing challenges:

• Limited or no 24/7 physician coverage

• Lack of specialty access for time-sensitive conditions (stroke, trauma, psychiatric crises)

• Long transport times to tertiary centers that can be dangerous in severe weather conditions or at night

• Boarding of behavioral health patients for days without care

• EMS teams forced to transfer low-acuity patients due to lack of decision support, tying up the ambulance for hours

Even when buildings stay open, patients too often receive incomplete or delayed care — driven not by clinical necessity, but by the absence of expertise or coverage.

There are actually three typical situations where improved access to emergency care is needed:

At the patient’s home or place of accident: When someone experiences a stroke, fall, overdose, or behavioral crisis, the first point of care is often EMS. But in rural areas, ambulance response can take 20+ minutes—followed by long transports to a distant hospital. Without field-based decision support, many patients are unnecessarily transported, while others don’t get the right interventions fast enough.

At the rural emergency department: Many rural EDs lack 24/7 physician staffing or specialty coverage. Nurses or advanced practice providers may be left managing complex patients solo, especially at night or during weekends. Time-sensitive conditions — like stroke, trauma, or acute psychiatric episodes — require consults that most rural hospitals simply can’t provide on-site.

During transport between facilities: For critical patients being transferred — whether by ground or air — care often occurs in a clinical vacuum. There’s typically no oversight from the receiving facility, no specialist involvement, and no escalation support if a patient deteriorates en route. These are high-risk, high-cost gaps in care where virtual support can be life-saving.

These are precisely the moments when emergency telehealth can change outcomes — and where scalable, reimbursable models already exist.

Proven Telehealth Solutions for Rural Emergency Care

Each point in the rural emergency care journey presents a unique challenge—but also an opportunity for targeted, high-impact intervention. These proven telehealth-enabled models map directly to the three moments of need outlined above.

3 Telehealth Solutions “At the Scene”

Emergency care often begins far from any facility. These telehealth solutions equip EMS and dispatch teams with real-time clinical support to intervene earlier, treat-in-place when appropriate, and reduce unnecessary transports.

1. EMS-Based Telehealth

Mobile-enabled video consults between EMS teams and remote physicians or nurses support better triage, treatment-in-place, and destination decisions. This model prevents unnecessary transports and enables real-time medical oversight for rural field responses.

2. Remote Triage Support for 911/Dispatch

Some rural systems now integrate clinical oversight into dispatch — providing nurse or physician input before EMS is deployed. This helps match the right resource to the right situation and can reduce strain on limited EMS capacity.

3. TeleBehavioral Health for Field Encounters

When behavioral health crises occur in the community, EMS or mobile crisis teams can initiate remote psychiatric consults on-site. This enables de-escalation and care planning without immediate ED transport or law enforcement custody.

5 Telehealth Solutions for the Rural ED

Many rural EDs operate with limited staffing and no specialty access. These solutions bring virtual emergency physicians, specialists, and diagnostics to the bedside — stabilizing patients locally and improving quality of care.

4. TeleED / Virtual Emergency Physician Coverage

Remote board-certified emergency physicians provide 24/7 support for rural hospitals—covering shifts, supplementing local APPs, or serving as the primary ED provider. This improves quality, documentation, and continuity of care.

5. TeleStroke

Neurologists provide real-time consults, image review, and thrombolytic guidance for rural stroke patients. Proven to reduce door-to-needle times and prevent unnecessary transfers.

6. Emergency TeleBehavioral Health (“TeleCrisis”)

Psychiatric consults available within minutes help evaluate and stabilize behavioral health patients, reducing ED boarding and unnecessary inpatient admissions.

7. TeleSpecialty Consults (Trauma, Cardiology, Pediatrics, etc.)

Virtual access to specialty care during emergency episodes ensures appropriate decision-making and may enable local treatment rather than automatic transfers.

8. Teleradiology

Proven since the mid 1990s and readily available virtually everywhere, 24/7 radiology reads ensure timely diagnostics for trauma, stroke, or abdominal pain to guide appropriate treatment.

3 Telehealth Solutions During Transport

When a patient’s condition is too severe to manage locally, the decision to transfer is critical — and so is the care that happens en route. These telehealth-enabled solutions support timely, informed transfer decisions and provide oversight during high-risk transport, reducing complications and unnecessary ICU or tertiary admissions.

9. En-Route Telemonitoring

With a plethora of connectivity options – 4G, 5G, and near-earth satellite-based services, EMS crews can connect with hospital-based physicians or specialists during long transports — supporting escalation if patient status changes, improving continuity of care, and ensuring the best possible action upon arrival.

10. Transfer Center Integration with Telehealth

Coordinated transfer centers using telehealth can involve specialists before transfer, ensuring patients are stabilized, necessary diagnostics are complete, and receiving teams are prepared — avoiding duplication and delay.

11. TeleICU Support for Transfer-In Decisions

When rural EDs are unsure whether ICU transfer is necessary, remote intensivist consults can assess the case and recommend either transfer or continued local management with virtual ICU backup—reducing unnecessary transfers and keeping patients closer to home.

Why It Matters for RHTP

Emergency care is one of the most visible—and most fragile—points in the rural health system. These 11 telehealth solutions address the exact gaps CMS is targeting under RHTP: improving timely access, reducing avoidable transfers, and strengthening local capacity without requiring more staff or new buildings.

Every one of these models is proven, scalable, and reimbursable — making them ready for deployment as states design their rural health transformation plans.

Next Up in the Series: How telehealth is transforming primary care access in rural settings—across chronic disease management, virtual triage, remote monitoring, and hybrid models that extend primary care teams.

Do you want to discuss how to integrate these solutions into your state’s Rural Health Transformation Program application? Let’s chat!