“Interstate telehealth could be lifesaver for Maui patients.”

by Malia Hill, Grassroot Institute, July 31, 2025

Certain things are just a part of living on Maui — such as the fact that what you need isn’t always readily available.

You might have to wait for the hardware store to restock the right screws, or for the grocery store to get a new shipment of spices. It’s a trade-off that comes with life in paradise. Most of the time, it’s just a mild inconvenience.

But sometimes it can be a matter of life or death.

If, God forbid, you need to see a medical specialist, you have to hope there is one on-island with an open appointment before it’s too late. Or maybe you could spend a bunch of money and time to travel to Honolulu and visit the doctor you need to see there — assuming there is one in Honolulu.

But what if you found the perfect specialist on the mainland — someone with years of expertise, who maybe has even written about your condition in medical journals or taught classes about it? That doctor isn’t in Hawaiʻi, but his office would be happy to consult with you via Zoom or some other video and audio-conferencing platform to help you determine what might be the best course of treatment for your particular life-threatening condition.

That would be good, right?

Well, yes, except Hawaiʻi law currently forbids that. Regardless of how qualified they might be, out-of-state doctors are not allowed to provide telehealth services to patients in Hawaiʻi unless they are also licensed to practice in Hawaiʻi.

Who is this helping? Definitely not patients on Maui who already are suffering because of Hawaiʻi’s acute physician shortage and have long had to deal with serious gaps in specialty care.

All things considered, it seems the sensible move would be for Hawaiʻi lawmakers to allow residents on Maui, and throughout the state, to obtain telehealth services from licensed providers elsewhere in the U.S.

As I explained in a recent white paper issued by the Grassroot Institute of Hawaiʻi, there are multiple ways this unnecessary barrier to healthcare access could be removed without endangering public health or safety.

In fact, the state already did this during the COVID-19 crisis, when cross-border telehealth was allowed nationwide. What’s more, studies of telehealth services show they do not hinder healthcare outcomes. In some circumstances, they can reduce costs and unnecessary hospitalizations while providing care comparable to in-person visits.

Research also shows that interstate telehealth can be especially beneficial for patients living in rural areas and those in need of specialty care.

In other words, Maui residents could really use access to interstate telehealth. 

Twenty-seven other states already have implemented some kind of exception or alternative to full licensure for out-of-state telehealth providers without any negative effects. Hawaiʻi would do well to join them.

Given Hawaiʻi’s geographic challenges, we should be asking why we haven’t put more resources into telehealth access. Interstate telehealth wouldn’t solve all of Hawaiʻi’s healthcare woes, but it would help — especially for vulnerable patients on Maui and other neighbor islands.

For those unable to see doctors and specialists without flying to the mainland, it could be a lifesaver.