Advancing Health – Encore: Bridging Distances with AI and Telemedicine and Destigmatizing Mental Health for Health Care Workers

American Hospital Association | December 29, 2025

Episode Overview

This end-of-year encore episode of Advancing Health highlights two of the most impactful conversations from 2025:

1. “Bridging Distances with AI and Telemedicine” — A deep dive into how Sanford Health is harnessing innovation to serve rural communities, featuring Dr. Chris Di Rienzo (AHA Chief Physician Executive) and Dr. David Newman (Chief Medical Officer for Virtual Care, Sanford Health).
2. “Being Okay with Not Being: Destigmatizing Mental Health for Health Care Workers” — A candid discussion on barriers to mental health care for health workers, with Rebecca Chicky (AHA), Corey Feist (Dr. Lorna Breen Heroes’ Foundation), and Tiffany Little (Centra Health).

The episode explores the use of AI and telemedicine to address rural healthcare gaps and the ongoing fight against mental health stigma within the healthcare workforce.

Bridging Distances: Innovation in Rural Health

Dr. Chris Di Rienzo (B), Dr. David Newman (C) — [00:50–07:44]

The Rural Challenge at Sanford Health

• Sanford Health Profile: Largest rural healthcare system in the U.S., spanning from Wyoming to Michigan, serving widely dispersed populations, ranging from large hospitals to critical access centers, clinics, and nursing homes.
• Key Challenge: Insufficient providers for remote communities.

  “One thing that we don't have, though, is a problem that a lot of rural America has, is enough providers. We realize that we have to jump to innovative care models to survive…”
  — Dr. Newman [01:17]

A Day in Rural Medicine

• Extreme Distances: Patients often drive 400 miles one way for a 15-minute appointment.

• Provider Shortage: Dr. Newman is the sole andrologist in North Dakota.

  “I'm the only andrologist for the state of North Dakota... It is a 400 mile drive one way to get to see me.”
  — Dr. Newman [02:00]

• Obstacles for Patients: Weather, travel fatigue, childcare, multiple days away from home/work.

Virtual Care Innovations

• Avoiding Transfers: Used to be standard that children needing pediatric infectious disease consultations were transferred hundreds of miles to big hospitals.

  “...leveraging virtual care, we can beam our own providers, our own pediatric infectious disease doctors into their hospitals. We can keep the patient there. Sometimes you can just see how relieved the patients are…”
  — Dr. Newman [04:09]

• Hub-and-Spoke Virtual Model:

  • Patients can visit a local clinic, be “roomed” by a nurse, and connect to a specialist via video, with immediate access to labs and imaging.
  • Reduces fragmentation of care and unnecessary patient travel.

  “If they're not tech savvy, [patients] can go to the clinic...the provider beams into the room. So it's just like a normal visit.”
  — Dr. Newman [05:14]

Measuring Impact

• Real-World Example: Dickinson, ND—Kids with chronic conditions no longer need to drive 1,100 miles roundtrip.

  “Now maybe it's an hour’s drive from the ranch that they live to Dickinson rather than seven hours each way.”
  — Dr. Di Rienzo [04:36]

• Provider Buy-in & Patient-Centric Design: Building systems patients can access easily, with trusted local staff assisting.

Telemedicine's Spectrum and AI Integration

• Visit Types: At-home telemedicine works for many, but some cases require local clinical setups with virtual specialist guidance.

  “There are telemedicine visits you can do in a patient’s home...but these kinds of visits...you need really special setup.”
  — Dr. Di Rienzo [05:53]

• AI in Diabetes Care:

  • AI-driven insulin pumps paired with glucose sensors manage type 1 diabetes, drastically reducing the provider and patient time burden.
  • Transitioned from “clunky” hardware systems to seamless virtual, app-based management.

  “There is an artificial intelligence algorithm that tells you when you need more insulin and when you need less...it’s the easy button.”
  — Dr. Newman [06:41]

  “For a condition like type 1 diabetes...we have completely revolutionized it.”
  — Dr. Newman [07:25]

Destigmatizing Mental Health for Health Care Workers

Rebecca Chicky (E), Corey Feist (D), Tiffany Little (F) — [08:07–15:18]

Core Barriers to Mental Health Support

• Credentialing Fears: Health workers fear punitive consequences (loss of license/credentials) for seeking mental health care.

  “...overly invasive and really inappropriate questions that clinicians are asked about whether they've ever been diagnosed or treated for mental illness, whether they've gone to therapy...my sister-in-law was terrified...following a singular mental health episode.”
  — Corey Feist [08:31]

• Systemic Stigma: Many hospitals and boards include “have you ever” questions about treatment or diagnosis in credentialing, discouraging help-seeking.

National Advocacy & Change

• Lorna Breen Foundation Efforts:

  • Advocated for and achieved removal or revision of stigmatizing credentialing/licensing questions.
  • 1.5 million health workers now benefit from these policy changes.
  • Organizations awarded “All In Wellbeing First for Healthcare Champions” badges for making changes.

