It has been more than a century since the first telehealth session took place; Alexander Graham Bell made his iconic telephone call to his assistant, Thomas Watson, reporting that he had spilled battery acid on himself and needed medical attention. Forty-nine years later, in 1925, a German immigrant named Hugo Gernsback foretold of a device that used his own radio communications inventions, which he called a “teledactyl,” that “would allow doctors to not only see their patients through a viewscreen, but also touch them from miles away with spindly robot arms.”

But it wasn’t until 2020 that telehealth achieved broad adoption thanks to the COVID-19 pandemic. Before the pandemic, approximately 10% of outpatient encounters took place using telehealth. That surged to between 80% and 90% during the height of the pandemic. However, telehealth wasn’t just used for outpatient encounters; hospitals and other in-patient facilities used the technology when possible to remotely monitor and communicate with patients as a way to keep staff safe from infection.

Current State of Telehealth

In 2023, the Centers for Disease Control (CDC) conducted a survey using electronic health records to identify current telehealth usage. The survey found that more than one in four medical specialists still used telehealth for at least half of their patient visits. The majority of primary care physicians used telehealth for less than one-fourth of patient visits, while just 14.7% used telehealth for at least half of their visits.

While the use of telehealth has waned significantly, its use has become more targeted. Rural healthcare is a prime example. According to the CDC, 46 million Americans live in rural communities, which is 15% of the population. Individuals living in rural areas are “more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke than their urban counterparts.”

Besides being “older and sicker” than those living in more urban areas, rural residents have less access to medical care. The National Rural Health Association reports that there are just 39.8 physicians for every 100,000 people in rural areas compared to 53.3% in urban areas. Becker’s Hospital Review reports that more than 100 rural hospitals have closed since 2005, thirty-seven of those since 2020. Another 600 rural hospitals are at risk of closing in the near future. Close to 90 more have now stopped providing inpatient services altogether.

Telehealth is also beneficial for removing barriers, improving health equity, and expanding access to individuals living in healthcare deserts or underserved communities. In addition to lacking easy access to providers, these communities often also lack healthy food options, recreational facilities, and other resources that promote health.

In addition to leveraging telehealth for specific populations, it is being used more frequently for certain services. While most medical services had returned to in-person care by 2023, mental health services have continued to use telehealth for the majority of patient visits. A survey of 1,221 mental health service providers found that 80% still offered telehealth services. Ninety-seven percent said they used it for counseling, 77% for medication management, and 69% for diagnostic services.

The use of telehealth for mental health care is vital in addressing the stress and mental health challenges brought about by the pandemic. It is also valuable in addressing the long wait times patients can face when scheduling an appointment. In addition, it can reduce stigma around mental health by giving patients the option to see a provider in the privacy of their own homes.

Remote patient monitoring for chronic conditions is another area where the use of telehealth continues to be strong. With the broad adoption of remote digital devices like smartphones and smartwatches, and the advent of wearable and remote monitoring devices, remote monitoring has become a more viable option. Telehealth can be especially helpful in monitoring patients after discharge from a hospital or emergency department, helping to reduce complications and prevent readmissions.

Policy Changes

Federal lawmakers have recognized the benefits of using telehealth for rural populations, mental health, and other services. The Consolidated Appropriations Act of 2023 extends the use of telehealth for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) through the end of 2024. The same is true for behavioral and mental health services. The Consolidated Appropriates Act of 2024 includes additional policy changes, most notably for the 2024 Physicians Fee Schedule.

With an election year approaching, it remains uncertain whether current telehealth policies will be further extended or if new policies will be implemented. However, one thing is certain: If telehealth is to remain, it must be financially viable for the providers who use it.

The Future of Telehealth

The expected growth of the U.S. telehealth market is expected to reach $140.7 billion in value by 2030. Patients continue to embrace telehealth. They appreciate the convenience of not having to travel to the physician’s office, not having to take as much time off of work, not having long waits in the waiting room, and not having to find child care.

For providers, telehealth allows them to see more patients and expand their service area. It also enables more collaborative healthcare, as specialists and other healthcare providers can easily be included in telehealth appointments and consultations. In addition, offering telehealth can give providers a competitive advantage over those who don’t. However, as mentioned above, the continued use of telehealth must be financially beneficial for providers.