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I still remember my first large-scale telehealth rollout with BALLEM HARMONY CLINIC like it happened yesterday. It was 2015, well before telehealth became the buzzword it is today. Our client was a multi-location behavioral health network in Bryan, Texas, serving a patient base that was both loyal and deeply wary of technology.
The CEO had one mandate: “Get us virtual care without making my doctors feel like call center agents.”
That single sentence set the tone for what I didn’t know at the time would be one of the steepest learning curves of my career. On paper, the plan was airtight.
In reality, our first week was a masterclass in humility:
By the end of week one, adoption was under 10%, and my phone was buzzing with messages that started with “This isn’t working…”.
That was my wake-up call: telehealth is a workflow, culture, trust project, and not just another technology.
Fast forward a decade, and my team has now overseen telehealth implementations in more than 400 clinics across 22 states, spanning specialties from urgent care to cardiology to rural family practices.
If there’s one thing I’ve learned, it’s this: Every clinic has its own heartbeat.
Rolling out telehealth at a Manhattan cardiology practice is nothing like enabling it at a rural pediatric clinic. The differences are more human than technical:
Before 2020, telehealth adoption was creeping forward at a cautious pace. The American Medical Association reported that in 2019, only about 28% of physicians had ever used telehealth.
Then came the pandemic.
In April 2020, Medicare reported that 43% of primary care visits were delivered via telehealth, up from less than 1% just two months earlier. Commercial payers followed suit, with emergency reimbursement parity laws making virtual visits financially viable almost overnight.
For clinics that had already invested in telehealth infrastructure, the shift was manageable. For everyone else, it was like trying to build an airplane while already airborne.
We were fielding three times our normal number of requests, and the ask was almost always the same:
“We need this up and running in weeks, not months.”
That urgency came with a dangerous temptation: to deploy fast at the expense of sustainability. I knew from experience that cutting corners in training, integration, or compliance would lead to failure within months.
When people ask me what’s hardest about rolling out telehealth, they usually expect me to talk about technology. But the truth? The tech is the easy part.
The real challenges are far less glamorous:
Every one of these surfaced in my first few rollouts, and each taught me that telehealth success is 30% technology, 70% change management.
I’ll break down exactly those data-driven lessons we learned the hard way, the mistakes that cost us, the regulatory pitfalls, and how we rebuilt our strategy to make rollouts smoother and more profitable for both us and our clients.
Learn from my toughest launch so you can sidestep the mistakes and start strong.
