Prior to the pandemic, telehealth felt a little like a pipe dream—even if your medical provider offered it, your insurance company might not have offered coverage. Then the United States was hit by COVID-19, and telemedicine skyrocketed.
Now if you start feeling achy and notice you have a sore throat, you can call your doctor's office and schedule a video or phone appointment. You no longer need to sit in a waiting room among other coughing, sniffling patients; you can have a virtual consult with your medical provider and get a prescription sent to your pharmacy in the time it would've taken you to get dressed and pull out of your driveway.
Perhaps the biggest benefit of the telehealth explosion: With the pandemic continuing into 2021, virtual medicine allows you see your providers without leaving your home. No more worries about masking up and social distancing to prevent the spread of infection.
"The quote I like to cite is that we advanced 10 years in telehealth progress in the course of 10 weeks, and it's pretty accurate," Colin Banas, MD, chief medical officer of health care software company DrFirst, which helps connect patients to health care providers, tells Health. "I think a lot of this would have taken a lot longer had it not been for the crisis."
Telemedicine is clearly a hit with patients. In April, 44% of Medicare primary care visits were done via telehealth, compared with less than one percent (0.1%) in February before the COVID-19 public health emergency, according to the US Department of Health and Human Services. Both rural and urban counties nationwide saw upticks in telehealth adoption and usage, and even after Medicare resumed in-person primary care visits last May, demand for telehealth stayed steady. One 2020 report from the health care network Doximity estimated that 20% of all medical visits last year were conducted via phone or video.
"What we saw during COVID was a real shift from the in-person visit to the phone visit and video visit with patients," Mary Oseid, senior vice president of regional strategy and operations of Dartmouth-Hitchcock Health, a health system in New Hampshire, tells Health. "We did that out of necessity—we closed our hospitals, but we still needed to care for our patients, so we started seeing them through these other means. And we're seeing that continuing."
It's no surprise, then, that the business side of telehealth is also booming, with companies in the sector reporting rapid growth and a meteoric rise in revenues. Teladoc Health, a telemedicine and virtual health care company that was clocking more than 20,000 virtual medical visits per day in the US prior to the pandemic, saw visits in the first quarter of 2020 shoot to 2 million, a 92% increase. San Francisco-based telehealth platform 1Life Healthcare reported a 25% increase in membership during the same period.
While telemedicine isn't new, this widespread use of it—and the development of new technologies that expand its capabilities—are changing the way medicine works. Here's what wellness currently looks like, and what the future might hold, in the telemedicine era.
Previously, health care was time-consuming: You had to get to your provider, sit in a waiting room, and then watch the clock tick away in the exam room. The process could be frustrating, especially if you knew you had something straightforward that could be solved by a quick prescription. Telehealth, on the other hand, can reduce a routine visit to exactly what you want: one-on-one time with your doctor.
"Over the holidays, I had vertigo, and I didn't want to leave the house," Oseid says. "I was sick, I felt crummy, and telehealth was a great opportunity for me to see my provider at home and be comfortable."
Telehealth also comes in handy for people with chronic conditions, who often need regular in-person visits with multiple doctors. "My quarterly oncology appointment usually takes half a day between travel time, bloodwork, two injections, and a conversation with my oncologist," says Sally Wolf, a wellness entrepreneur in New York City who is living with metastatic breast cancer. "During COVID, most of the doctor discussions were moved to telehealth, so the only things that required an in-person visit were the bloodwork and injections, thereby minimizing my time inside the facility."
It's especially convenient for parents who may not want to cart a sick kid to a medical facility. Jamie Hickey recalls how nice it was to keep his 9-year-old daughter at home for a telehealth visit when she had a cold last year. "She's sitting on the couch, relaxing," says Hickey, a barista and founder of a coffee e-commerce platform who lives in Aston, Pennsylvania. "I get her when the doctor comes on, he talks to her, figures out the symptoms, and I talk to the doctor, and it's done. I never have to leave or take her out into the cold."
Telehealth isn't limited to virtual doctor visits. Advances in technology mean there are now apps and gadgets that allow doctors to monitor bodily functions from a patient's computer or phone. This means that a person who is immunocompromised, for example, might be able to stay out of the doctor's office, and someone who doesn't have the time to come in for regular appointments could check in at regular intervals from their living room.
"You can monitor people's blood sugar remotely, and people have home blood pressure cuffs," Spencer Kroll, MD, PhD, an internal medicine specialist in Morganville, New Jersey, tells Health. "There are devices that can attach to your smartphone to assess your heart function and heart rhythm."
Soon, it may not even be medically necessary for a provider to be present for some routine physical examinations. Telemedicine company Eko makes technology that allows doctors to monitor heart sounds, lung sounds, and ECG readings from afar. With this kind of tech, you can imagine a future where an off-site doctor listens to a nursing home resident's lungs, for example, while an on-site nurse holds a telehealth-friendly stethoscope to their chest.
Prior to COVID, insurers were reluctant to cover video or telephone mental health services. Seeing a therapist meant traveling to and from an office, assuming there was a mental health professional within a reasonable distance from your home.
Now it's possible to see a therapist via video call, and that's changed the game. With the elimination of travel and the availability of good providers no matter where you're located, anyone can seek help and do it regularly and efficiently. It also makes the experience extremely private, for those who feel there's a stigma around needing mental health help.
The availability of telehealth therapy—along with the stress of the pandemic and fallout from the 2020 election—has led to a crush of demand. Ginger, a company that offers text-based teletherapy, reported in September that usage of their text-based mental health coaching was up 159%, and virtual therapy and psychiatric services surged 302% compared to pre-pandemic numbers.
"I think that's one of the areas that will never go back to having in-person care be the default way of getting care," Lisa Ide, MD, chief medical officer for Zipnosis, a health care technology company, tells Health. "I do not see patients being willing to come in person when they've had the convenience of getting that kind of care from home."
This is a biggie, because insurers have historically been reluctant to cover telehealth appointments. But during the pandemic, they broadened coverage and widely reimbursed for telemedicine visits. In August, the nonprofit group FAIR Health—which helps people understand insurance and health care costs—reported a 5,680% growth in telemedicine claims to private insurers over the prior year.
"The biggest insurer is Medicare, and they have really signaled their intent to make this part of their payment methodology," Oseid says. "And the insurers are following suit in a lot of cases."
Anthem, for instance, i