The pre-Covid-19 reality
Telehealth seemed to be near a tipping point for widespread adoption at the beginning of 2020—just as it seemed to be near this same tipping point at the beginning of 2019. And 2018. And each of the previous five years.
The reality of telehealth before Covid-19 was unfulfilled promise at the national level. Two out of three consumers said they were interested in telehealth services, but fewer than one in ten had ever used them. Only about one in five physicians had ever done a virtual visit. A hospital telehealth program with annual visits in the hundreds—that is, one or two telehealth visits per day—could reasonably have been described as “robust,” relative to the average hospital.
All stakeholders encountered significant obstacles to telehealth. Consumers were unaware of the availability of telehealth services from their providers. Clinicians worried that they wouldn’t be reimbursed adequately for telehealth and that telehealth might not be an appropriate way to deliver care. Payers and purchasers were afraid that telehealth would turn out to be an ineffective alternative to in-person care that would ultimately increase overall utilization and total cost of care.