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A multiyear effort to pipe big-city mental health providers to rural communities over video accomplished a trifecta of telehealth victories: It reached people who wouldn’t otherwise have access to mental health care; it tackled difficult diagnoses that don’t have simple answers; and it stretched how many people the most skilled providers can treat.

Now comes the inevitable question that follows any technology breakthrough: Does it scale?

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Over a four-year span, a study led by researchers at the University of Washington sought to deliver treatment to rural patients with post-traumatic stress disorder and bipolar disorder, complex diagnoses for which treatment is often located hours away, if it’s accessible at all. Researchers connected psychiatrists and psychologists to primary care clinics within federally qualified health centers in three states that didn’t have any on staff.

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