Dartmouth Health expects to end its Tele-ICU and Tele-ED services, a move that would affect five Vermont hospitals and more across the region.
They “are two services whose costs, at our current scale, without external support, are simply unsustainable,” Audra Burns, a spokesperson for the New Hampshire-based health network, told VTDigger. The network, which has two affiliate hospitals in Vermont and its flagship academic medical center minutes across the border in Lebanon, New Hampshire, is the second-largest healthcare provider to Vermonters.
Burns declined to comment on how much the two services cost Dartmouth Health.
Tele-ICU and Tele-ED are two of the nearly 20 kinds of remote healthcare Dartmouth provides. Both are designed to give rural hospitals access to specialists at Dartmouth Hitchcock Medical Center.
A representative for Grace Cottage Hospital, in Townshend, which uses the Tele-ED services, confirmed that Dartmouth Health informed the Vermont hospital of its decision to close on Friday and is now working through the timeline of the closure.
The remote intensive care unit services connect Dartmouth’s intensive care physicians and critical care nurses with a patient’s bedside team, so rural hospitals can care for patients needing acute care and so clinicians can do more high-level, continuous monitoring. Dartmouth Health says the service reduces mortality rates and the length of stay in the ICU. The network also says it reduces the need for a patient to be transferred — allowing them to stay in a less-expensive local setting.
Northwestern Medical Center in St. Albans and Southwestern Vermont Medical Center, a Dartmouth affiliate in Bennington, both use the network’s Tele-ICU, according to materials Dartmouth Health shared with VTDigger in 2025. Dartmouth Hitchcock, in Lebanon, also uses its own service internally to help avoid staff burnout and improve safety and quality of patient care, the Tele-ICU medical director told the New Hampshire Union Leader when they launched the service line in 2019. Three other New Hampshire hospitals use Dartmouth Health’s Tele-ICU.
The remote emergency department services are meant to help providers with higher-level care and documentation as they transport an emergency patient, transfer a patient to a higher-acuity hospital or treat them in a smaller hospital setting.
In promotional materials, Dartmouth Health called the service “a life-saving connection.” The health network says it reduces transfers, staffing costs and the need for more expensive temporary clinicians. The network also says the service helps open up emergency department capacity.
In Vermont, Brattleboro Memorial Hospital, Grace Cottage Hospital in Townshend, Southwestern Vermont Medical Center and Mt. Ascutney Hospital and Health Center, a Dartmouth Health affiliate in Windsor, all use the service, according to Dartmouth Health’s 2025 list.
In May, Dartmouth Health reported an overall $63.5 million operating deficit, as expenses — things like staffing and pharmaceutical costs — outpaced the hospital’s revenue, the Valley News reported.
Burns cited these “significant financial challenges” as the push to evaluate the cost of continuing the Tele-ICU and Tele-ED services.
“External funding for these telehealth programs that often serve rural critical access hospitals, but rarely reach the scale to account for the 24/7 staffing required, is often critically scarce, yet is vital to maintaining these services,” she wrote in a statement to VTDigger.
“As the nation’s most rural academic medical center and health system, we are steadfast in our commitment to deliver exceptional care to the farthest corners of our service region. Our sustainability during challenging financial times will require changes and new approaches to this important care model,” she added.
Burns said the health network will “be working closely” with the hospitals that rely on these services to make sure that alternatives are in place before Dartmouth Health finalizes its closures.
This story will be updated.
