Telehealth Nursing: How FNPs Bridge Gaps through Virtual Health Care

This article has been updated on July 1, 2025

Learn more about Carson-Newman's online FNP programs.

Telehealth is here to stay, with utilization continuing to exceed pre-pandemic levels. Telehealth now plays a significant role in connecting patients to timely, convenient and high-quality care wherever they are.

For family nurse practitioners (FNPs), telehealth nursing has become a powerful method of delivering comprehensive, patient-centered care. Whether conducting virtual patient visits or using remote patient monitoring tools, FNPs providing telehealth services help meet the rising demand for health care, expand health care access and maintain continuity of care/

In this guide to telehealth nursing, you will learn about the role and career outlook of FNPs in telehealth and how the COVID-19 pandemic accelerated the adoption and development of telehealth nursing. Plus, discover the benefits of telehealth nursing and the critical considerations needed to address its potential limitations.

What is Telehealth Nursing? 

Telehealth nursing uses electronic communications and telecommunications to transmit medical information while delivering remote nursing care. 

The technology used in telehealth nursing has expanded from mobile communications to other applications such as live videoconferencing, store and forward transmission, email communications, instant messaging, remote patient monitoring and more.

Telehealth nursing allows nurses to answer patient questions, provide remote guidance and engage in ongoing patient monitoring from a distance.

What Is the History of Telehealth?

Telehealth has emerged as a solution for delivering health care from a distance, evolving alongside communication technologies.

According to the Upper Midwest Telehealth Resource Center, physicians began transmitting radiological images and conducting neurological exams via telephone in the 1940s. In the 1960s and 1970s, closed-circuit television enabled psychiatric consultations. The introduction of high-speed internet, webcams, laptops and smartphones fostered more opportunities for remote health care through the early 2000s.

Telehealth adoption rose dramatically during the COVID-19 pandemic. Today, over half of Americans have had a telehealth visit, and patient satisfaction with telehealth is high.

Telehealth vs. Telemedicine: What's the Difference? 

The difference between telehealth and telemedicine is the delivery of clinical vs. non-clinical services.

The federal government defines telehealth as the use of electronic information and telecommunications technologies to support clinical care delivery, patient and provider education and public health and health administration from a distance. 

Telehealth encompasses a wide range of clinical and non-clinical services, such as:

• Provider training and continuing education
• Administrative meetings
• Scheduling, billing and registration support
• Virtual patient visits
• Teletriage

Telemedicine is the delivery of remote clinical services using electronic information and telecommunications technologies. It does not include non-clinical services.

Telemedicine involves:

• Virtual patient visits
• Teletriage
• Diagnostic testing
• Remote patient monitoring
• Specialist referrals

While telehealth encompasses all clinical and non-clinical services, telemedicine refers exclusively to the clinical applications of telehealth.

What Is the Role of FNPs in Telehealth? 

FNPs are advanced practice registered nurses (APRNs) who assess, diagnose and treat patients of all ages. They focus on conditions and injuries that fall under primary care, such as abdominal pain and urinary tract infections.

FNPs may see patients in person, virtually or both, depending on their specific role. By delivering comprehensive, patient-centered care remotely, FNPs help expand access to primary care, improve continuity of care and enable patients to manage their health more conveniently and consistently.

Every state regulates the extent to which FNPs can practice. Depending on the state where they practice, FNPs can use telehealth to:

• Conduct virtual visits to assess, diagnose and treat patients
• Provide preventative care, such as wellness check-ups, screenings and patient education
• Monitor chronic conditions through virtual follow-ups and remote patient monitoring tools
• Consult with specialists or arrange referrals
• Prescribe, refill and monitor the side effects of medication

What Is the Job and Salary Outlook for FNPs in Telehealth?

FNPs entering the workforce in the next few years have a bright career outlook.

