How Early Collaboration, and NASA, Helped Launch Telehealth in Virginia
To help celebrate VTN’s 20th anniversary of advancing telehealth across Virginia, we’re continuing our blog series highlighting founding board members whose early work shaped the organization’s direction.
We spoke with Azhar Rafiq, M.D., MBA, MEd, who spent much of his career at Virginia Commonwealth School of Medicine before retiring from his faculty role. Prior to his time at VCU, Dr. Rafiq served as the Director of Health Informatics within NASA’s Office of the Chief Health and Medical Officer and the Information System Security Officer for NASA’s agency‑wide Electronic Health Record System (EHRS). His career includes nearly 100 peer‑reviewed publications, global telemedicine initiatives, and award‑winning federal research programs.
The Academic Roots of Telehealth in Virginia
In the earliest days of telehealth, Virginia’s academic medical centers were exploring the field independently, each experimenting with what “telemedicine” meant before policy, reimbursement, or legislation entered the conversation.
At VCU School of Medicine, Dr. Rafiq and his mentor focused on developing communication platforms and working to apply it within the confines of VCU.
UVA was doing the same, approaching vendors like Polycom from different angles and sharing lessons learned through an emerging statewide collaboration.
These early exchanges helped unify Virginia’s academic telehealth efforts and laid the foundation for what would eventually become VTN.
NASA’s Influence on Telehealth Innovation
A defining thread in Dr. Rafiq’s career was NASA’s investment in telehealth research. As part of a multimillion dollar federal program, his team developed technologies to monitor astronauts in the International Space Station and remote field simulations.
“Telehealth started with astronaut care,” he said. “The whole concept of astronauts being up in the International Space Station, communicating by radio and addressing their care.”
Under the Medical Informatics and Technology Application Consortium, Rafiq’s team expanded these capabilities to disaster response, global health initiatives, and military partnerships. One of the most striking examples was their deployment to Pakistan following a major earthquake, where Dr. Rafiq coordinated donated equipment, trained local clinicians, and delivered telehealth support across time zones.
Locally, Dr. Rafiq helped establish VCU’s telemedicine program, connecting satellite clinics across Virginia, from the Eastern Shore to Southside, while also championing mental health access. At Petersburg’s Pathways Clinic, he secured free telehealth software and recruited volunteer psychiatrists from Richmond to serve patients weekly.
Pivotal Moments in VTN’s Work
For Dr. Rafiq, one of VTN’s most significant milestones was its shift from technology‑focused collaboration to the legislative side. In the early years — and still today — VTN intentionally avoided vendor influence to keep the focus on shared learning rather than equipment promotion. As telehealth matured, reimbursement emerged as a critical barrier for providers, prompting VTN to expand its advocacy efforts
Over time, that advocacy has grown to support the development of policies, programs, and care models that make telehealth possible in more settings and help address access challenges across Virginia. As Dr. Rafiq noted, reimbursement will always remain a key issue for providers, making VTN’s role even more important.
The Next Frontier for Telemedicine
Dr. Rafiq describes the pandemic as a catalyst that accelerated telehealth adoption across the country. Health systems realized they needed virtual care to maintain patient engagement and revenue. Platforms like Zoom and Teams became essential tools, and electronic health record systems evolved rapidly to support remote workflows.
Demographic shifts are now a major driver of telehealth innovation. As more seniors prefer to age at home instead of a facility, medical centers are revisiting house calls and developing hybrid care models that blend virtual and in-person support. Medical centers must determine how virtual care fits into long‑term patient management and how to use it effectively.
Community Impact
The last two decades have shown how quickly telehealth can advance. As Virginia faces new challenges and opportunities, VTN will continue championing access, equity, and innovation across the Commonwealth. Leaders like Dr. Rafiq remind us how foundational research and collaboration can shape the future of care. Your support helps VTN advance telehealth through education, innovation, and advocacy.
Donate today to help ensure every Virginian has access to high-quality care.