About six months into the pandemic, my daughter’s orthodontist texted: Time for a check up. Do you want to come in or do it by video? And even though their office is less than a mile from our house, my thumbs immediately tap-tap-tapped: VIDEO!
Avoiding unnecessary Covid exposure was a motivator, sure, but here’s the real reason: I knew the appointment itself would take 3 minutes, but if we went in, it would be a 30-minute ordeal, at minimum. Chalk up another win for telehealth. (Her teeth are progressing nicely, by the way.)
While telemedicine has been around for decades, it was never a physician or patient’s first choice. It was almost always used as a last resort, such as with patients living in deeply rural areas with no decent access to a doc.
But when the pandemic hit, telemedicine became the belle of this terrible ball, giving patients a way to stay on top of their health while in lockdown and helping physician practices stay afloat. Almost overnight, virtual appointments went from “Um, what?” to “Send me that Zoom link pronto!”
In fact, experts say that the U.S. made 10 years of telehealth progress during the first 10 weeks of the pandemic. According to a study by the Journal of the American Medical Association, in-person medical services dropped by 52% in April, 2020, while telemedicine services grew by more than 4000% in that same month.
And these figures are borne out on the ground: Kaiser Permanente reports that at the height of the pandemic last year, their system delivered 90% of its appointments via telehealth, compared with just 26% in all of 2019 and all without a drop in access to care.
The Zoomification of Mental Health
After more than a year of having our normal lives upended by the pandemic, telemedicine has become very much the norm. And nowhere is that more evident than in the mental health realm. Tune into pretty much any podcast on the planet, and you’ll be inundated with ads for all kinds of online therapy—by text, by Zoom, by way of an AI robot. Ginger, one of the newer entrants into the world of technology-enabled therapy, reports that usage of their text-based mental health coaching was up 159%, and virtual therapy through their app surged 302% compared to pre-pandemic numbers.
If you were already in therapy, you’ve likely made the shift from sitting on the therapist’s couch next to a box of tissues to sitting on your own couch next to a glass of wine. And if you weren’t in therapy before the pandemic, the stress of it all—job insecurity, isolation, flat-out boredom—might have guided you there. The “normalization” of teletherapy has made it dramatically easier to seek care because it’s so much more convenient. You can do that oh-so-valuable 50 minutes on your lunch break or during that precious window of pause between work and dinner.
Primary Care is Ready for its Close Up
The bread-and-butter aspect of primary care medicine makes it a particularly ripe area for embracing telehealth. Like with therapy, a lot of primary care is about asking the right questions and talking about what’s going on in a patient’s life, all of which work just fine in the virtual world. And the more physical aspects of a standard primary care visit—measuring weight and taking blood pressure—can be done at home by a patient with inexpensive tools. If there is something that needs to be examined physically, the cameras on smartphones and laptops are surprisingly good guides for a virtual diagnosis.
Beyond the Covid-safe benefits of telehealth, it’s also darn convenient. Studies show that you’re twice as likely to get a same-day telehealth appointment versus an in-person visit, and physicians are now offering more opportunities to get care after regular 9-to-5 workdays.
This overall shift from office to screen has been powered, in large part—and sometimes reluctantly—by insurers. Long skeptical of reimbursing for telehealth appointments, insurance companies were forced to broaden their coverage once the lockdowns started, both to keep their customers in good health and to keep physicians in business. And the giant in the market, Medicare, took measures (which they call “temporary”) to make it easier for the patients to get treated virtually. According to the U.S. Department of Health and Human Services, 44% of Medicare primary care visits were done via telehealth in April, 2020, compared with less than one percent (0.1%) in February, 2020 before the pandemic hit.
Specialty Care: Slower on the Uptake
The one area of medicine that’s been lagging in embracing telehealth is specialty care, which, to be fair, was also squeamish about it before the pandemic; before Covid, fewer than 2% of specialty practices used telemedicine. A study of which specialties were using telehealth more during the pandemic ranked endocrinology, neurology, and gastroenterology highest and optometry and physical therapy lowest.
But experts predict that specialty care will be along for the virtual ride thanks in large part to new care-enablement platforms like Heartbeat Health, a virtual care platform for cardiologists and Babyscripts for OB-GYNs. And the recent merger of digital health Goliaths, Teladoc and Livongo, is an indication that remote care is viable for the chronic disease space.
As we start to see light at the end of this very long pandemic tunnel, the big question is whether telehealth will continue to be a thing. McKinsey’s recent post-pandemic prediction report found that along with online grocery shopping, virtual healthcare visits were more likely to stick (while remote learning and online “live” entertainment won’t).
The pandemic has also accelerated new models of care like the subscription healthcare startup, Forward. For $149 a month, you have unlimited access to Forward’s futuristic, technology-enhanced services, which are delivered virtually or in their minimalist offices.
Mega-insurers in health care all say telehealth is here to stay. Anthem is continuing to invest in their telemedicine service called LiveHealth Online. Aetna and Blue Cross Blue Shield say they expect to continue to cover telemedicine visits after we get back to the “new normal.” And Kaiser Permanente projects that up to 80% of its care in the coming year will be through telehealth.
This is clearly a worldwide train. In Spain, for example, a company called Savia is leading a mass trend towards telemedicine. Dubbed in the Spanish press as the “Spotify of Salud” or the “Spotify of health,” Savia is a subscription-based digital platform dedicated to health and wellness. With an initial investment from MAPFRE, a $26 billion health insurance company, the year-old startup is being led by the ex-Googler Pedro Diaz Yuste.
Others in the industry say it’s unlikely we’ll go back to the before times for one very important reason: dollar bills. Experts predict that telehealth could save U.S. companies more than $6 billion a year in health care expenses. And while I don’t expect my daughter’s orthodontist to magically straighten her teeth via Zoom, I’m happy to know that from now on, I won’t have to cancel a meeting or bail on my morning run to take her in for those 3-minute check ups. Thank you, pandemic?