A Laboratory and a Lighthouse—a Conversation With Dr Saurabh Chandra of UMMC

Saurabh Chandra, MD, is the chief telehealth officer at the University of Mississippi Medical Center (UMMC), based in Jackson, Mississippi.

Q: Can you give us a summary of your background, and what brought you to your current position at UMMC?

A: I grew up in India and attended medical school there before coming to the United States for advanced training and completed my critical care fellowship at the University of Pittsburgh Medical Center. I then worked as an intensivist in Cincinnati, Ohio, where I was first introduced to tele-ICU. Like many clinicians, I was initially skeptical about using telehealth to care for acutely ill patients. But I remember being told, “Come do a few shifts. If you don't like it, we're not going to ask you to do more.” I also remember that it was a night shift, and I was working in a hub connected to a very busy ICU, with residents and nurses on the other end. It was truly an “aha” moment, because at the bedside I focus on one patient at a time, whereas across the camera in the hub I could see the entire ICU. With so much data and information flowing, I could contribute meaningfully not only to patient care but also to supporting the bedside team. It was a powerful learning moment for me.

From there, I was fortunate to be hired to develop a tele-ICU program at Northwell Health in New York. I arrived in 2014 and spent six terrific years there. I served as the enterprise-wide medical director for tele-ICU/telehealth, and we built numerous programs for inpatient care. I also had the privilege of setting up their tele–critical care response to the COVID-19 pandemic starting in 2020.

What ultimately brought me to UMMC was that, until then, most of my work had been in urban settings, and I wanted to move to a more rural and underserved area where we could truly demonstrate the value of telehealth. So, I made the transition in August 2020 and was fortunate to be invited to lead the Center for Telehealth at UMMC, which has a rich, 20-year history of using telehealth.

Q: I do not come across a lot of chief telehealth officers. In terms of governance, how does your role interact with the other leaders across UMMC?

A: The creation of the chief telehealth officer position was intentional—it elevated the role across the enterprise and placed it on par with other senior leaders such as the CIO and CMIO.

Equally important, my position now reports directly to the associate vice chancellor for health affairs, who in practical terms is the second in command at UMMC. This reporting structure provides the support and guidance from the top leadership at UMMC, which in turn empowers me to align telehealth with the strategic vision of the leadership and work across the entire health system to create opportunities for expanding telehealth.

The timing of this change was critical, coming on the heels of the pandemic, and it established the governance structure necessary for success. It has created direct pathways to engage leaders across the system and has given me the access needed to build strong, collaborative relationships to advance our telehealth mission.

Q: UMMC was designated as a Telehealth Center of Excellence back in 2017, alongside the Medical University of South Carolina. What does that mean in practice for your organization?

A: At that time, the vision was to bring forward academic medical centers with a proven track record of building telehealth programs that serve rural and underserved communities. It was both an honor and a privilege for UMMC to be designated as one of only two Telehealth Centers of Excellence in the nation. In practice, this designation positions us as a national leader in telehealth innovation and research. It provides us with resources not only to expand access to care in rural and underserved areas across the country, but also to generate evidence, establish best practices and create scalable models that can be replicated nationwide.

One example is our tele-emergency program, where UMMC emergency physicians provide real-time consultations to critical access hospitals across rural parts of the state. We advanced this model further by rigorously studying its impact and publishing research showing that it improves patient outcomes while also strengthening the financial viability of rural hospitals. This paradigm has since been adopted in other states across the country.

As a Telehealth Center of Excellence, I see our role as being both a laboratory and a lighthouse—we develop new innovative models, do rigorous analysis, and then we publish that work and disseminate that information to guide others around the country to be successful in implementing their own programs.

Q: We are now five years out from the 2020 pandemic. There has been a lot of debate around the use of virtual care, particularly around its clinical appropriateness. From your viewpoint as a physician, what is that optimal balance of virtual and in-person care?

A: During the pandemic, health care delivery pivoted rapidly to telehealth. At that time, the priority was providing immediate access to care while in-person services were shut down. Many programs were launched quickly, often without a framework to evaluate quality or long-term effectiveness. Still, as a modality for maintaining access and continuity of care during that crisis, telehealth was phenomenal.

As the system matured, important questions emerged: what is the quality of care delivered through telehealth? What is its true impact on cost? In which settings does it work best? Is it a substitute for in-person care, or does it function best as a supplement? These remain valid debates today.

What we and many other health systems have come to recognize is that the strongest results come not from treating telehealth as a standalone silo, but from integrating it into hybrid models. When virtual care and in-person care are woven together based on specific care gaps, adoption is higher, outcomes are better and workflows are more seamless. These models are not one-size-fits-all—they must be carefully designed to address the unique challenges of each organization.