The increasing need for preventive and primary care and the ongoing shortage of primary care physicians means that FNPs are in high demand. According to the U.S. Bureau of Labor Statistics (BLS), the employment of nurse practitioners will grow by an estimated 46% between 2023 and 2033, almost 12 times faster than average.

Telehealth adoption is further fueling FNP demand. FNPs are needed to provide telehealth services as more patients seek virtual care and as telehealth expands in rural and underserved areas.

The demand for nurse practitioners is driving up their earning potential. The median annual salary for all nurse practitioners is $129,210. Telehealth nursing salaries vary widely by experience level, location and type of employer.

As telehealth evolves, FNPs are well-positioned to build rewarding careers while expanding access to care. 

How to Become a Telehealth FNP?

Becoming a telehealth FNP follows a similar path to traditional FNP practice, consisting of education, certification and licensure. 
To become an FNP, registered nurses must obtain:

• FNP Degree: Earn a minimum of a Master of Science in Nursing (MSN) with an FNP specialty. A registered nurse can become an FNP in just 32 months by choosing an RN to MSN-FNP program. Post-master’s certificate programs prepare registered nurses with a master’s degree to become FNPs in under two years. FNP programs consist of coursework, often covering virtual care delivery and technologies, and several hundred supervised clinical hours in a relevant health care setting.
• FNP Certification: After earning your FNP degree, you’ll need to obtain FNP certification from the American Nurses Credentialing Center (ANCC) or the American Association of Nurse Practitioners (AANP). The certification process includes an application and exam.
• FNP State Licensure: Once you achieve a passing grade on your certification exam, you will apply for state licensure as an FNP with your state board of nursing.
• Continuing Education: Throughout your FNP career, you will be required to complete continuing education to maintain your certification and state licensure.

No national or state-mandated telehealth certifications are required for delivering telehealth services as an FNP. You may need to complete telehealth training, credentialing or privileging according to state or employer guidelines.

The Impact of COVID-19 on Telehealth Nursing

The COVID-19 pandemic marked a turning point for telehealth in the U.S., rapidly accelerating its adoption. For nurses, telehealth quickly shifted from an emerging to an essential method of health care delivery. As a result, it fueled changes in nurse practitioner practice autonomy and nursing practice standards. 

How Did COVID-19 Affect Telehealth Use?

Before the COVID-19 pandemic, the primary drivers of health care demand were the growing population of aging adults and the physician shortage. The pandemic amplified these factors, increasing the unmet need for primary care.

Yet the pandemic also catalyzed the widespread adoption of telehealth and telehealth nursing. Telehealth encounters rose 766% in the first three months of the pandemic compared to the same period the previous year. Since 2020, telehealth has emerged as a vital force in health care delivery.  

How Has COVID-19 Transformed Nurse Practitioner Practice Authority?

The pandemic has also elevated the issue of nurse practitioner practice authority.

Some states issued executive orders to address the pandemic emergency, waiving or temporarily suspending legal barriers to full practice authority. This lifting of restrictions allowed nurse practitioners to temporarily practice with greater autonomy than previously authorized in their state.

Nurse practitioners made significant contributions to bridging gaps in primary care during the pandemic, both on the ground and through telehealth nursing. Some pandemic-era waivers were made permanent, and other states have adopted full practice authority since 2020. As a result, telehealth nursing is now a long-term solution in health care delivery. 
 

Read about COVID's Impact on Nurse Practitioner Practice Authority

How Did the Pandemic Redefine Telehealth Nursing Practice?

The pandemic also redefined telehealth nursing, elevating it as a core component of nursing practice.

In 2022, the American Association of Nurse Practitioners (AANP) released a new position statement on telehealth advocating for telehealth services to be “recognized, regulated and reimbursed on parity with the same services delivered in person.”

