Study: Hospitals' telehealth scale indicates digital readiness for AI

Recent research reveals that telehealth capacity could serve as a marker of hospitals' broader digital readiness for AI adoption. However, the study could not establish whether telehealth expansion precedes or causes AI adoption.

Published in the Journal of Medical Internet Research, the study sought to determine whether having scaled telehealth operations is associated with the adoption of operational and clinical AI in U.S. hospitals. The study authors noted that telehealth and AI adoption both require a "foundation of digital infrastructure, data availability, workflow integration, and organizational capacity." Thus, they posited that there may be a relationship between the scale of telehealth operations and hospital AI maturity.   

The retrospective cross-sectional study included data from 6,173 U.S. acute care hospitals represented in the 2024 American Hospital Association Annual Survey and AHA Information Technology Supplement, as well as 2023 Healthcare Cost Report Information System datasets.

The hospitals were stratified by clinical AI adoption tiers: 3,441 (55.7%) were classified as tier 0, 1,544 (25%) as tier 1 and 1188 (19.2%) as tier 2. Clinical AI adoption scores increased from a median of zero among tier 0 hospitals to 22 among tier 2 hospitals, while operational AI scores increased from zero to 14. Telehealth volume increased in parallel, the research shows.

Further, the study revealed that 57% of hospitals did not report telehealth volume, and a vast majority of these hospitals (91.4%) were concentrated in clinical AI adoption tier 0. Hospitals that did not report telehealth volume were uncommon in tier 2.

"In this national cross-sectional study of US hospitals, telehealth scale was strongly associated with hospital AI adoption tiers, with a particularly strong relationship for clinical AI," the researchers concluded.

The study also found that rural hospitals had weaker associations between telehealth scale and clinical AI patterns than metropolitan hospitals with similar telehealth volumes.

"From a digital health and health informatics perspective, the results indicate that equitable AI adoption may depend not only on access to AI tools themselves but also on the organizational and infrastructural conditions that support digital care delivery," the study authors stated.

However, the study has several limitations, including the cross-sectional design, which does not establish a causal relationship between the telehealth scale and AI adoption. So, while the research shows that telehealth scale and AI adoption grow together, it does not determine whether one causes the other.

The research comes as health AI utilization skyrockets nationwide. AI utilization among 3,151 surveyed physicians jumped from 47% in April 2025 to 63% in January 2026, according to survey results released earlier this year. About a third of the physicians (31%) who were not using AI in January 2026 said they were interested in using the technology.

Not only that, but AI is increasingly being integrated into virtual care, including telehealth. AI-driven tools are being used to enhance telehealth intake assessments, provide clinical decision support during virtual visits and personalize at-home treatments.

As the trajectories of AI and telehealth become increasingly intertwined, the study provides a deeper understanding of how these digital health modalities impact one another.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers healthcare IT and innovation, including artificial intelligence, digital healthcare, EHRs and interoperability.