We’ve seen strong examples of this in practice. At South Central Regional Medical Center in Mississippi, a neurologist left, leaving only one neurologist to serve the entire hospital. Their options were either to limit neurology services or partner with us. Together, we built a hybrid model where some patients are seen in person by the local neurologist, while others are cared for via telehealth by our specialists at UMMC. Our data show that outcomes are comparable between telehealth and in-person visits, while the hospital has been able to sustain its services.

Another case involves a pediatric surgeon who noticed that many post-operative visits were brief, 15-minute check-ins, yet families were driving 100 miles or more for these appointments. Transitioning those follow-ups to telehealth preserved care quality while saving patients time and cost.

These examples underscore the lesson that hybrid care is the way forward. But the starting point should always be a clear understanding of the care gap you’re trying to solve. That is where telehealth can truly add value—by extending reach, improving continuity and making care more patient-centered.

Q: Another big factor has been the shifting regulatory and reimbursement landscape. Since the pandemic, we’ve had several waivers that eased restrictions around telehealth use and payment, but as of this interview they are still only in place temporarily unless Congress says otherwise. It seems to me that many hospitals feel stuck here because they're not sure if they can support a viable telehealth program without firmer ground to stand on. How do you feel a health system can future-proof virtual care programs amid all this uncertainty?

A: You are absolutely right. The uncertainty around federal flexibilities and not knowing how long they would remain in place has led many health systems to treat telehealth primarily as an emergency response to the pandemic. That uncertainty has discouraged durable investments and prevented telehealth from being fully embraced as a permanent model of care. This has been detrimental to widespread adoption and utilization.

When we talk about future-proofing telehealth, the path forward requires alignment across multiple stakeholders: payers, regulatory agencies including state legislatures, internal leadership and consumers.

We need to move beyond fee-for-service reimbursement and accelerate the shift toward value-based care. The evidence is compelling, particularly in chronic disease management; with conditions like hypertension and diabetes, remote patient monitoring programs have demonstrated outstanding results in improving outcomes while reducing costs. Payers benefit, patients benefit and health systems strengthen long-term sustainability.

Even when reimbursement is available, it doesn’t always translate into coverage and payment parity for telehealth. Working with state legislatures is critical to enshrine parity statutes that reflect telehealth’s value and ensure providers are not penalized for offering virtual services.

We must also explore alternative models. For instance, in our state we provide behavioral health services to public university students. We are working with institutions to consider subscription models for low-cost, scalable approaches that reduce financial burden for students and families while sustaining access to care. Other telehealth innovations are proving so effective that they should be considered the new standard. Our virtual nursing program at UMMC is a strong example. Early results show high patient satisfaction, improved care quality and dramatic reductions in nursing turnover. Units implementing virtual nursing report some of the highest employee engagement scores across the system. While there are upfront costs, the return in workforce retention and patient outcomes is undeniable.

At the core of all these approaches is one essential principle: data, data, data. To win support from payers, legislators or internal leadership, we must rigorously measure outcomes and [key performance indicators]—whether that’s clinical quality, patient satisfaction, workforce retention or cost savings. Reliable data is the most powerful tool we have to demonstrate telehealth’s value and secure its place as an integral part of health care delivery.

Q: Let’s pivot to talk about some supplemental technologies that could impact virtual care. There are digital therapeutics, consumer wearables, extended reality technologies and the rise of generative AI like ChatGPT. How do you see telehealth integrating with these different advancements, especially given the growing focus of direct-to-consumer care models and home-based care? Do you see this as a net positive, or do you have some concerns around these trends?

A: We are very excited about the range of technologies shaping the future of health care, and we believe telehealth should no longer be limited to audio, video and store-and-forward modalities. Telehealth must broaden in scope, integrating emerging technologies to achieve the best outcomes for patients. Reflecting this vision, we recently renamed our program from the Center for Telehealth to the Center for Telehealth and Emerging Technologies—a clear recognition of the value these innovations bring in enhancing care delivery.

Like many others, we are intrigued by the potential of artificial intelligence, though we are mindful of the risks. Our approach has been careful and responsible, acknowledging that AI applications fall across a spectrum of risk levels. For lower-risk use cases, one of the areas we’ve focused on is the use of AI scribes in telehealth encounters. While there is published research on AI scribes for in-person care, there is far less data on how they might improve the telehealth experience. Our hypothesis is that AI scribes can help address some of the long-standing challenges with patient-clinician engagement during virtual visits. Early results have been promising, and we are in the process of publishing our findings.

Overall, we are optimistic about the future. We see virtual care programs evolving as these different components (eg, traditional telehealth, AI, other emerging technologies) merge to create greater value for patients, providers and health systems. That is the direction the field is heading, and it is the path we are committed to at UMMC.

This blog post is part of an ongoing Q&A series with digital health leaders at organizations across the US. These in-depth interviews aim to provide real-world perspective and insights in this rapidly evolving space. Don’t miss the other blogs in the series, found here.

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