Telemedicine—remote provision of clinical services through the use of digital technologies—has the potential of significantly improving access to healthcare in rural areas across several low- and middle-income countries. However, evidence regarding the impact of this new channel of healthcare delivery on access and health outcomes is sparse. We contribute to this important and emerging stream of literature by studying the impact of introduction of telemedicine-equipped “vision centers” that are connected to a tertiary care “base hospital” in one of the world’s largest eye care networks situated in South India. analyzing data on more than 2.5 million visits over a period of 10 years from. We exploit spatiotemporal variation in the opening of the vision centers using quasi-experimental difference-in-differences approach to estimate the impact on multiple outcomes including patient visit volumes to this new channel as well as existing healthcare facilities, revenues and patient outcomes. We find that vision centers substantially improve access to care, leading to a 16% increase in patient visits, of which more than 90% are from simple patients (refractive errors, cataracts, general check-ups). We do not find significant evidence for corresponding reduction in hospital visits by patients with simple needs or an increase in visits by patients with complex needs. These findings suggest that the new channel is perhaps used as an additional point of access by patients but is not very effective in its potential role as gate keeping, i.e., to facilitate substitution of simple patient visits away from the base hospital and referral of complex patients toward the base hospital. These results highlight multifaceted and a heterogenous impact the new healthcare delivery channel and have important implications for management of multi-channel healthcare networks.