Telehealth has revolutionized access to care, but adoption remains uneven across populations and health settings. Despite years of progress and post-pandemic normalization, many patients and providers still face significant obstacles.
This week, we examine the persistent barriers that hinder telehealth engagement — and the creative, inclusive, and evidence-based solutions we have implemented over the past 15+ years of launching and optimizing telehealth.
These barriers are not only technical but also behavioral, cultural, and systemic.
Patients may lack digital skills, access to private space, or trust in the technology, while clinicians grapple with shifting workflows, training gaps, and skepticism about virtual care quality. The health system itself — fragmented, unevenly resourced, and shaped by legacy reimbursement structures — often exacerbates rather than alleviates these challenges.
Here are the seven most common barriers we regularly come across — and the strategies and tactics to overcome them.
1. Patient Engagement and Education: Beyond “Just Click the Link”
Patients are often expected to navigate telehealth platforms with little to no orientation. For digitally savvy individuals, this might not be a hurdle — not everybody is a “digital native”. But for older adults, non-native English speakers, or those with cognitive challenges, the expectation to “just click the link” is unrealistic.
Our team has long advocated for intentional, tailored support for patients to prepare them for their first virtual experience. One of our key tactics are “Telehealth TechChecks” a few days before a video visit — an approach we created in the early stages of Covid in 2020. Other approaches include culturally appropriate onboarding videos (e.g., in the patient’s native language).
The idea is to employ high-impact strategies that meet patients where they are and build trust from the first interaction. Tapping into other community resources such as digital navigators, community health workers, or community paramedics is another way to empower patients to have a great digital health experience.
2. Telehealth Technology Training for Clinicians and Staff
Low digital proficiency affects every role in the care continuum. Clinicians, front-desk staff, medical assistants, and care coordinators are often asked to support telehealth with little or no formal preparation. From knowing how to launch a secure video session to guiding a patient through basic troubleshooting, these skills are essential — and trainable.
But it’s rarely just about the technology — it is mostly about the workflows that guide how the technology is being used and when.
We’ve helped organizations create standardized training across different roles and departments, recognizing that effective telehealth requires a team-based approach. Our comprehensive programs address platform navigation, virtual communication, privacy protocols, and workflow integration. By embedding these tools into onboarding, refresher training, and day-to-day practice, we ensure that both clinical and non-clinical staff are confident, consistent, and compliant. The result is a smoother experience for everyone—patients included.
3. (Mis)perceptions of Telehealth Quality
Another barrier to telehealth adoption are clinicians’ concerns about the quality of telehealth, especially its equivalency to in-person visits. In most cases concerns about quality stem from inconsistent experiences and unclear clinical guidance.
To address this barrier, we’ve helped clinical teams define and reinforce telehealth’s role as a clinical tool — not a convenience feature. By mapping clinical appropriateness and building confidence in virtual exam techniques, we reframe telehealth as safe, effective, and aligned with medical excellence. Our Virtual First mindset (promoting “100% Telehealth” under specific conditions) for more advanced teams and virtual physical exam training empower clinicians to deliver high-quality care across modalities.
4. Provider Resistance: Culture, Workflows, and Change Fatigue
After 25 years of “forced” EHR rollouts, it’s almost become a cliche: “I didn’t go into medicine to stare at a screen.” Provider resistance to changing the way they are practicing medicine is real and understandable.
If there is one thing that clinicians are sick and tired of, it’s to be presented with new solutions without having had a say in the decision in the first place. That’s a surefire way to ensure that adoption will be hard, contentious, and sluggish.
Rather than pushing harder, we start by listening. Our team works with clinicians and operational leaders to co-design telehealth workflows that reduce friction, protect clinician time, and uphold the therapeutic relationship. We also train internal champions who can model success and coach peers. Change is more sustainable when it’s owned by those closest to the care.
5. Financial Barriers: Reimbursement
Across the board, the perception in many minds is that the reimbursement landscape remains patchy. But for Medicaid, Medicare, and commercial payors in many states, payment parity for video visits is currently a reality. While Congress is making a sport out of kicking the can down the road to make the COVID-introduced telehealth regulations permanent, telehealth enjoys strong bipartisan support — and we simply don’t see a world where we return to pre-COVID limitations.
That said, we continue to advise clients on practical ways to navigate the existing terrain. We offer guidance on coding strategies, payer alignment, and using hybrid care models to optimize both revenue and patient experience. Through strategic planning and resource navigation, we help organizations sustain and scale telehealth in a way that’s both financially sound and mission-aligned.
6. Technology Costs: Dispelling the Myth
When it comes to the so-called “cost of technology,” we challenge the assumption that it’s a major barrier. Smartphones, webcams, and bandwidth solutions are more affordable than ever, and we’ve helped organizations secure and deploy these tools at scale through smart procurement and targeted grant funding.
Most grant programs (e.g., from the USDA or FCC) focus on offsetting the cost of technology (and, regrettably, don’t pay for the technical assistance required to create a high-functioning system where the technology can be plugged in).
Using our systems approach, we also encourage forming partnerships with philanthropic and community-based organizations to close remaining gaps — ensuring that digital access is a standard, not a privilege. In our experience, it’s often not about the price tag — it’s about planning, logistics, and prioritization.
7. Access to Technology and Private Spaces
For patients, though, digital access goes beyond devices. Patients also need privacy, bandwidth, and support with technical challenges.
We’ve worked in rural communities to set up telehealth access points in trusted locations such as libraries to schools. These hubs provide not just connectivity, but dignity and discretion. Other digital equity initiatives some of our clients are leveraging involve handing out tablets or smartphones and training patients on their use through digital navigators.
Looking Ahead: Designing with Empathy and Equity
Overcoming these barriers isn’t about tech fixes alone.
It requires listening deeply to patient and provider experiences and in turn designing systems that incorporate their ideas and address their concerns.
Telehealth has immense potential — but only if we ensure that no one is left behind.
Would you like to pick my brain on how to overcome barriers to telehealth you are experiencing in your clinic? Reach out to me for a complimentary conversation!
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Christian Milaster and his team optimize Telehealth Services for health systems and physician practices. Christian is the Founder and President of Ingenium Digital Health Advisors where he and his expert consortium partner with healthcare leaders to enable the delivery of extraordinary care.
Contact Christian by phone or text at 657-464-3648, via email, or video chat.
