The future is smaller than you might have thought. Sure, it’s kinda sci-fi, with the ability to listen to heartbeats and look into people’s ears through a tablet and all, but the gear to do so could fit into cash register drawer with plenty of room left for actual cash -- if anyone still used cash, of course.
Telehealth enables this easily bundled future. Schools that use telehealth through their nurse’s offices pack heartbeat monitors and those little ear cone thingies and tongue depressors into a little box, and when a student comes in with a sore throat or a headache, a nurse can hook the gear into a tablet and feed real-time data to a doctor who is … somewhere.
And telehealth certainly opens the door for people not in school to get medical care remotely too. It’s advantage is immediate for people living in rural areas where certain kinds of doctors might not be; for small hospitals and medical practices that can’t afford to keep medical professionals on staff; for parents who can’t easily leave work to get their kids from school to a hospital; for city dwellers who have trouble getting around.
Since legislation established the South Carolina Telehealth Alliance, through MUSC in Charleston, in 2014, the presence of telehealth has grown to encompass more of the state by the year. Covid, of course, ramped up the need for telehealth visits.
The frequency of those visits ebbed as the pandemic cooled. But, says Telehealth Alliance Director Sonya Ebeling, “we still see much more elevated levels of telehealth than pre-pandemic. It’s clearly integrated into a hybrid care delivery.”
One area that’s clearly benefitted from the presence of telehealth is mental health treatment.
In 2025, Mental Health America ranked South Carolina 39th in the nation, on 17 markers, for mental healthcare. That’s a bit of an average of MHA’s rankings for care of youth (43rd) and adults (23rd), plus its ranking for the prevalence of mental health issues (8th). The last shows that South Carolina has fewer mental health issues than 42 other states, plus D.C.
But MHA also found that for South Carolinians who do seek mental healthcare, their state ranks 49th, only better than Texas and Alabama for mental healthcare access.
Ranking nearly last for access suggests telehealth is a key answer. For Dana Rideout, a licensed professional counselor in Aiken, telehealth does offer its advantages.
“[It’s] been helpful … being able to see some folks that ordinarily couldn't get here,” Rideout says. “Let's say from Orangeburg County, because I do a fair amount, especially with first responders, in that county. When they can't make it to Aiken, then we can use telehealth, and that's been successful for them.”
Conducting a teletherapy session also lets therapists see something they don’t always get -- how a patient lives in their own space.
“ You do get a chance to see a little bit, if they don't blur out their background, kind of where they're at, how messy is their desk at home,” Rideout says.
And that can be extremely useful in guiding her care.
“They may not even know that that might actually impact their nervous system,” she says of clutter and noise in the home. “There are some … things in their environment that might be contributing to some of their angst.”
The other side of all this is that telehealth can seem impersonal. Rideout says she and all (actually all) of her patients prefer to meet in person, rather than on a screen. She finds that her patients’ walks, their body postures, their demeanors in her office tell her a lot about their emotional states.
She also doesn’t like that when a patient is home, there might be someone else in the house.
“Even if they tell me, ‘Oh, and you can say anything, they won't mind," I'm not super comfortable with that,” she says.
Moreover, she says therapy can bring up a lot of emotions that she doesn’t want to leave someone with in their home.
“The memories, the stories, the vibrations that get created in a session, I don't want that in their space,” she says. “That's supposed to be here. And I tell them, ‘I clean that up. I know how to handle that, and you just leave that here.’”
But Rideout does understand the value of telehealth and says that more therapists, even those who exclusively do teletherapy, are needed in South Carolina. And, she says, changes to licensure requirements could be a start. A therapist with a license in South Carolina is not allowed to treat anyone who is not physically present in South Carolina, even if the patient is an existing one. Rideout would like to see that opened up a little.
She would also like to see better connectivity for more remote parts of South Carolina, where getting online to talk to a therapist can be blocky and glitchy.
Ebeling, for her part, would like to see better connectivity too. She would also like to find the right uses for AI in telehealth treatment.
“ It’s something that like we think about all the time in the telehealth world,” she says. “Like, how do we think about AI and how can we leverage this as a tool, but also be very cautious and have guardrails.”
One great use of AI would be paperwork, Ebeling says -- using technology for things like pre-visit questionnaires and processing payments. But certainly not replacing people who, even via screen, are there for patients.
And even though AI looms large in conversations about the near future, Ebeling says the Telehealth Alliance is more concerned at the moment with reaching people who don’t have an easy time physically getting to a doctor and who might not be so comfortable with technology.
“ I think of what we're working on with our expansion and access to our rural and underserved communities,” she says, “Just a comfort level more generally with a smartphone, with an email address. The computer basics and things like that in order to have people become more comfortable with the idea that healthcare could be delivered in a virtual way.”