During the pandemic, AANP also released resources to help nurses adapt to rapidly evolving telehealth demands. This move highlighted the new knowledge and capabilities required for telehealth nursing, including:

• Billing and Insurance: Understanding Medicare, Medicaid and insurance payor telehealth coverage to communicate coverage options to patients
• Federal Guidance and Policy Updates: Staying current with changing telehealth consent laws, federal guidelines and regulatory changes
• Technical Proficiency: Developing the technical skills to operate telehealth technologies and address minor technical issues
• Mental Health Uses: Expanding competencies in delivering telebehavioral health services  

Benefits of Telehealth Nursing

Telehealth and telehealth nursing have numerous benefits for providers and patients, including improved health care access, cost and quality. 

How Does Telehealth Nursing Improve Health Care Access?

Telehealth provides millions of people with access to health care wherever they are. It extends beyond geographic reach and can improve access in rural and underserved areas.

According to the Centers for Disease Control and Prevention (CDC), telehealth enables medically and socially vulnerable populations to access health care providers and participate in the prevention and management of illnesses and diseases.

Telehealth is also crucial in meeting the growing consumer demand for health care. Increased health care spending can strain in-person health care settings, but telehealth provides access even as the volume of needed services increases. A 2024 report by health care consultant Sg2 estimates that approximately 23% of evaluation and management visits will be delivered virtually by 2034.

Through telehealth, health care providers can:

• Screen patients for symptoms  
• Provide remote medication consultations and assessments
• Provide remote access to mental and behavioral counseling
• Support patients with one or more chronic conditions
• Monitor clinical signs of existing medical conditions (e.g., blood pressure, blood glucose levels, etc.)
• Relay education to caregivers and patients

Telehealth and telehealth nursing help pave the way for essential health care and broaden the reach of health care systems. 

How Does Telehealth Nursing Increase Cost Efficiencies?

Cost is a significant barrier to accessing timely, essential health care for many Americans.

According to the Commonwealth Fund 2023 Health Care Affordability Survey, half of working-age U.S. adults reported that affording their health care costs was very or somewhat difficult. Nearly 40% said they delayed or skipped necessary health care or prescriptions in the past year due to cost.

Fortunately, telehealth can help reduce upfront health care costs. It also saves patients money by saving them time. Telehealth and telehealth nursing can reduce wait times, eliminate the need for commuting to in-person health care settings and minimize time away from work.

For example, telehealth use among $11,600 adults with cancer during the pandemic was associated with average cost savings of $147 to $186 per appointment.

By offering more accessible and efficient care, telehealth and telehealth nursing helps patients get necessary care with fewer financial burdens. 

How Does Telehealth Nursing Contribute to Quality Health Care?

The J.D. Power 2024 U.S. Telehealth Satisfaction Study shows that overall satisfaction with telehealth remains high. From 2023 to 2024, patient satisfaction with direct-to-consumer telehealth decreased by only one point, while patient satisfaction with payer-provided telehealth increased by 18 points.

According to the J.D. Power study, telehealth improves health care quality through greater convenience and efficiency. For example, telehealth provides immediate access to care for minor or urgent issues and simplifies follow-up and routine check-ins. Because telehealth is easier to access, it can also encourage patients to seek care sooner and more often, leading to earlier interventions.

Other research shows that telehealth and in-person care are comparable across many outcomes and clinical areas, supporting that telehealth and telehealth nursing can enhance access without compromising care quality. 

What Are the Potential Limitations of Telehealth Nursing?

Telehealth nursing presents unique challenges to health care delivery. Yet, it can be as effective as in-person care when FNPs commit to clear and compassionate communication, and following regulations, ethical standards and privacy and security rules. 

How Does Online Etiquette Affect Virtual Care Quality?

Many people are familiar with the phrase "bedside manner," which refers to how health care providers interact with their patients.

Telehealth has introduced a new phrase, "webside manner," which refers to how health care providers interact with their patients through technology such as video conferencing, email and telecommunications.

Whether an FNP delivers health care in-person or virtually, their ability to establish a trusting, collaborative relationship with patients and caregivers is fundamental to achieving positive outcomes.