  “As I sit here with you today, there are 1.5 million health workers in the United States that are benefiting from the changes that we've made...”
  — Corey Feist [09:48]

• AHA Alignment: Suicide prevention guide spotlights fear of licensure loss as the primary driver of suicide in health workers.

  “The first one that you all identified is...concern around the loss of license and credentials associated with the stigma for mental health care.”
  — Corey Feist [10:14]

Statewide Support: "Caring for Caregivers" Initiatives

• Learning Collaboratives: Launched “Caring for Virginia’s Caregivers,” with similar programs in NC, NJ, WI, combining national resources with state-level implementation.
  • Three-phase approach: eliminate barriers, educate local teams, launch collaborative operational initiatives to address burnout.

  “Caring for Virginia's caregivers, caring for North Carolina's caregivers, caring for New Jersey's caregivers, and now caring for Wisconsin's caregivers are all efforts for us to take organizations through the phases of work from the Impact well Being guide.”
  — Corey Feist [11:42]

Centra Health’s Commitment: Leader Perspective

• Recognizing Wellbeing as Essential: Centra Health proactively prioritized workforce wellbeing pre-pandemic, identifying the crisis well before COVID-19.

• Data-Driven Approach:

  • Healthcare workers have higher rates of depression, suicidal ideation, biomarkers of stress, and substance use than general population.
  • Historically, minimal infrastructure to support staff mental health.

  “We had never provided healthcare workers with the avenues, tools, and support...to say, ‘Hey, we need help for coping with the very large burden of taking care of our communities...’”
  — Tiffany Little [13:13]

• COVID-19 Impact: Amplified need for support, preventing “compassion crisis” where emotional callouses replace caring.

  “When we tell people, you know, you have to be strong, you have to be confident...But we also have to deal with messy, beautiful situations of life and humanity. And that can take a toll on us. It can leave echoes and it can leave scars.”
  — Tiffany Little [14:16]

Memorable Moment: The “Code” Analogy

• Preparedness for Patient Emergencies vs. Self-Care:

  • Healthcare workers rigorously train for clinical emergencies but receive no training for self-care or mental resilience.

  “If you think about a code situation, we are practiced, rehearsed, we simulate it...What do we have in place for taking care of ourselves?...Nothing.”
  — Tiffany Little [14:32–14:48]

• Destigmatizing, Destabilizing Stigma: Finding and spreading practical tools through partnerships like the Lorna Breen Foundation is essential.

  “That’s been one of the most important parts of engaging in our healthcare workforce's well-being is destabilizing stigmatizing healthcare.”
  — Tiffany Little [15:17]

Notable Quotes & Timestamps

• “We realize that we have to jump to innovative care models to survive because our patients really need it.”
  — Dr. David Newman [01:17]

• “I'm the only andrologist for the state of North Dakota...It is a 400 mile drive one way to get to see me.”
  — Dr. David Newman [02:00]

• “…leveraging virtual care, we can beam our own providers...into their hospitals. We can keep the patient there...they’re not going to have to be transferred and...still get...high quality specialty care in their hometown hospital.”
  — Dr. David Newman [04:09]

• “There is an artificial intelligence algorithm that tells you when you need more insulin and when you need less insulin and it will do it for you...it's the easy button.”
  — Dr. David Newman [06:41]

• “These mostly appear in the form of overly invasive and really inappropriate questions that clinicians are asked about whether they’ve ever been diagnosed or treated for mental illness...my sister-in-law was terrified...”
  — Corey Feist [08:31]

• “As I sit here with you today, there are 1.5 million health workers in the United States that are benefiting from the changes that we've made…”
  — Corey Feist [09:48]

• “...healthcare workers were far more likely to suffer from depression, to have thoughts of suicidal ideation...but we had never provided healthcare workers with the avenues, tools and support that they needed to be able to speak up...”
  — Tiffany Little [13:14]

• “If you think about a code situation, we are practiced, rehearsed, we simulate it...What do we have in place for taking care of ourselves?...Nothing.”
  — Tiffany Little [14:32–14:48]

Timeline of Key Segments

• [00:50–07:44] — Rural innovation at Sanford Health: telemedicine, AI, case studies
• [08:07–15:18] — Destigmatizing mental health: credentialing reforms, national/state initiatives, lived leader experiences

Tone & Language

The conversation is candid, compassionate, and deeply rooted in both the practical realities of rural healthcare and the emotional, systemic challenges faced by the health workforce. Dr. Newman brings a mix of humility and urgency to discussions of innovation; the segment on mental health balances direct personal testimony with hope and policy progress.

Conclusion

This episode underscores the dual imperatives of leveraging technology to bridge gaps in access and of fostering supportive, stigma-free environments for health workers. From virtual diabetes care to trauma-informed mental health advocacy, Advancing Health shines a light on the creativity, humanity, and shared resolve driving healthcare forward.