Telehealth usage soared during the pandemic, and industry commenters believed it had become the "new normal." The virtual nature of telehealth indisputably minimized the spread of the coronavirus by preventing direct physical contact. Clinicians could continue providing care to their patients, and the medium helped reduce morbidity and mortality in COVID-19 outbreaks. As the world recovers, however, telehealth’s popularity is waning in all spheres except mental health, where it continues to rise. 

Here’s why telehealth usage is decreasing in other specialties and our projections on the channel’s future as an instrument of healthcare delivery. 

The Decline in Telehealth Usage

Even though telehealth usage surged at the start of the pandemic, its decline in popularity didn’t happen as rapidly. Becker’s Hospital Review reports that telehealth usage rose from less than 1% of outpatient visits before the pandemic to 13% in the first six months. That’s the highest point it reached, however, because usage declined to 11% during the next 6-month period. One year into the pandemic, usage had already dropped to 8%. 

Researchers believe the decrease in usage is mainly due to the ongoing reduction in COVID-19 prevalence and severity. In fact, the decline is more evident in specific modalities than in others. Despite the fall-off, its use has not yet receded to pre-pandemic levels. 

Tracking Telehealth Trends

As telehealth grew in popularity during the pandemic, researchers began tracking usage trends. One in five American adults (that’s nine million people) has unmet mental health needs, and access to care is especially difficult in rural areas. A study found patients with mental health conditions and substance abuse disorders utilized telehealth more than ever before, rising from 1% before the pandemic to 41% in 2021. Usage among this group remains at 36% in 2022, which is much higher than the 5% of patients using telehealth in other specialties. 

Why Mental Health Matters

Mental health is a growing global concern, with 40 million people experiencing the impact at some point in their lives. The vast shortage of mental health professionals leaves millions fending for themselves, which can have long-term adverse effects on both individuals and their communities. The ongoing opioid epidemic exacerbates the problem, and together these issues cause the loss of an estimated one trillion dollars each year in economic activity worldwide. 

Telehealth has shown tremendous promise in improving access to treatment for mental health and substance abuse patients, for several reasons: 

• Mental health treatment typically doesn’t require a physical examination, so it can be done remotely. 
• The use of technology mitigates the shortage of mental health professionals and allows practitioners to treat patients irrespective of either party’s location. This is particularly helpful for patients living in rural areas who face insurmountable challenges in accessing care. 
• The virtual consultation model helps preserve confidentiality for patients who fear being seen or recognized when going to mental health appointments. The stress created by these concerns can aggravate the patient’s condition.  
• Telehealth minimizes the challenges and costs of transportation to a treatment center and allows patients to access care from the comfort of their homes. 
• Many patients with mental health conditions and substance abuse disorders hold minimum-wage occupations. Telehealth negates the need to take time off work to visit a practitioner, which can be difficult and embarrassing for the individual. 

These benefits help encourage mental health patients to seek treatment and enable practitioners to offer care and resources to people and communities who would otherwise not have access to them.

Future Projection: A Hybrid Model?

So, where can we expect telehealth to land in the post-pandemic healthcare environment? Clearly, it offers tremendous promise for mental health patients, so it’s unlikely to run out of steam. According to Ann Mond Johnson, CEO of the American Telemedicine Association, the future could potentially deliver a hybrid model that includes in-person care. She believes people should be able to access medical care where—and when—they need it, with complete confidence that it’s safe, effective, and affordable. 

Such a model accepts that there will always be instances where patients need face-to-face or in-person care. Telehealth is no substitute for a physical examination, but it will become one of many modalities of care that clinicians can choose between when working with their patients. Challenges include digital literacy, patient access to appropriate devices and software, and the ever-present cybersecurity threat, but many of these were already addressed during the pandemic. 

Achieving a viable hybrid model will require federal regulators and Congress to expand coverage for the medium and support the broader use of virtual care in the long term. However, unless financial incentives are available, providers may be less inclined to use telehealth. Since some of the big health insurers are already pulling back on telehealth coverage for non-COVID-19 issues, this could become the new battleground for advocates.