Telehealth nursing can make it harder for FNPs to convey the warmth, trust and professionalism of in-person care. The potential challenges include:

• Lack of nonverbal cues that aid in emotional support and clinical assessment
• Environmental distractions that can affect the tone of the patient interaction
• Perceived impersonality from interacting with patients through a screen
• Technical disruptions that can interrupt the flow of conversation and appear disrespectful or inattentive

FNPs must consider the many factors contributing to telehealth etiquette to ensure successful encounters, including their own behavior, communication and the environment.

How Private and Secure is Telehealth Nursing?

Another potential limitation of telehealth and telehealth nursing is the need for enhanced privacy and security. Patient confidentiality is paramount, and the level of protection a health care setting uses could influence a patient's likelihood of using virtual care options.

The privacy and security essentials needed for a successful telehealth encounter include:

• HIPAA-compliant and secure platform
• Confirmation of patient consent for telehealth services
• Confirmation of patient identity
• Reassurance to patients of a secure visit environment
• Enclosed private space  

When delivering telehealth nursing, FNPs must be intentional with privacy and security to maintain high standards of care and professionalism. 

How Are Regulations Keeping Up with Telehealth Growth?

Telehealth regulations govern how health care professionals and systems can deliver services remotely using technology. They help ensure that patients receive safe and high-quality care.

In some cases, telehealth regulations are not evolving fast enough to keep pace with telehealth’s growing role in health care. Here are a few examples:

• Licensure: Nurses may be limited to practicing only in states where they are licensed, complicating cross-state virtual care.
• Temporary Waivers: Many regulatory flexibilities granted during the COVID-19 pandemic have ended or are uncertain, reducing access and flexibility.
• Reimbursement: Not all insurers reimburse telehealth nursing at the same rate as in-person care, which can limit adoption.
• Privacy and Security: Many telehealth platforms may not fully meet HIPAA standards.

Still, there is growing momentum to modernize telehealth regulations, which will pave the way for more patient-centered virtual care.  

What Are the Ethical Challenges of Telehealth Nursing?

According to the American Nurses Association (ANA) Core Principles on Connected Health, nursing care must be rooted in the Nurses Code of Ethics, regardless of delivery method. These ethical standards ensure that professional nursing practice provides lawful, evidence-based, high-quality personalized care.

The Core Principles on Connected Health are a guide to providing quality care for nurses who use connected health technologies. They call for nurses delivering care via telehealth to:

• Maintain professional standards virtually
• Protect patient privacy and confidentiality
• Preserve the nurse-patient relationship 
• Ensure informed consent and patient awareness
• Ensure safety, competence and accountability

Telehealth nursing requires focus on professionalism, patient trust, privacy and explicit consent. Nurses who adhere to these ethical standards provide consistent and compassionate care. 

Prepare to Define the Future of Primary Care with an Online MSN-FNP from Carson-Newman University

FNPs fulfill a critical need in today’s health care system. By becoming an FNP, you can help bridge gaps in primary care and provide comprehensive, patient-centered services to patients across the lifespan, in-person and virtually.

Carson-Newman University empowers working nurses to define their future as holistic and confident FNPs, ready to impact their communities. It offers two accredited online FNP programs—the MSN-FNP and Post-Master's FNP Certificate—that give registered nurses an affordable opportunity to expand their careers through primary care delivery.

As a student in Carson-Newman’s online MSN-FNP or Post-Master's FNP Certificate programs, you can benefit from:

• 100% online coursework (not including clinicals, residency and on-campus certification review)  
• Clinical placement support
• Support from the first day of class until graduation by a dedicated Student Success Advisor
• Savings of up to $200 per credit hour compared to nationwide competitors 

Are you ready to grow your autonomy in nursing? 

Learn more about our online MSN-FNP program or Post-Master's FNP Certificate program.