Dilemmas in Telehealth
Credit: nursingschoolsnearme.com/
Credit: nursingschoolsnearme.com/
In an August 22, 2025 decision, the U.S. District Court, Northern District of Illinois, Eastern Division, granted Defendants’ motion to dismiss.
The Illinois Nurses Association (Association) represented registered nurses in Illinois and sued a number of officials and employees of the University of Illinois Hospital (Defendants), alleging that nurse members were instructed to provide nursing care across state lines in violation of state laws. The Defendants comprise a large hospital system and provide complex medical services, including organ transplants and delivery of pre-and post-care for patients even when no longer present in the hospital. Failure to provide after-care could have significantly negative results for the patient. Thus, nurses in the Hospital provided telephonic and web-based follow-up care for patients and may not have known where the patient was located, as the Hospital did not require patients to disclose their physical location.
Member nurses of the Association working in the Hospital repeatedly notified their supervisors that this approach to telehealth could expose them to liability, as providing care to out-of-state patients is unlawful in many states. The Association learned that “the Hospital provided care to 4,099 unique patients who did not have an Illinois address” between 2023 and 2024. When a nurse refused an out-of-state telehealth assignment, the nurse would be subject to discipline under the policies of the Hospital and with the state licensing agency. Attempts to change the Hospital policy were unsuccessful prior to the lawsuit, and the Association argued that ignorance is not a defense of liability for the nurse members. However, the Hospital did provide a guidance letter to nurses noting that there was no requirement to ask where the patient was located for telephone calls or web-based communications.
Here, the Court considered the arguments of Defendants: 1) the Association lacked standing to bring the suit; 2) the Association has not identified a liberty interest to support the Section 1983 claim; and 3) no actual case or controversy existed to support a declaratory judgment. The Court determined that the Association did establish standing, given the Association represented members that would have the ability to sue in their own right and face an actual risk of harm given the dilemma they faced of either violating state law or violating ethical and professional obligations if they refused treatment. However, the Court also determined the Association failed to establish a “deprivation of its members’ liberty interest” under the 1983 claim. Specifically, “it is the liberty to pursue a calling or occupation” that is secured by the 14th Amendment. While the nurses may have faced discipline or termination, the Association had not established that any nurse would be excluded from the occupation of nursing as a result, and thus no liberty interest had been identified.
Motion to dismiss granted with prejudice, leave to Association to cure the pleading and jurisdictional deficiencies.