For patients scattered across Sioux Falls, S.D.-based Sanford Health’s rural footprint, telemedicine has become embedded in everyday care. But as pandemic-era telehealth policies face an uncertain future in Washington, Sanford leaders say the stakes are significant for the communities they serve.
Dave Newman, MD, chief medical officer of virtual care at Sanford Health, said telemedicine started as a new innovation but has become an expectation and is now integrated into 78 specialties across the system. Patients now anticipate being able to see not only their primary care providers but also subspecialists virtually. He described the shift in patient expectations as wanting virtual visits to be “as easy as ordering something off Amazon.”
“We innovated out of necessity,” Dr. Newman told Becker’s. “Based upon our massive rural footprint, we had to figure out how to meet patients where they are.”
Behavioral health has been one of the clearest areas of impact. Roughly 40% of Sanford’s behavioral health visits now take place virtually, according to Dr. Newman, who called it a “complete game changer” for patients and employees.
He shared an example of a physician friend in a small community who sought mental health care but did not want to be seen by patients in a waiting room or run into the provider around town. Through Sanford’s direct-to-consumer behavioral health service, he was able to connect virtually with a psychiatrist outside his area from home. Dr. Newman described it as beneficial for both the patient and provider.
The reach of telehealth has also reduced the burden of travel for rural patients. Dr. Newman, who is the only andrologist in North Dakota, said patients previously drove several hundred miles each way to see him. Now, virtual visits save the average patient 176 miles of travel, along with money for gas and hotels and time away from work.
He emphasized that for many patients, the alternative to virtual care is not in-person care — it is no care at all.
Patients have expressed strong support for telehealth, Dr. Newman said. “The overwhelming feedback that we have is, do not take this away,” he explained.
If telehealth options were eliminated, Sanford would face millions of dollars in logistical changes, and many patients would lose access to specialty and primary care. Dr. Newman noted that in Washington, the debate isn’t over whether telehealth should continue, but over who gets recognition for it. “It’s not controversial to have this,” he said. “It’s controversial who gets the kind of credit for it.”
Policy uncertainty affects day-to-day planning as well. When reimbursement rules are unclear, providers and patients face disruptions. Dr. Newman said that if a virtual visit is not covered, patients may have to rearrange their schedules, drive long distances or miss family commitments to attend in-person appointments. “In 2025, that’s just not acceptable,” he said.
Despite these challenges, Sanford is not scaling back its telehealth operations. Dr. Newman expressed the organization’s confidence in telehealth and continues to reassure patients and providers that virtual care remains a priority. He added that the system sees virtual care as the best option for its rural patient population.
For Sanford, telehealth is now a core part of how care is delivered. The system is using nurse practitioners to help manage conditions like heart failure, diabetes and depression remotely, and is exploring how technology can reach more patients before they fall through the cracks.
Looking ahead, Dr. Newman pointed to expanding mental health coverage and chronic disease management as key opportunities for telehealth. He said one of the most important factors affecting health in the U.S. is a person’s ZIP code, not their genetic code. In that regard, telehealth could become a significant equalizer.
