Telehealth Dramatically Changed the Face of Healthcare

While the COVID-19 pandemic brought many challenges, one bright spot was the rapid growth and acceptance of telehealth, making healthcare more accessible than ever before.

‌These online, face-to-face appointments are now a given for several types of patient visits, especially for primary care and behavioral health.

‌‌It's one of many habit changes that emerged during and after the pandemic lockdowns, including the growing preference for grocery and meal deliveries, and online shopping over trips to traditional brick-and-mortar stores.

For busy people – including but not limited to students and parents with young children -– it is exponentially easier to use delivery services than in-person visits not only to grocery stores, but to restaurants, for fast food, casual or fine dining. You might walk into what looks like a busy eatery and see that most of the activity is not in the dining area, but near the front door, where delivery drivers line up for their customers’ orders.

‌‌Healthcare is, of course, a vastly different enterprise, but we too have seen a major shift. We know that more and more patients now expect access in a way that works for them, and in this environment, it’s something we aim to provide. We want to meet our patients’ needs and choices in as frictionless and hospitable a manner as possible, just as we do for in-person visits.

‌While it might seem that young people would be driving the trend toward online transactions of all kinds, data shows that at UH and nationally, the use of telehealth is fairly evenly spread across age groups – and actually higher for people over 60, according to Brian D’Anza, MD, and Brian Zack, MD, UH Medical Directors of Telehealth.

‌Nationally, data from a National Institutes of Health survey covering 2022 showed that telehealth visit rates were similar across age, as well as race or ethnicity, income, and urban vs. rural locations.

‌Our UH data from last year tells us that 22% of telehealth patients were 40 and under; 20% were age 41 to 60, and 30% were people over 60.

‌Generally, the preference at all ages is for ease of access, which means avoiding traffic, driving, and parking. The time savings is significant, as is the reduction in stress.

‌More than 260,000 outpatient telehealth visits took place at UH in 2024, of which nearly 20% were for behavioral health. Telehealth was adopted by the UH Behavioral Health Institute within days of COVID-19 precautions being mandated. “This was based on patient and provider needs, and our  mission to continue caring for patients even during a tumultuous time,” says Jeanne Lackamp, MD, DFAPA, FACLP, Chair of the Department of Psychiatry and Director of the Behavioral Health Institute.

‌Over the past five years, many behavioral health patients and providers have continued to rely on telehealth. In 2024, similar to our overall usage stats, the largest group of telehealth users of behavioral health patients at UH were 65 and older.

‌‌“We recognize the benefit of having both modalities [telehealth and face-to-face] available, and we are eagerly awaiting next steps which will inform our telehealth strategy,” says Dr. Lackamp.

‌Beyond ambulatory care, Dr. Lackamp notes that psychiatric clinicians in emergency departments or those doing inpatient consults also use this technology to see patients, which has expanded access to psychiatric evaluations throughout UH.

‌While some providers and patients have returned to in-person visits, Dr. Lackamp says that more than half of all ambulatory behavioral health visits are still conducted via telehealth.

‌Depending on where patients live, their access to transportation can make the difference in whether they access care at all –  elevating the critical role telehealth plays in enabling them to see a clinician. This is especially true with behavioral health patients, but also for patients seeking primary care or specialty care. In fact, secure online video visits that also facilitate privacy are now available through UH MyChart.

‌‌And let’s not forget – especially in a season when highly-contagious respiratory illnesses flourish – it’s much safer for patients and clinicians to utilize telehealth if appropriate.

As common as telehealth visits have become though, reimbursement by insurance companies could be at risk of changing.

During the pandemic, the federal government took swift action to leverage telehealth services to ensure patients could continue to obtain healthcare services when hospitals were overwhelmed with unprecedented demand in caring for COVID-19 patients. This included waiving certain regulatory requirements related to telehealth services for Medicare participants.

‌Those waivers are set to expire at the end of March unless Congress takes action to extend them or make them permanent.

‌In what is often the case, private insurers take their lead from actions implemented by Medicare.

In the interim, we are proactively preparing at UH to facilitate uninterrupted patient care in the event of a change.‌