Trends in Adoption and Maturation of Telehealth Programs at Teaching Hospitals and Health Systems

Document Type

Journal Article

Publication Date



Telemedicine journal and e-health : the official journal of the American Telemedicine Association








teaching hospitals; telehealth; telehealth adoption; telemedicine


Although early adopters of telehealth have built and sustained telehealth programs over long periods, little research has been conducted differentiating the characteristics of health systems at different stages of maturation. This study surveyed 165 major teaching hospitals and health systems from fiscal year 2015 through 2018 about the stage and characteristics of their telehealth services. Respondents reported (i) the progression level of their telehealth program, (ii) which of six services they provide, and (iii) greatest barriers and motivators to implementing telehealth, as well as their overall operational and financial characteristics. Telehealth programs at teaching hospitals progressed steadily and adoption of a wide range of telehealth delivery modes expanded. Hospital operational and financial characteristics corresponding to both higher maturation and the adoption of more delivery modes were identified. Reported barriers and motivations were similar across maturation levels. With telehealth's broader use and the heterogeneity of delivery modes being utilized, a binary metric of whether or not to implement telehealth does not sufficiently capture key differences in telehealth programs or differentiate implementation scope and scale across health systems. The findings suggest that programs at different levels of maturation are characteristically different from one another. Identifying factors related to mature telehealth programs may help guide policymakers, future telehealth program leaders, and other stakeholders in identifying barriers to continued investment in telehealth.


Emergency Medicine